摘要
背景:3D打印技术、计算机辅助设计技术辅助全膝关节置换均有研究报道,两者联合辅助全膝关节置换治疗膝关节骨关节炎能否取得更好效果尚不得知。目的:探讨3D打印技术联合计算机辅助设计技术在全膝关节置换治疗重度膝关节骨关节炎中的应用价值。方法:前瞻性选择2018年10月至2020年10月承德医学院附属医院收治的93例重度膝关节骨关节炎患者,采用随机数字表法随机分为对照组(n=46)和观察组(n=47),分别行传统的人工全膝关节置换手术、3D打印+计算机辅助设计技术引导下的人工全膝关节置换手术。统计两组患者疼痛程度、应激相关指标、膝关节功能恢复及并发症发生情况。结果与结论:①观察组术后7,14 d的疼痛目测类比评分低于对照组(P<0.05),术后1 d的D-二聚体、纤维蛋白原降解产物水平低于对照组(P<0.05),血红蛋白水平高于对照组(P<0.05);②两组间术后6个月的美国特种外科医院膝关节评分比较差异无显著性意义(P>0.05),观察组术后6个月的膝关节活动范围大于对照组(P<0.05)、下肢力线角度小于对照组(P<0.05);③术后6个月,观察组出现内侧胫骨平台骨质缺失1例(并发症总发生率2%),对照组出现内侧胫骨平台骨质缺失1例、假体松动1例、切口感染2例(并发症总发生率9%),两组间并发症发生率比较差异无显著性意义(P>0.05);④结果表明,与传统全膝关节置换相比,3D打印联合CAD技术引导下的人工全膝关节置换治疗重度膝关节骨关节炎,可缓解疼痛、改善膝关节功能、减轻应激反应。
BACKGROUND:There are research reports on 3D printing technology and computer-aided design technology assisted total knee arthroplasty.It is not known whether their combination assisted total knee arthroplasty for treatment of knee osteoarthritis can achieve better results.OBJECTIVE:To explore the application value of 3D printing technology combined with computer-aided design technology in total knee arthroplasty for severe knee osteoarthritis.METHODS:Totally 93 patients with severe knee osteoarthritis were prospectively selected in Affiliated Hospital of Chengde Medical College from October 2018 to October 2020.They were randomly divided into a control group(n=46)and an observation group(n=47),and underwent traditional artificial total knee arthroplasty and 3D printing technology+computer-aided design technology under the guidance of total knee arthroplasty.Pain degree,stress-related indicators,knee recovery rate,and complications were collected in both groups.RESULTS AND CONCLUSION:(1)The pain visual analogue scale score of the observation group at 7 and 14 days after operation was lower than that of the control group(P<0.05);the levels of D-dimer and fibrinogen degradation products at 1 day after operation were lower in the observation group than those of the control group(P<0.05);the level of hemoglobin was higher in the observation group than that of the control group(P<0.05).(2)There was no significant difference between the two groups in hospital for special surgery knee score 6 months after operation(P>0.05).The range of motion of the knee joint in the observation group was larger than that in the control group(P<0.05);the angle of the lower limb force line was smaller in the observation group than that in the control group(P<0.05).(3)At 6 months after operation,1 case affected medial tibial plateau bone loss(total incidence of complications 2%)in the observation group.There were medial tibial plateau bone loss in 1 case,prosthesis loosening in 1 case,and incision infection in 2 cases(total incidence of co
作者
吴迪
司丽娜
武丽珠
王建华
罗金伟
常乾坤
吕永明
杜元良
Wu Di;Si Lina;Wu Lizhu;Wang Jianhua;Luo Jinwei;Chang Qiankun;Lyu Yongming;Du Yuanliang(Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei Province,China;Chengde Medical College,Chengde 067000,Hebei Province,China;Chengde Central Hospital,Chengde 067000,Hebei Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第13期2051-2057,共7页
Chinese Journal of Tissue Engineering Research
基金
承德市科学技术研究与发展计划项目(202109A03A),项目负责人:吴迪。
