摘要
目的探讨临床应用3D打印解剖型钛合金胫骨假体重建胫骨下段骨髓炎病灶清除术后骨缺损的初步疗效。方法2015年1月至2020年12月解放军总医院第八医学中心收治胫骨下段骨髓炎病灶清除术后骨缺损患者5例,采用3D打印解剖型钛合金假体重建胫骨缺损。记录手术时间、术中出血量。术后随访12个月,采用VAS疼痛评分、膝关节HSS评分、AOFAS踝-后足评分、“起立-行走”时间、6 min步行距离、SF-36评分判定临床疗效。观察伤口愈合、并发症发生情况,监测白细胞计数、C反应蛋白、血沉。结果本组5例患者均按照术前计划重建胫骨下段骨缺损,手术时间(156.75±32.40)min,术中出血量(490.00±84.06)mL。术后随访12个月,VAS疼痛评分、HSS评分、AOFAS踝-后足评分较术前均有明显改善,差异有统计学意义(P<0.05)。术后“起立-行走”时间和6 min步行最长距离较术前均有明显提高,差异有统计学意义(P<0.05)。术后生活质量评分各项指标高于术前(P<0.05)。术后12个月随访白细胞计数、血沉、C反应蛋白均在正常范围内,伤口愈合良好,无窦道形成。结论应用3D打印解剖型钛合金胫骨假体重建骨髓炎术后胫骨下段骨缺损可获得良好的下肢功能,能够减轻术前疼痛,具有并发症少等优势。
Objective To investigate the therapeutic effect of 3 D printed anatomical tibial prosthesis in the repair of bone defects after debridement of tibial osteomyelitis.Methods Five patients with bone defects after debridement of lower tibial osteomyelitis were treated between January 2015 and December 2020 in the Eighth Medical Center of Chinese PLA General Hospital.Their bone defects were repaired via 3 D printed anatomical titanium alloy tibial prosthesis.The duration of surgery and volume of intraoperative bleeding were recorded.The patients were followed up regularly for 12 months.Visual analog scale(VAS)score,Hospital for Special Surgery(HSS)knee score,American Orthopedic Foot and Ankle Score(AOFAS)Ankle Hindfoot Scale and 6-minute walk distance(6 MWD),Timed“Up and Go”(TUG)test and 36-Item Short Form Health Survey were used to assess the clinical efficacy.The wound healing and complications were observed,while leukocyte count,C-reactive protein level and erythrocyte sedimentation rate(ESR)were detected and calculated.Results The mean duration of operation was 156.75±32.40 min,while the mean amount of intraoperative bleeding was 490.00±84.06 mL.After 12 months of follow-up,the VAS pain score,HSS score and AOFAS score were significantly improved(P<0.05).The time for TUG and 6 MWD were significantly extended and lengthened after operation(P<0.05).The scores of postoperative qualities of life were elevated(P<0.05).During the 12-month follow-up,the leukocyte count,ESR and C-reactive protein level were all within the normal ranges.The wounds healed well without sinus formation.Conclusion 3 D printed anatomical titanium alloy tibial prosthesis has the advantages of effectively restoring good function of the lower limbs,mitigating preoperative pain and reducing postoperative complications.
作者
彭伟
黄迅悟
徐洪伟
董志明
孙佳培
PENG Wei;HUANG Xunwu;XU Hongwei;DONG Zhiming;SUN Jiapei(Department of Joint Surgery,Section of Orthopedics,the Fourth Medical Center of Chinese PLA General Hospital,Beijing,100048;Orthopedic Department Stationed in the Eighth Medical Center,Orthopedic Department of Chinese PLA General Hospital,Beijing,100091,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2022年第15期1531-1537,共7页
Journal of Army Medical University
基金
军队医学科技青年培育计划(21QNPY117)
关键词
骨缺损
胫骨
3D打印
假体
骨髓炎
病灶清除
bone defects
tibia
3D printing
prosthesis
osteomyelitis
debridement
