摘要
目的:探讨三维可视化(3DV)与计算机辅助设计(CAD)在精准化全膝关节置换术(P-TKA)中的应用。方法:将19例拟行TKA的患者采用电脑随机法分为3DV-CAD组和常规手术组,3DV-CAD组先行基于膝关节高分辨CT与MR数据的CAD设计,再于术中采用3DV适时显示CAD设计结果,并在3DV指导下行TKA手术,常规手术组行常规的TKA。测量下肢解剖轴,确定截骨平面及截骨量、TKA假体型号,并与手术实际使用值对比。记录术中出血量、术后引流量、手术时间、术后并发症发生率,以及术后1d与1、2、4周的疼痛视觉模拟评分(VAS)与美国膝关节协会评分(KSS)。结果:3DV-CAD组术前计划的股骨及胫骨截骨量与实际值无统计学差异。3DV-CAD组手术时间、术后引流量均优于常规手术组。3DV-CAD组术后无膝内外翻畸形、假体松动等并发症发生,术后1 d、1、2、4周的VAS评分、KSS评分3DV-CAD组优于常规手术组(P<0.05)。结论:CAD可准确重建三维解剖形态并进行手术设计,3DV技术可以在术中适时显示CAD的计算结构,3DV-CAD计算的综合应用可提升TKA手术的精度与疗效。
Objective：To investigate the effect of 3DV and CAD technique on total knee arthroplasty （TKA） （OA）. Methods： 19 patients with OA were randomly divided into 2 groups. Patients in 3DV-CAD Group were examined using CT scanning. Anatomical data of Dicom was reconstructed to .STL data through M3D software. Then, the implantation of TKA prosthesis was designed with the prosthesis size and lower extremity force line examined. All the outcome of femoral line of force （LOF）, tibial line of force and osteotomy of femoral condyle and tibial plateau were examined and were showed on the 3DV system during TKA procedure. Time of operation, intra-operative blood lose, post-operative drainage volume and hospital stay time were recorded and compared to the traditional procedure. Results： No significant differences of the osteotomy of femoral condyle and tibial plateau were found between the implants for MOP and actual operation. 3DV-CAD procedure has a shorter time of operation and smaiIer amount of post- operative wound drainage, compared to the traditional procedure. After 4 weeks, no varus/algus deformity and prosthesis loosing were observed in 3DV-CAD assisted TKA. 3DV-CAD TKA has a lower VAS score and a higher KSS score at 1 day and 1 month postoperative, compared to the traditional procedure. Conclusion： 3DV-CAD technique can build up an accuracy design for TKA which may be useful for surgical accuracy improvement, complications rate reduction and rapid rehabilitation.
出处
《中国数字医学》
2017年第9期93-97,共5页
China Digital Medicine
关键词
膝骨关节炎
三维可视化
计算机辅助设计
全膝关节置换
osteoarthritis, three-dimensional visualization, computer aided design, total knee arthroplasty
