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3D打印个体化截骨导板辅助胫骨高位截骨术治疗内翻型膝骨关节炎精准性的临床疗效 |
张利勇1, 万春飞1, 张军1, 范立洪1, 田涛1, 傅强1, 马勇1,2, 笪巍伟1,3
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1.南京中医药大学扬州附属医院, 扬州 225000;2.南京中医药大学, 南京 210023;3.扬州大学, 扬州 225000
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摘要: |
目的: 观察3D打印个体化截骨导板(patient-specific instrumentation, PSI)辅助胫骨高位截骨术(high tibial osteotomy, HTO)治疗内翻型膝骨关节炎的精准性。方法: 2018年5月至2020年12月采用3D打印PSI辅助内侧开放胫骨高位截骨术治疗15例膝内翻畸形合并骨性关节炎患者,通过术前CT三维重建模拟规划截骨手术时的胫骨近端内侧角(medial proximal tibial angle, MPTA)、下肢负重线比率(weight bearing line, WBL)落点、撑开高度、胫骨后倾角(posterior tibial slope, PTS)、关节线交角(joint line convergence angle, JLCA),并与截骨术后实际测量值进行比较。结果: 术前规划与术后测量的MPTA、WBL落点、撑开高度、PTS及JLCA之间差异均无统计学意义,一致性良好。所有患者伤口均Ⅰ期愈合,无并发症。结论: 3D打印PSI辅助胫骨高位截骨术能够增加下肢力线矫正的精准性,降低PTS、JLCA等变化的风险,提高疗效。 |
关键词: 骨性关节炎 膝内翻 胫骨高位截骨术 3D打印 截骨导板 |
DOI:10.12025/j.issn.1008-6358.2021.20210602 |
分类号:R684.3 |
基金项目:国家自然科学基金(81904229),南京中医药大学"江苏高校护理学优势学科建设工程资助项目"(2019YSHL155),扬州市卫计委"十三五"科教强卫工程(ZDRC25). |
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Accuracy of high tibial osteotomy assisted by 3D printing patient-specific instrumentation guider in the treatment of varus knee osteoarthritis |
ZHANG Li-yong1, WAN Chun-fei1, ZHANG Jun1, FAN Li-hong1, TIAN Tao1, FU Qiang1, MA Yong1,2, DA Wei-wei1,3
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1.Yangzhou Affiliated Hospital of Nanjing University of Chinese Medicine, Yangzhou 225000, Jiangsu, China;2.Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu, China;3.Yangzhou University, Yangzhou 225000, Jiangsu, China
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Abstract: |
Objective: To observe the accuracy of 3D printing patient-specific instrumentation (PSI) guider assisted high tibial osteotomy (HTO) in the treatment of varus knee osteoarthritis.Methods: From May 2018 to December 2019, 15 patients with varus knee osteoarthritis were treated with 3D printing PSI guider assisted medial opening wedge high tibial osteotomy. The preoperative medial proximal tibial angle (MPTA), weight bearing line (WBL) point, distraction height, posterior tibial slope (PTS), and joint line convergence angle (JLCA) were simulated and measured by CT three-dimensional reconstruction, which were compared with the actual measurement value after osteotomy.Results: There was no significant difference between the preoperative and postoperative measurement of MPTA, WBL point, distraction height, PTS and JLCA, which were consistent. All patients' wounds were healed in the first stage without complications.Conclusions: 3D printing PSI guider assisted HTO can enhance accuracy in correcting lower limb alignment, reduce the risk of changes in PTS, JLCA, etc and improve the curative effect. |
Key words: osteoarthritis genu varus high tibial osteotomy 3D printing osteotomy guider |