2019 年第 7 期 第 14 卷

3D打印技术在行全膝关节置换术患者中的应用分析

Application of 3D printing technique in total knee arthroplasty

作者：辛锋赵凤朝

英文作者：

单位：221000徐州医科大学2014级骨科研究生(辛锋，现工作于江苏省徐州市肿瘤医院骨科)；221000徐州医科大学附属医院骨科（赵凤朝）

英文单位：

关键词：全膝关节置换术；3D打印技术；手术时间；术中出血量；膝关节活动度；膝关节美国特种外科医院评分;下肢力线

英文关键词：

• 摘要：

• 【摘要】目的    探讨3D打印技术在行全膝关节置换（TKA）术患者中的应用效果。方法    选择2015年10月至2018年10月徐州市肿瘤医院及徐州医科大学附属医院收治的行TKA术患者82例，按照随机数字表法分为对照组和观察组，各41例。对照组行常规TKA术治疗，观察组行3D打印技术辅助TKA术治疗。比较2组手术时间、术中出血量、手术前后膝关节活动度、膝关节美国特种外科医院（HSS）评分和下肢力线变化情况。结果    观察组手术时间短于对照组、术中出血量少于对照组［（101±15）min比（131±20）min、（355±92）ml比（503±138）ml］，差异均有统计学意义（均P＜0.001）。手术前2组膝关节活动度、膝关节HSS评分、下肢力线比较，差异均无统计学意义（均P＞0.05）。术后2周，2组膝关节活动度、膝关节HSS评分均高于手术前，下肢力线角度均小于手术前［对照组：（104±13）°比（83±20）°，（89±5）分比（39±6）分，（3.0±0.9）°比（7.3±2.4）°；观察组：（104±15）°比（83±19）°，（89±5）分比（41±5）分，（3.0±1.0）°比（7.2±2.5）°］，差异均有统计学意义（均P＜0.001）。观察组术后2周膝关节活动度、膝关节HSS评分、下肢力线角度与对照组比较差异均无统计学意义（均P＞0.05）。结论    3D打印技术辅助TKA术治疗效果与常规TKA术相当，均能有效改善膝关节活动度、膝关节功能和下肢力线，同时，3D打印技术辅助可缩短手术时间，减少术中出血量。

• 【Abstract】Objective    To explore the application effect of 3D printing technique on patients undergoing total knee arthroplasty(TKA). Methods    A total of 82 patients undergoing TKA in Xuzhou Cancer Hospital  and the Affiliated Hospital of Xuzhou Medical University from October 2015 to October 2018 were enrolled. They were randomly divided into control group and observation group, with 41 cases in each group. The control group underwent routine TKA; the observation group underwent TKA assisted by 3D printing technique. Operation time, intraoperative blood loss, knee joint mobility, Hospital for Special Surgery(HSS) score and changes of lower limb force line were analyzed. Results    Operation time and intraoperative blood loss in observation group were significantly shorter/less than those in control group［（101±15）min vs （131±20）min, （355±92）ml vs （503±138）ml］（both P＜0.001）. There were no significant differences of knee joint mobility, HSS score and lower limb force line angle between groups before operation(all P＞0.05). Two weeks after operation, knee joint range of motion and HSS score were higher and lower limb force line angle was smaller than those before operation in both groups［control group： （104±13）° vs （83±20）°， （89±5） vs （39±6）， （3.0±0.9）° vs （7.3±2.4）°； observation group： （104±15）° vs （83±19）°， （89±5） vs （41±5）， （3.0±1.0）° vs （7.2±2.5）°］（all P＜0.001）. There were no significant differences of the indicators between groups after operation(all P＞0.05). Conclusion    TKA assisted by 3D printing technique is equivalent to conventional TKA; both operating methods can effectively improve knee joint mobility, function and lower limb force line; 3D printing technique assistance can help shorten operation time and reduce intraoperative blood loss.