[三维打印整体解剖髋臼假体在克罗伊Ⅱ型和Ⅲ型髋关节发育不良全髋关节置换术中设计和开发的准确性和效率]。

H Zhang, X D Ma, B W Li, J N Zhao, J Q Wang, J S Zhou
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引用次数: 0

摘要

目的比较模型开发方法和软件开发方法在设计和开发用于克罗Ⅱ型和Ⅲ型髋关节发育不良(DDH)患者全髋关节置换术(THA)的 3D 打印整体解剖髋臼假体方面的准确性和效率。方法回顾性选取2015年1月至2023年6月期间在蚌埠医学院第一附属医院骨科接受THA治疗的15例CroweⅡ型和Ⅲ型DDH终末期髋关节骨性关节炎患者作为研究对象。其中男性 1 例(1 髋),女性 14 例(17 髋),平均年龄(55.1±9.1)岁。其中 12 个髋关节为 Crowe Ⅱ型,6 个髋关节为 Crowe Ⅲ型。这些患者的术前骨盆三维 CT 数据被用于设计整体解剖型髋臼假体。模型开发小组利用三维打印技术打印出真人大小的骨盆模型。按照传统的 THA 手术方法,对髋臼进行扩孔,并将髋臼杯植入臼中。髋臼杯上方的骨缺损用骨蜡填充。软件开发小组使用 Mimics 和 3-matic 软件模拟 THA 手术过程,设计并安装一体化解剖髋臼假体。比较了两种方法的手术时间、髋臼杯的大小、髋臼骨缺损的体积和表面积、髋臼杯的倾斜度和前倾度、髋关节旋转中心的水平距离和垂直距离。结果:两组研究均基于 15 位患者 18 个髋关节的数据。模型开发组和软件开发组的旋转中心水平距离和垂直距离分别为(32.08±1.80)毫米、(32.17±2.40)毫米和(14.36±1.53)毫米、(15.11±1.45)毫米(均P>0.05)。模型开发组的髋臼杯大小为(48.56±1.15)毫米,软件组为(48.77±1.22)毫米(P=0.160)。模型组和软件组的髋臼杯前倾角和后倾角分别为(23.79°±6.31)°、(30.49°±11.03)°和(15.17°±0.52)°、(40.24°±0.58)°(均为P3)和(8.31±2.21)mm2,而软件开发组分别为(4.01±2.56)mm3和(6.83±2.71)mm2(均为PPC结论:应用Mimics和3-matic软件设计和开发Crowe Ⅱ型和Ⅲ型DDH全髋关节置换术中的一体化解剖髋臼假体,与3D打印模型开发方法相比,具有方便、高效、准确的优点。
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[The accuracy and efficiency of design and development of 3D printed integral anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip].

Objective: To compare the accuracy and efficiency between the model development method and the software development method, which design and develop 3D printed integral anatomical acetabular prosthesis to be used in total hip arthroplasty(THA) for patients with Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH). Methods: Fifteen patients with end-stage hip osteoarthritis due to Crowe type Ⅱ and Ⅲ DDH who underwent THA in the Orthopedics Department of the First Affiliated Hospital of Bengbu Medical College between January 2015 and June 2023 were selected in this study retrospectively. There were 1 male (1 hip) and 14 females (17 hips) with a mean age of (55.1±9.1) years. There were 12 hips with Crowe type Ⅱ, 6 hips with Crowe type Ⅲ. The preoperative pelvis three-dimensional CT data in those patients were used to design integral anatomical acetabular prosthesis. The model development group used 3D printing technology to print life-size pelvis models. The acetabulum was reamed and the acetabulum cup was inserted into the socket according to conventional THA procedures. The bone defect above the acetabulum cup was filled with bone wax. The Mimics and 3-matic software were used to simulate the THA procedures, design and install the integrated anatomical acetabular prosthesis in the software development group. The operation time, the size of the acetabular cup, the volume and surface area of the acetabulum bone defect, the acetabular cup's inclination and anteversion, the horizontal distance and the vertical distance of hip rotation center were compared between the two methods. Results: The study in the two groups were all based on the data of 18 hips in the 15 patients. The horizontal and vertical distances of rotation center in the model development group and software development group was (32.08±1.80) mm, (32.17±2.40) mm and (14.36±1.53) mm, (15.11±1.45) mm, respectively (both P>0.05). The cup size in model development group was (48.56±1.15)mm, and it was (48.77±1.22) mm in the software group (P=0.160). The anteversion and inclination of the acetabular cup in the model and software groups were 23.79°±6.31°, 30.49°±11.03° and 15.17°±0.52°, 40.24°±0.58°, respectively (both P<0.01). The volume and surface area of the acetabulum bone defect in the model development group was (5.06±2.86) mm3 and (8.31±2.21) mm2, respectively, while it was (4.01±2.56)mm3 and (6.83±2.71) mm2, respectively, in the software development group (both P<0.05). The work time in the model development group was (24.43±0.68) h and (0.47±0.12) h in the software development group, respectively (P<0.001). Conclusion: Compared with the 3D printing model development method, the application of Mimics and 3-matic software to design and develop integrated anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ DDH show advantages of convenience, high efficiency and more accuracy.

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Zhonghua yi xue za zhi
Zhonghua yi xue za zhi Medicine-Medicine (all)
CiteScore
0.80
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0.00%
发文量
400
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