3D 打印个体化截骨导板在全膝关节 表面置换术中的临床应用及评价

Clinical Application and Evaluation of 3D Printed Individualized Osteotomy Guide Plate in Total Knee Arthroplasty

摘要:

〔摘 要〕 目的：探讨 3D 打印个体化截骨导板在全膝关节表面置换术（TKA）中的临床应用及效果。方法：选取 2020 年 3 月至 2020 年 12 月佛山市第一人民医院收治的 30 例膝关节骨性关节炎并需行单侧 TKA 的 30 例患者，根 据治疗方法的不同分为对照组和观察组，各 15 例。其中，对照组应用传统 TKA 治疗，观察组应用基于 3D 打印技术 的个体化截骨导板辅助下的 TKA 治疗。30 例患者均顺利完成手术，并随访至少 2 个月，比较两组患者的并发症发生 率、手术时间、术中出血量、术后引流量；术前、术后 1 周、2 个月的美国特种外科医院（HSS）膝关节评分标准评 价患测膝关节功能。结果：观察组患者的手术时间、术中出血量、术后引流量明显低于对照组，差异具有统计学意义 （P ＜ 0.001）。术后 1 周、2 个月后，观察组患者的 HSS 评分明显高于对照组，差异具有统计学意义（P ＜ 0.001）。 两组患者均未发生骨折、膝内外翻畸形、关节脱位、假体松动、关节感染等并发症。结论：与传统 TKA 治疗比较， 3D 打印个体化截骨导板辅助 TKA 手术操作更加简便，进而有效缩短手术时间，减小手术损害，减少出血，有利于患 者膝关节功能康复。

Abstract:

〔Abstract〕 Objective The clinical application and evaluation of 3D printed individualized osteotomy guide plate in total knee arthroplasty (TKA). Methods 30 patients with knee osteoarthritis requiring unilateral TKA were selected from the First People's Hospital of Foshan from March 2020 to December 2020 were divided into control group and observation group, with 15 cases in each group. Among them, the control group was treated with traditional TKA, and the observation group was treated with TKA assisted by individualized osteotomy guide plate based on 3D printing technology. All 30 patients successfully completed the operation and were followed up for at least two months. The incidence of complications, operation time, intraoperative bleeding and postoperative drainage were compared between the two groups. The knee function was evaluated by the knee score standard of American hospital for special surgery (HSS) knee score before operation, one week and two months after operation. Results The operation time, intraoperative bleeding and postoperative drainage volume of the observation group were significantly lower than those of the control group (P < 0.001). One week and two months after operation, the HSS score of the observation group was significantly higher than that of the control group (P < 0.001). There were no complications such as fracture, knee varus deformity, joint dislocation, prosthesis loosening, joint infection and so on. Conclusion Compared with traditional TKA treatment, 3D printing individualized bone interception guide plate assisted TKA operation is easier, which can effectively shorten the operation time, reduce the damage of surgery, reduce bleeding, which is conducive to the functional rehabilitation of the knee joint.