摘要
目的探讨3D打印技术经直接前方入路(DAA)实施全髋关节置换术(THA)的临床疗效。方法回顾性分析2020-11—2021-07行THA治疗的65例股骨颈骨折、股骨头坏死患者的临床资料。分为3D打印组(31例)和传统组(34例)。比较2组患者的手术时间、术中出血量、术后24 h引流量,以及髋臼假体置入外展角、前倾角与设计值的差异和术后髋关节假体角度。术后1个月、3个月、6个月以髋关节Harris评分标准评价髋关节功能。统计术后并发症率。结果2组患者的手术时间、术中出血量及术后24h引流量差异均无统计学意义(P>0.05)。术后3D打印组患者髋臼前倾角和外展角均优于传统组,差异均有统计学意义(P<0.05)。3D打印组患者的髋臼前倾角和外展角与术前设计值差异无统计学意义(P>0.05);传统组患者的髋臼前倾角和外展角与术前设计值差异有统计学意义(P<0.05)。术后1个月时髋关节3D打印组患者的Harris评分优于传统组,差异有统计学意义(P<0.05)。术后3个月、6个月2组患者的Harris评分均较术后1个月时显著改善,差异有统计学意义(P<0.05);但2组间差异无统计学意义(P>0.05)。2组术后并发症发生率差异无统计学意义(P>0.05)。结论3D打印技术DAA行THA,能提高髋臼假体前倾角及外展角安放精确度,改善患者术后早期髋关节功能,是安全、可行性的治疗股骨颈骨折、股骨头坏死患者的手段。
Objective To investigate the clinical efficacy of 3D printing technology for total hip arthroplasty(THA)performed via direct anterior approach(DAA).Methods The clinical data of 65 patients with femoral neck fracture and femoral head necrosis treated with THA from 2020-11 to 2021-07 were retrospectively analyzed.They were divided into 3D printing group(31 cases)and conventional group(34 cases).The operative time,intraoperative bleeding,24 h postoperative drainage,and the difference between the abduction angle and anteversion angle of acetabular prosthesis placement and the design value and postoperative hip prosthesis angle of the 2 groups were compared.Hip function was evaluated at 1 month,3 months and 6 months postoperatively by the Harris score of the hip joint.The postoperative complication rates were counted.Results There were no statistically significant differences in operative time,intraoperative bleeding and postoperative 24h drainage in the 2 groups(P>0.05).The acetabular anteversion angle and abduction angle of the patients in the 3D printing group were better than those of the traditional group,and the differences were statistically significant(P<0.05).There was no significant difference between the acetabular anteversion and abduction angle of the 3D printing group and the preoperative design value(P>0.05);the acetabular anteversion and abduction angle of the traditional group were statistically different from the preoperative design value.(P<0.05).The Harris score of patients in the 3D printing group was better than that of the conventional group at 1 month after surgery,and the difference was statistically significant(P<0.05).The Harris scores of patients in the 2 groups at 3 and 6 months postoperatively were significantly improved compared with those at 1 month postoperatively,and the difference was statistically significant(P<0.05);however,the difference between the 2 groups was not statistically significant(P>0.05).There was no statistically significant difference in the incidence of postoperative complications between the 2 groups(P>0.05).Conclusions The 3D printing technology implemented THA by DAA,can improve the accuracy of acetabular prosthesis anteversion and abduction angle placement,improve the patient's early postoperative hip function,which is a safe and feasible means of treating patients with femoral neck fracture and femoral head necrosis.
作者
贾延庆
庞炎旭
邵丰博
齐良军
杨民坤
穆峰
Jia Yanqing;Pang Yanxu;Shao Fengbo;Qi Liangjun;Yang Minkun;Mu Feng(Gongyi City People's Hospital,Gongyi 451200,China)
出处
《河南外科学杂志》
2022年第3期27-31,共5页
Henan Journal of Surgery
基金
2020年度河南省医学科技攻关计划(联合共建)项目(LHGJ20200996)。
关键词
全髋关节置换
直接前方入路
3D打印模型导板
total hip arthroplasty
direct anterior approach
3D printing model guide plate
