摘要
目的探讨组合3D打印导板辅助胫骨高位截骨术在治疗膝内翻畸形骨关节炎中的应用效果。方法回顾性分析2016年5月至2019年3月期间长沙市第三医院骨科利用组合3D打印导板辅助胫骨高位截骨术治疗的12例膝内翻畸形骨关节炎患者资料。男2例,女10例;年龄46~65岁,平均55.1岁。术前应用3D打印技术设计并打印组合手术导板,患者截骨前均行膝关节镜检查,术中使用组合3D打印导板辅助截骨矫形。通过测量并比较术前及术后12个月胫骨后倾角(PTS)、Insall-Salvatti指数、股胫角、下肢负重力线比率(WBL)、内侧胫骨近端角(MPTA)、膝关节美国特种外科医院评分(HSS)及疼痛视觉模拟评分(VAS)评定疗效。结果12例患者术后获15~36个月(平均14.7个月)随访。所有患者术后伤口均一期愈合,无感染、神经损伤、下肢深静脉血栓形成、骨折延迟愈合、不愈合等并发症发生。随访期间无钢板断裂、内固定松动等并发症发生。患者术后12个月的胫股角(181.09°±3.94°)、WBL(19.11%±17.61%)、MPTA(81.20°±1.15°)、HSS[(87.6±7.1)分]、VAS[0(0,1)分]均较术前[171.79°±2.77°、61.71%±2.14%、88.06°±1.44°、(64.6±12.9)分、4(3,5)分]显著改善,差异均有统计学意义(P<0.05)。术后12个月的PTS、Insall-Salvatti指数与术前比较差异均无统计学意义(P>0.05)。末次随访时按HSS膝关节评分标准评定疗效:优10膝,良1膝,可1膝。结论组合3D打印导板在胫骨高位截骨术治疗膝内翻畸形骨关节炎中能够精确纠正下肢力线,具有精确、可靠的近期治疗效果。
Objective To explore the efficacy of a 3D printed personalized composite template in the high tibial osteotomy for genu varum.Methods A retrospective analysis was conducted of the 12 patients with genu varum who had been treated by high tibial osteotomy assisted by a 3D printed composite template at Department of Orthopaedics,The Third Hospital of Changsha between May 2016 and March 2019.They mere 2 men and 10 women,with a mean age of 55.1 years(range,from 46 to 65 years).Before operation,3D printing technology was used to design and print a personalized composite osteotomy template for each patient.All patients underwent knee arthroscopy before osteotomy.The personalized 3D printed composite template was used to assist the high tibial osteotomy.The therapeutic outcomes were evaluated by comparison of posterior tibial slope angle(PTS),patellar height(Insall-Salvatti index),femorotibial angle,weight-bearing line(WBL)and medial proximal tibial angle(MPTA)on X-ray radiographs,American Hospital for Special Surgery(HSS)knee score and visual analogy scale(VAS)between pre-operation and 12 months after operation.Results The 12 patients were followed up for 15 to 36 months after operation,with an average of 14.7 months.All wounds healed at the first stage after operation with no complications like infection,nerve injury,deep vein thrombosis at lower limbs,delayed fracture union or nonunion.Follow-ups revealed no such complications as plate breakage or internal fixation loosening.The values of femorotibial angle(181.09°±3.94°),WBL(19.11%±17.61%),MPTA(81.20°±1.15°),HSS(87.6±7.1)and VAS[0(0,1)]at 12 months after operation were significantly improved compared with those before operation[171.79°±2.77°,61.71%±2.14%,88.06°±1.44°,64.6±12.9 and 4(3,5),respectively](all P<0.05).There was no significant difference in PTS or Insall-Salvatti index between pre-operation and 12 months post-operation(P>0.05).According to the HSS scores at the last follow-up,the efficacy was excellent in 10 knees,good in one and fair in on
作者
邓婷
陈松
余先
蔡立宏
刘堂友
张卓
雷青
Deng Ting;Chen Song;Yu Xian;Cai Lihong;Liu Tangyou;Zhang Zhuo;Lei Qing(Department of Orthopaedics,The Third Hospital of Changsha,Changsha 410015,China;Department of Radiology,The Third Hospital of Changsha,Changsha 410015,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2020年第10期887-892,共6页
Chinese Journal of Orthopaedic Trauma
基金
湖南省科技创新平台与人才计划(2018SK4014)。
关键词
骨关节炎
膝内翻
截骨术
3D打印
组合式截骨导板
Osteoarthritis
Genu varum
Osteotomy
3D printing
Composite osteotomy template
