应用3D打印技术联合组配式S-ROM假体人工髋关节置换术治疗成人CroweⅣ DDH

杨佳; 杨毅; 赵云宏; 张正学; 杨清; 杨柳; 溪应龙; 段于平; 李彪

应用3D打印技术联合组配式S-ROM假体人工髋关节置换术治疗成人CroweⅣ DDH

昆明医科大学第一附属医院骨科

基金项目:

基金：国家自然科学基金资助项目 (8176010097); 云南省医疗卫生单位内设研究机构科研基金资助项目 (2016NS 023);

计量
- 文章访问数: 2023
- HTML全文浏览量: 668
- PDF下载量: 113
- 被引次数: 0
出版历程
- 收稿日期: 2018-02-22

Application of 3D Printing Combined with S-ROM Total Hip Arthroplasty in the Treatment of Adult Crowe Ⅳ DDH

Funds:

基金：国家自然科学基金资助项目 (8176010097); 云南省医疗卫生单位内设研究机构科研基金资助项目 (2016NS 023);

摘要

摘要: 目的探讨3D打印技术联合组配式S-ROM假体人工髋关节置换术在治疗成人CroweⅣ DDH的应用.方法 2014年9月至2017年9月, 随机选取10例成人CroweⅣ DDH患者, 分为3D组 (5例) 和常规组 (5例) .男性4例, 女性6例, 年龄2763岁, 平均43.6岁.2组病例术前均进行Harris评分, 3D组根据患者三维CT数据, 制作髋关节3D打印模型.并依据模型测量选择假体大小、确定手术方案并进行模拟手术.随后采用组配式S-ROM假体进行人工关节置换术, 记录术中髋关节实际情况、假体型号、手术时间及出血量等.术后1周再次行Harris评分, 随访早期疗效和并发症发生率.结果 3D组术中髋关节实际情况与术前3D打印模型一致, 术中出血量、手术时间、术后Harris评分提高情况均优于常规组, 术后髋关节功能改善明显, 活动良好.结论应用3D打印技术联合组配式S-ROM假体人工髋关节置换术治疗成人CroweⅣ DDH, 可以进一步提高手术精确度和成功率, 减少手术时间、出血量及并发症发生率等.
- DDH /
- 3D打印 /
- 组配式S-ROM假体 /
- 人工全髋关节置换术
Abstract: Objective To investigate the application of 3 D printing combined with S-ROM total hip arthroplasty in the treatment of adult Crowe IV DDH. Me thods Between September 2014 and June 2017, 10 patients of adult Crowe IV DDH were selected and divided into 3 D group (5 cases) and non-3 D group (5 cases) . There were 4 males and 6 females with an average age of 43.6 years (range, 27-63 years) . Harris scores were recorded in both groups before the operation, and in the group 3 D, patients underwent spiral CT scanning to make the hip 3 D models. According to the hip 3 D models, the sizes of prosthesis and operation schemeswere estimated before the operation, and the surgery simulation was performed. Then the S-ROM prosthesis was used for total hip arthroplasty. The actual situation of hip joint, the size of prosthesis, time of operation and blood loss were recorded.Harris Score at 1 week post-operationwere recorded again. All patients were followed up related postoperative complications for at least 2 weeks.Re s ults The 3 D printing models coordinated with the actual sizes of the hips in the3 D group.The time of operation and blood loss were less than the non-3 D group. Higher Harrisscore was observed at 1 week post-operation in the 3 D group, compared to non-3 D printing group.The follow-up showed that the motion of the hips was improved obviously. Conclus ion The Application of 3 D Printing combined with S-ROM total hip arthroplasty in the treatment of adult crowe IV DDH can improve efficiency and accuracy of the operation, shorten time of operation, reduce operative blood loss and rate of complications.
- Developmental dysplasia of the hip /
- Three dimensional printing /
- S-ROMprosthesis /
- Total hip arthroplasty

HTML全文

参考文献(31)

[1]	[1]RUBINI M, CAVALLARO A, CALZOLARI E, et al.Exclusion of COL2A1 and VDR as developmental dysplasia of the hip genes[J].Clinical Orthopaedics&Related Research, 2008, 466 (4) :878-883.
[2]朱建辛, 王跃, 庞健, 等.人工全髋关节置换术治疗重度成人髋关节发育不良疗效分析[J].中国修复重建外科杂志, 2014, 28 (3) :335-338.
[3]	[3]DAPUZZO M R, SIERRA R J.Acetabular considerations during total hip arthroplasty for hip dysplasia[J].Orthopedic Clinics of North America, 2012, 43 (3) :369-375.
[4]王忠宏, 李扬帆, 张曼茵.中国3D打印产业的现状及发展思路[J].经济纵横, 2013, 23 (1) :90-93.
[5]贺超良, 汤朝晖, 田华雨, 等.3D打印技术制备生物医用高分子材料的研究进展[J].高分子学报, 2013, 52 (6) :722-732.
[6]	[6] HARTOFILAKIDIS G, KARACHALIOS T.Total hip arthroplasty for congenital hip disease[J].Journal of Bone&Joint Surgery American Volume, 2004, 86-A (2) :242-250.
[7]	[7] NOBLE P C, KAMARIC E, SUGANO N, et al.Three-dimensional shape of the dysplastic femur:implications for THR.[J].Clinical Orthopaedics&Related Research, 2003, 417 (417) :27-40.
[8]	[8]NAKAMURA Y, MITSUI H, KIKUCHI A, et al.Total hip arthroplasty using a cylindrical cementless stem in patients with a small physique[J].Journal of Arthroplasty, 2011, 26 (1) :77-81.
[9]	[9] CHRISTIE M, BRINSON M F.Proximal/distal mismatch:type A and C femurs[J].Orthopedics, 2005, 28 (9 Suppl) :s1033.
[10]	[10] HARTOFILAKIDIS G, STAMOS K, KARACHALIOS T, et al.Congenital hip disease in adults.Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty.[J].Journal of Bone&Joint Surgery American Volume, 1996, 78 (5) :683-692.
[11]	[11] FURNES O, LIE S A, ESPEHAUG B, et al.Hip, disease, and the prognosis, of total, hip, replacements.A review, of 53, 698, primary, total, hip, replacements, reported, to the Norwegian, Arthroplasty, Register, 1987-99.[J].Journal of Bone&Joint Surgery British Volume, 2001, 83 (4) :579-586.
[12]曾晖, 刘国平, Michael Nogler, 等.手术导航系统提高全髋关节置换术中髋臼假体植入精确度的研究[J].中华创伤杂志, 2004, 20 (7) :418-420.
[13]	[13] ZHANG Y Z, CHEN B, LU S, et al.Preliminary application of computer assisted patient specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip[J].International Journal of Medical Robotics&Computer Assisted Surgery, 2011, 7 (4) :469-474.
[14]王晖, 王磊, 于媛, 等.数字解剖学在骶髂关节损伤手术治疗中的应用[J].中国骨与关节损伤杂志, 2014, 29 (6) :524-527.
[15]程晓光, 顾翔, 张毅军.肌骨影像学发展方向[J].中国骨与关节杂志, 2014, 13 (11) :806-808.
[16]陆声, 徐永清, 张元智, 等.计算机辅助导航模板在下颈椎椎弓根定位中的临床应用[J].中华骨科杂志, 2008, 28 (12) :1002-1007.
[17]	[17] CHARLES M, BOURNE R.Soft-tissue balancing of the hip[J].Journal of Bone&Joint Surgery American Volume, 2004, 54 (5) :1078-1088.
[18]王皓宇, 黄明, 高明杰, 等.后外侧入路高脱位髋关节假体重建软组织处理[J].中华解剖与临床杂志, 2011, 16 (5) :412-414.
[19]	[19]KIM M, KADOWAKI T.High Long-term survival of bulk femoral head autograft for acetabular reconstruction in cementless THA for developmental hip dysplasia[J].Clinical Orthopaedics&Related Research, 2010, 468 (6) :1611-1620.
[20]官建中, 刘亚军, 吴敏, 等.3D打印技术在成人DDH人工全髋关节置换术中的临床应用研究[J].中华全科医学, 2016, 14 (7) :1080-1082.
[21]	[21] FARRELL C M, SPRINGER B D, HAIDUKEWYCH G J, et al.Motor nerve palsy following primary total hip arthroplasty[J].Journal of Bone&Joint Surgery-american Volume, 2005, 87 (12) :2619-2625.
[22]张小兆, 陈继营.全髋关节置换治疗成人发育性髋关节发育不良[J].实用骨科杂志, 2017, 23 (8) :720-723.
[23]	[23]BAO N, MENG J, ZHOU L, et al.Lesser trochanteric osteotomy in total hip arthroplasty for treating CROWE type IV developmental dysplasia of hip[J].International Orthopaedics, 2013, 37 (3) :385-390.
[24]	[24]NEUMANN D, THALER C, DORN U.Femoral shortening and cementless arthroplasty in crowe type 4 congenital dislocation of the hip[J].International Orthopaedics, 2012, 36 (3) :499-503.
[25]	[25] KRYCH A J, HOWARD J L, TROUSDALE R T, et al.Total hip arthroplasty with shortening subtrochanteric osteotomy in crowe type-IV developmental dysplasia[J].Journal of Bone&Joint Surgery American Volume, 2009, 91 (9) :2213.
[26]	[26]HASEGAWA Y, IWASE T, KANOH T, et al.Total hip arthroplasty for crowe typeⅣdevelopmental dysplasia[J].Journal of Arthroplasty, 2012, 27 (9) :1629-1635.
[27]	[27]YAN F, CHEN G, YANG L, et al.A reduction technique of arthroplasty without subtrochanteric femoral shortening osteotomy for the treatment of developmental high dislocation of hip:a case series of 28 hips[J].Journal of Arthroplasty, 2013, 29 (12) :2289-93.
[28]吴显培, 唐建东, 秦汉兴, 等.应用S-ROM全髋关节置换术治疗CroweⅣ型髋臼发育不良[J].中华关节外科杂志:电子版, 2010, 4 (3) :27-30.
[29]	[29]BRUCE W J, RIZKALLAH S M, KWON Y M, et al.A new technique of subtrochanteric shortening in total hip arthroplasty:surgical technique and results of 9 cases.[J].Journal of Arthroplasty, 2000, 15 (5) :617-626.
[30]	[30] SUGANO N, NOBLE P C, KAMARIC E, et al.Tullos.The morphology of the femur in developmental dysplasia of the hip.[J].J Bone Joint Surg Br, 1998, 80 (4) :711-719.
[31]魏瑄, 宋树春, 邹士平.全髋关节置换治疗成人髋关节发育不良临床研究.[J].医药论坛杂志, 2008, 29 (22) :51-52.

相关文章(20)

[1]	黄玲, 胡琪川, 段金秀, 朱炳辉, 崔培培, 余友敏. 基于时机理论的照顾者健康教育在老年人工髋关节置换术后护理中的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240226
[2]	江陈榕, 周旋然, 蒲龙, 袁勇. 不同入路半髋关节置换术治疗老年股骨粗隆间骨折的疗效分析, 昆明医科大学学报.
[3]	胡清, 李川, 史冲, 阮默, 杨靖泽. 膝关节骨性关节炎全膝关节置换术中新型改良3D PSI的应用效果观察, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240313
[4]	曾超胜, 刘姝, 李鹏翔, 陈敏, 陈琳. 3D动画与传统教学在神经解剖中的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220102
[5]	杨政鸿, 宁明杰, 何大千, 杨猛哲, 黄永平, 黄云超. 不同3D打印精度制作的生物材料表面形貌对表皮葡萄球菌生物膜形成影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220228
[6]	李正刚, 寸新华, 唐兴, 王国梁, 杨毅, 陈佳晖, 李彪. 组配式与一体式股骨假体联合转子下短缩截骨治疗Crowe IV型DDH的疗效比较, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210115
[7]	杜棣, 马慧芳, 乔静静, 白艳, 徐晓燕, 杜晶晶, 赵南南. 加速康复外科理念在高龄髋关节置换术患者围手术期护理中的应用, 昆明医科大学学报.
[8]	阿各, 刘晓艳, 刘莉, 詹瑜佳, 唐婷婷, 陶静楠. 全髋关节置换术后患者家庭韧性现状及其影响因素的调查, 昆明医科大学学报.
[9]	王震, 曹慧, 杨彩彩, 刘冲. 骨科康复一体化模式对全膝关节置换术后功能恢复的临床研究, 昆明医科大学学报.
[10]	袁春敏, 周贵, 马福军, 张建萍. 网络延续护理平台在医联体髋关节置换术后康复中的应用, 昆明医科大学学报.
[11]	倪慧霞, 赵卫, 胡继红, 王滔. 基于CTA数据源3D打印技术在神经介入教学中的应用, 昆明医科大学学报.
[12]	周萍, 施春香, 黄正. 基于快速康复外科理念的护理干预对人工跖趾关节置换术患者术后恢复的影响, 昆明医科大学学报.
[13]	彭中鸿, 刘劲松, 李溪, 李根涛, 庞佳宁. 氨甲环酸联合肾上腺素对全膝关节置换术失血量及膝关节功能恢复的影响, 昆明医科大学学报.
[14]	梁大伟. 不同假体的人工髋关节置换术治疗老年骨质疏松性股骨颈骨折, 昆明医科大学学报.
[15]	杨玲. 腰硬联合麻醉与气管插管全麻应用于人工全膝关节置换术的临床观察, 昆明医科大学学报.
[16]	杨云丽. 高龄髋关节置换术后谵妄患者血清S-100β蛋白和NSE浓度的变化及临床意义, 昆明医科大学学报.
[17]	高东梅. 早期康复治疗在全膝关节置换术后功能改善中的应用, 昆明医科大学学报.
[18]	魏卫. 老年髋关节置换术后康复训练对关节功能恢复的观察, 昆明医科大学学报.
[19]	任少海. 人工关节置换术后感染早期的监测, 昆明医科大学学报.
[20]	刘军. 全髋关节置换术后深静脉血栓形成的危险因素分析, 昆明医科大学学报.