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[1]孫振國,翁偉,李恒,等.3D打印技術(shù)輔助全膝關(guān)節(jié)置換術(shù)治療骨關(guān)節(jié)炎膝外翻畸形的臨床研究[J].中醫(yī)正骨,2018,30(06):34-39.
　SUN Zhenguo,WENG Wei,LI Heng,et al.A clinical study of total knee arthroplasty assisted by 3D printing technology for treatment of valgus knee secondary to osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(06):34-39.
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3D打印技術(shù)輔助全膝關(guān)節(jié)置換術(shù)治療骨關(guān)節(jié)炎膝外翻畸形的 臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年06期
頁碼:
34-39
欄目:
臨床研究
出版日期:
2018-06-20

文章信息/Info

Title:
A clinical study of total knee arthroplasty assisted by 3D printing technology for treatment of valgus knee secondary to osteoarthritis
作者:
孫振國; 翁偉; 李恒; 楊紅航; 施利華
浙江省湖州市第一人民醫(yī)院,浙江 湖州 313000
Author(s):
SUN Zhenguo; WENG Wei; LI Heng; YANG Honghang; SHI Lihua
The First People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China
關(guān)鍵詞:
骨關(guān)節(jié)炎;  膝外翻;  關(guān)節(jié)成形術(shù); 置換; 膝;  3D打印
Keywords:
osteoarthritis;  genu valgum;  arthroplasty; replacement; knee;  three-dimensional printing
文獻(xiàn)標(biāo)志碼:
A
摘要:
目的:觀察3D打印技術(shù)輔助全膝關(guān)節(jié)置換術(shù)(total knee arthroplasty,TKA)治療骨關(guān)節(jié)炎膝外翻畸形的臨床療效。方法:將32例骨關(guān)節(jié)炎膝外翻畸形患者隨機(jī)分為3D打印技術(shù)輔助TKA組和單純TKA組,每組16例。記錄并比較2組患者手術(shù)時(shí)間、失血量,及術(shù)前和術(shù)后2周的膝關(guān)節(jié)活動(dòng)范圍、股脛角、美國特種外科醫(yī)院(hospital for special surgery,HSS)膝關(guān)節(jié)評(píng)分及簡明健康狀況調(diào)查表(short form 36 health survey questionnaire,SF-36)評(píng)分。結(jié)果:3D打印技術(shù)輔助TKA組患者的手術(shù)時(shí)間短于單純TKA組[(64.69±8.46)min,(72.31±5.44)min,t=3.033,P=0.005],失血量小于單純TKA組[(448.13±48.20)mL,(495.00±49.13)mL,t=2.724,P=0.011]。術(shù)前2組患者膝關(guān)節(jié)活動(dòng)范圍比較,差異無統(tǒng)計(jì)學(xué)意義(71.06°±5.54°,72.63°±5.46°,t=0.803,P=0.428); 術(shù)后2周,2組患者膝關(guān)節(jié)活動(dòng)范圍均大于術(shù)前(116.63°±7.81°,71.06°±5.54°,t=19.024,P=0.000; 112.94°±8.38°,72.63°±5.46°,t=16.121,P=0.000); 2組患者膝關(guān)節(jié)活動(dòng)范圍比較,差異無統(tǒng)計(jì)學(xué)意義(t=1.288,P=0.208)。術(shù)前2組患者股脛角比較,差異無統(tǒng)計(jì)學(xué)意義(17.75°±6.02°,18.94°±6.71°,t=0.527,P=0.602); 術(shù)后2周,2組患者股脛角均小于術(shù)前(4.19°±1.11°,17.75°±6.02°,t=8.867,P=0.000; 5.38°±0.89°,18.94°±6.71°,t=8.018,P=0.000); 3D打印技術(shù)輔助TKA組股脛角小于單純TKA組(t=3.348,P=0.002)。術(shù)前2組患者HSS膝關(guān)節(jié)評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義[(50.75±6.26)分,(51.25±5.73)分,t=0.236,P=0.815]; 術(shù)后2周,2組患者HSS膝關(guān)節(jié)評(píng)分均高于術(shù)前[(81.19±4.72)分,(50.75±6.26)分,t=15.534,P=0.000;(81.69±4.91)分,(51.25±5.73)分,t=16.131,P=0.000]; 2組患者HSS膝關(guān)節(jié)評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.294,P=0.771)。術(shù)前2組患者SF-36評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義[(53.75±5.32)分,(52.88±5.25)分,t=0.468,P=0.643]; 術(shù)后2周,2組患者SF-36評(píng)分均高于術(shù)前[(80.00±3.74)分,(53.75±5.32)分,t=16.138,P=0.000;(78.50±4.40)分,(52.88±5.25)分,t=14.964,P=0.000]; 2組患者SF-36評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(t=1.039,P=0.307)。結(jié)論:采用3D打印技術(shù)輔助TKA治療骨關(guān)節(jié)炎膝外翻畸形,能改善膝關(guān)節(jié)活動(dòng)范圍,恢復(fù)下肢力線,促進(jìn)膝關(guān)節(jié)功能恢復(fù),提高患者生活質(zhì)量; 且3D打印技術(shù)輔助TKA比單純TKA手術(shù)時(shí)間短、失血量少、下肢力線恢復(fù)好,值得臨床推廣應(yīng)用。
Abstract:
Objective:To observe the clinical curative effects of total knee arthroplasty(TKA)assisted by 3D printing technology in treatment of valgus knee secondary to knee osteoarthritis(KOA).Methods:Thirty-two patients with valgus knee secondary to KOA were randomly divided into 3D printing assisted TKA group and traditional TKA group,16 cases in each group.The operative time and intraoperative blood loss were recorded and compared between the 2 groups respectively.Moreover,the range of motion(ROM)of knee,femorotibial angle,hospital for special surgery(HSS)knee score and short form 36 health survey questionnaire(SF-36)score were measured and compared between the 2 groups before the surgery and at 2 weeks after the surgery respectively.Results:The operative time was shorter and the blood loss was less in 3D printing assisted TKA group compared to traditional TKA group(64.69+/-8.46 vs 72.31+/-5.44 min,t=3.033,P=0.005; 448.13+/-48.20 vs 495.00+/-49.13 mL,t=2.724,P=0.011).There was no statistical difference in ROM of knee between the 2 groups before the surgery(71.06+/-5.54 vs 72.63+/-5.46 degrees,t=0.803,P=0.428).The ROM of knee increased in both of the 2 groups at 2 weeks after the surgery compared to pre-surgery(116.63+/-7.81 vs 71.06+/-5.54 degrees,t=19.024,P=0.000; 112.94+/-8.38 vs 72.63+/-5.46 degrees,t=16.121,P=0.000),and there was no statistical difference in ROM of knee between the 2 groups(t=1.288,P=0.208).There was no statistical difference in femorotibial angles between the 2 groups before the surgery(17.75+/-6.02 vs 18.94+/-6.71 degrees,t=0.527,P=0.602).The femorotibial angles decreased in both of the 2 groups at 2 weeks after the surgery compared to pre-surgery(4.19+/-1.11 vs 17.75+/-6.02 degrees,t=8.867,P=0.000; 5.38+/-0.89 vs 18.94+/-6.71 degrees,t=8.018,P=0.000),and the femorotibial angles were smaller in 3D printing assisted TKA group compared to traditional TKA group(t=3.348,P=0.002).There was no statistical difference in HSS knee scores between the 2 groups before the surgery(50.75+/-6.26 vs 51.25+/-5.73 points,t=0.236,P=0.815).The HSS knee scores increased in both of the 2 groups at 2 weeks after the surgery compared to pre-surgery(81.19+/-4.72 vs 50.75+/-6.26 points,t=15.534,P=0.000; 81.69+/-4.91 vs 51.25+/-5.73 points,t=16.131,P=0.000),and there was no statistical difference in HSS knee scores between the 2 groups(t=0.294,P=0.771).There was no statistical difference in SF-36 scores between the 2 groups before the surgery(53.75+/-5.32 vs 52.88+/-5.25 points,t=0.468,P=0.643).The SF-36 scores increased in both of the 2 groups at 2 weeks after the surgery compared to pre-surgery(80.00+/-3.74 vs 53.75+/-5.32 points,t=16.138,P=0.000; 78.50+/-4.40 vs 52.88+/-5.25 points,t=14.964,P=0.000),and there was no statistical difference in SF-36 scores between the 2 groups(t=1.039,P=0.307).Conclusion:The 3D printing technology assisted TKA can improve knee ROM,restore lower limb force-lines,promote knee functional recovery and improve patient's life quality in treatment of valgus knee secondary to KOA.Moreover,the 3D printing technology assisted TKA has the advantages of shorter operative time,less blood loss and better lower limb force-lines compared to traditional TKA,so it is worthy of popularizing in clinic.

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更新日期/Last Update: 2018-10-30