摘要
目的探讨三维(3D)打印PSI导板辅助单髁关节置换术(UKA)治疗膝骨性关节炎的临床疗效。方法选取2017年8月~2019年1月河北省沧州中西医结合医院关节科收治的膝关节内侧骨间室关节炎80例患者为研究对象,随机分为3D打印个体化导板组(PSI组,n=40)与传统UKA组(CON组,n=40)。PSI组中,患者年龄50~68岁,平均(58.5±11.5)岁;CON组中,患者年龄55~72岁,平均(61.5±23.6)岁。比较两组手术时间、术中出血量、术后下地时间、住院时间、术后3个月膝关节活动度(ROM)、疼痛评分(VAS),纽约特种外科医院膝关节评分(HSS)及术后3个月髋膝踝角(HKA)的变化差异。结果两组手术时间、住院时间比较,差异有统计学意义(P<0.05)。而两组术中出血量、术后下地时间比较,差异无统计学意义(P>0.05)。所有患者术后VAS评分、HSS评分、ROM与术前相比,差异有统计学意义(P<0.05);但术后3个月两组相比,差异无统计学意义(P>0.05)。术后3月,两组患者髋膝踝角(HKA)显著增加,且PSI组HKA角高于CON组(P<0.05)。结论3D打印PSI导板引导下截骨效果与术前计划高度一致,截骨角度和假体位置更精准,可减少手术时间和住院时间,且能获得较好的短期临床疗效。
Objective To investigate the clinical effect of three-dimensional(3D)printing-guided unicompartmental knee arthroplasty(UKA),and provide a basis for individualized and accurateartificial UKA.Methods From August 2017 to January 2019,80 patients with medial compartment arthritis of knee joint were randomly divided into 3D printing individualized guide group(PSI group,n=40)and traditional UKA group(CON group,n=40).In the PSI group,the age of the patients ranged from 50 to 68 years(58.5%±11.5).In con group,the age of patients ranged from 55 to 72 years(61.5%±23.6).The operation time,blood loss,postoperative ambulation time,hospital stay,ROM,VAS,HSS and HKA were compared between the two groups.Results The operation time in the traditional UKA group and PSI group were(69.5±8.8)min,(56.3±4.9)min.The length of hospital stay in the traditional UKA group and PSI group were 6.8±2.1 d and 5.0±1.5 d(P<0.05).The intraoperative blood loss in the traditional UKA group and PSI group were 50.6±5.5 mL and 48.5±4.0 mL(P>0.05).The landing time after operation in the traditional UKA group and PSI group were 6.4±2.5 and 5.5±4.0 h(P>0.05).The VAS score,KSS score,and knee joint mobility(ROM)of all patients were significantly improved compared with those before surgery,with significant differences and statistical significance.There was no significant difference in VAS score,HSS score and ROM at 3 months after operation(P>0.05).The HKA angle of the PSI group at 3 months after operation was(178°±2.3°),CON group was(176°±2.3°).There were statistical differences between two groups in these two items(P<0.05).Conclusion The effect of 3D printing PSI guided osteotomy is highly consistent with the preoperative plan,and the osteotomy angle and prosthesis position are more accurate,which can reduce the operation time and hospital stay,and obtain better short-term clinical efficacy.
作者
郭东辉
董军
马世强
郭彬芳
赵云超
邢宝瑞
周婷婷
李晓明
GUO Donghui;DONG Jun;MA Shiqiang;GUO Binfang;ZHAO Yunchao;XIN Baorui;ZHOU Tingting;LI Xiaoming(Department of Orthopedic, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou 061000, Hebei, China;Department of Neonatolgoy, Cangzhou Central Hospital, Cangzhou 061000, Hebei, China)
出处
《西部医学》
2021年第8期1189-1193,共5页
Medical Journal of West China
基金
河北省卫计委项目(20180969)。
