摘要
[目的]探讨个体化截骨导板辅助全膝关节置换术治疗合并股骨关节外畸形的膝关节骨性关节炎的方法、疗效及适应证。[方法]2014~2016年收治4例膝关节骨性关节炎合并股骨关节外畸形患者,男2例,女2例,年龄62~70岁,平均年龄(66.12±3.02)岁。行下肢CT检查,重建下肢力线,应用3D打印技术制作膝关节1:1医用尼龙模型,确定假体型号,制作个体化截骨导板,术后观察临床疗效及并发症情况。[结果]4例患者均获得随访,术后未出现膝关节感染、下肢深静脉血栓形成、近期内假体松动等并发症。HSS评分由术前(27.75±3.30)分提高至末次随访时(87.75±6.34)分,而冠状面内翻成角畸形由术前(15.38±3.97)°改善至(1.45±0.26)°,近期效果良好。[结论]3D打印个体化截骨导板可有效辅助全膝关节置换术治疗合并关节外畸形的膝关节骨性关节炎,精确恢复下肢机械轴线。
[Objective] To explore the efficacy and indications of individualized osteotomy guider assisted total knee arthroplasty（TKA） for knee osteoarthritis accompanied with external deformities. [Methods] From October 2014 to November 2016,4 patients underwent TKA assisted with individualized osteotomy guider for knee osteoarthritis combined with femoral deformities outside the knee, including 2 males and 2 females aged from 62 to 70 years with an average of 66 years. After CT scanning the lower limbs, reconstruction of lower limb alignment was mimicked, subsequently a 1：1 medical nylon guider were made by3 D printing to determine the prosthesis selected and individual bone cutting. The clinical outcomes and complications were observed after operation. [Results] All the 4 patients were followed up. No infection and deep venous thrombosis were noted in anyone of them. The HSS score significantly increased from（27.75±3.30） preoperatively to（87.75±6.34） at the latest follow up,whereas the coronal varus angulation considerably decreased from（15.38±3.97） ° to（1.45±0.26） °, the short-term outcomes were satisfactory. [Conclusion] The individualized osteotomy guide made by 3 D printing does effectively assist TKA for knee osteoarthritis with femoral deformities to restore the mechanical axis of lower limb accurately.
作者
张凤军
李新花
王强
巴昭臣
孔庆国
郝彬
ZHANG Feng-jun;LI Xin-hua;WANG Qiang;BA Zhao-chen;KONG Qing-guo;HAO Bin(Department of Spine and Joint Surgery,People＇s Hospital of Zhanhua District,Bingzhou 256600;Department of Orthopaedics,Beijing Hospital,Beijing 100730,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第15期1423-1426,共4页
Orthopedic Journal of China
