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3D打印髋关节假体为复杂髋臼骨缺损翻修全髋关节置换术提供精准重建、稳定固定和功能恢复
Yongqiang Hao,
Lei Wang,
Wenbo Jiang,
Wen Wu,
Songtao Ai,
Lu Shen,
Shuang Zhao,
Kerong Dai
工程（英文） ›› 2020, Vol. 6 ›› Issue (11) : 1285-1290.
PDF(1510 KB)
PDF(1510 KB)
3D打印髋关节假体为复杂髋臼骨缺损翻修全髋关节置换术提供精准重建、稳定固定和功能恢复
3D Printing Hip Prostheses Offer Accurate Reconstruction, Stable Fixation, and Functional Recovery for Revision Total Hip Arthroplasty with Complex Acetabular Bone Defect
复杂而严重的髋臼骨缺损是人工髋关节置换术重建过程中最主要的挑战和难点。本研究旨在探讨3D打印技术在重建这种复杂髋臼骨缺损中的优势。我们回顾性分析了3例使用3D打印技术治疗的复杂髋臼骨缺损患者的预后，其中一例患者涉及双侧缺损重建。这些髋臼骨缺损的共同特点为常规方法难以重建。因此，在本研究中，我们首先结合了医学影像学分析、计算机软件模拟和重建（如MIMICS软件和西门子NX软件）及实际手术经验对缺损体积、假体重建稳定性和假体安装精度进行预测和评估，Harris髋关节评分被用来评估肢体功能。我们的结果表明3D打印假体可以精准重建骨缺损，并获得良好的假体稳定性，并且Harris髋关节评分显示3位患者肢体功能得到较好的恢复。总而言之，3D打印技术在人工髋关节翻修术中应对复杂且程度较为严重的骨缺损具有非常好的治疗效果，最终患者获得满意的预后。
Complicated and large acetabular bone defects present the main challenges and difficulty in the revision of total hip arthroplasty (THA). This study aimed to explore the advantages of three-dimensional (3D) printing technology in the reconstruction of such acetabular bone defects. We retrospectively analyzed the prognosis of four severe bone defects around the acetabulum in three patients who were treated using 3D printing technology. Reconstruction of bone defect by conventional methods was difficult in these patients. In this endeavor, we used radiographic methods, related computer software such as Materialise's interactive medical image control system and Siemens NX software, and actual surgical experience to estimate defect volume, prosthesis stability, and installation accuracy, respectively. Moreover, a Harris hip score was obtained to evaluate limb function. It was found that bone defects could be adequately reconstructed using a 3D printing prosthesis, and its stability was reliable. The Harris hip score indicated a very good functional recovery in all three patients. In conclusion, 3D printing technology had a good therapeutic effect on both complex and large bone defects in the revision of THA. It was able to achieve good curative effects in patients with large bone defects.
3D打印 / 髋关节翻修 / 复杂严重髋臼骨缺损 / 精准重建
3D printing / Hip revision / Complex and large acetabular bone defect / Accurate reconstruction
| [1] |
Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007;89(4):780–5.
|
| [2] |
Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am 2009;91 (1):128–33.
|
| [3] |
Delaunay C, Hamadouche M, Girard J, Duhamel A. SoFCOT Group. What are the causes for failures of primary hip arthroplasties in France? Clin Orthop Relat Res 2013;471(12):3863–9.
|
| [4] |
D’Antonio JA. Periprosthetic bone loss of the acetabulum. Classification and management. Orthop Clin North Am 1992;23(2):279–90.
|
| [5] |
Paprosky WG, Bradford MS, Younger TI. Classification of bone defects in failed prostheses. Chir Organi Mov 1994;79(4):285–91.
|
| [6] |
Fitzpatrick CK, Hemelaar P, Taylor M. Computationally efficient prediction of bone-implant interface micromotion of a cementless tibial tray during gait. J Biomech 2014;47(7):1718–26.
|
| [7] |
Jasty M, Bragdon C, Burke D, O’Connor D, Lowenstein J, Harris WH. In vivo skeletal responses to porous-surfaced implants subjected to small induced motions. J Bone Joint Surg Am 1997;79(5):707–14.
|
| [8] |
Pilliar RM, Lee JM, Maniatopoulos C. Observations on the effect of movement on bone ingrowth into porous-surfaced implants. Clin Orthop Relat Res 1986;208:108–13.
|
| [9] |
Sporer SM, Paprosky WG, O’Rourke MR. Managing bone loss in acetabular revision. Instr Course Lect 2006;55(7):287–97.
|
| [10] |
Philippe R, Gosselin O, Sedaghatian J, Dezaly C, Roche O, Sirveaux F, et al. Acetabular reconstruction using morselized allograft and a reinforcement ring for revision arthroplasty with Paprosky type II and III bone loss: survival analysis of 95 hips after 5 to 13 years. Orthop Traumatol Surg Res 2012;98 (2):129–37.
|
| [11] |
Kim KC, Ha YC, Kang BJ, Lee YK, Ji HM, Koo KH. Use of cementless acetabular component with a hook and iliac flanges in revision arthroplasty for massive acetabular defect. J Orthop Sci 2012;17(1):18–24.
|
| [12] |
Li H, Qu X, Mao Y, Dai K, Zhu Z. Custom acetabular cages offer stable fixation and improved hip scores for revision THA with severe bone defects. Clin Orthop Relat Res 2016;474(3):731–40.
|
| [13] |
Xu G, Gao L, Tao K, Wan S, Lin Y, Xiong A, et al. Three-dimensional-printed upper limb prosthesis for a child with traumatic amputation of right wrist: a case report. Medicine 2017;96(52):e9426.
|
| [14] |
Deng M, Cai H, Fang W, Long X. Three-dimensionally printed personalized guide plate for percutaneous radiofrequency thermal coagulation in idiopathic trigeminal neuralgia. Int J Oral Maxillofac Surg 2018;47(3):392–4.
|
| [15] |
Wang B, Hao Y, Pu F, Jiang W, Shao Z. Computer-aided designed, three dimensional-printed hemipelvic prosthesis for peri-acetabular malignant bone tumour. Int Orthop 2018;42(3):687–94.
|
| [16] |
Ackland DC, Robinson D, Redhead M, Lee PVS, Moskaljuk A, Dimitroulis G. A personalized 3D-printed prosthetic joint replacement for the human temporomandibular joint: from implant design to implantation. J Mech Behav Biomed Mater 2017;69:404–11.
|
| [17] |
Li G, Wang L, Pan W, Yang F, Jiang W, Wu X, et al. In vitro and in vivo study of additive manufactured porous Ti6Al4V scaffolds for repairing bone defects. Sci Rep 2016;6:34072.
|
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| 〈 |
|
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