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应用数字模板指导使用生物计量标准置换系统进行全异体关节置换手术。

Application of digital templates to guide total alloplastic joint replacement surgery with biomet standard replacement system.

作者信息

Bai Guo, He Dongmei, Yang Chi, Chen Minjie, Yuan Jianbing, Wilson Julian J

机构信息

Resident, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Stomatology, Shanghai, China.

Professor, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Stomatology, Shanghai, China.

出版信息

J Oral Maxillofac Surg. 2014 Dec;72(12):2440-52. doi: 10.1016/j.joms.2014.08.014. Epub 2014 Aug 12.

Abstract

PURPOSE

To design and manufacture digital templates to guide Biomet total alloplastic joint replacement surgery (Biomet, Warsaw, IN) and evaluate the clinical efficacy.

MATERIALS AND METHODS

Six patients who underwent total alloplastic joint replacement surgery from November 2013 to March 2014 were included in this study. Before surgery, the Biomet standard prostheses were scanned and imported into the ProPlan CMF 1.4 software (Materialise NV, Leuven, Belgium) for virtual positioning and osteotomy planning. Digital templates were then designed to guide intraoperative bone trimming and prosthesis placement. A postoperative computed tomography scan was taken and used to measure how well the postsurgical images corresponded to the images generated in the preoperative plan.

RESULTS

The digital templates were smoothly positioned and easily adapted, and they accurately guided bone trimming and prosthesis implantation. In addition, vital anatomic structures such as the skull base and inferior alveolar neurovascular bundle were not injured during the procedures. The result of the merged postoperative and preoperative computed tomography scans showed that the position of the prostheses corresponded quite accurately to the preoperative design, with an error of 1.139±0.183 mm.

CONCLUSIONS

Digital templates can accurately guide the bone trimming required for placement of Biomet total alloplastic joints. Likewise, these templates help place the prostheses in the desired locations, enhance stability, and avoid damage to the skull base and inferior alveolar neurovascular bundle.

摘要

目的

设计并制造数字模板以指导Biomet全异体关节置换手术(Biomet,华沙,印第安纳州)并评估其临床疗效。

材料与方法

本研究纳入了2013年11月至2014年3月期间接受全异体关节置换手术的6例患者。术前,对Biomet标准假体进行扫描并导入ProPlan CMF 1.4软件(Materialise NV,鲁汶,比利时)进行虚拟定位和截骨规划。然后设计数字模板以指导术中骨修整和假体置入。术后进行计算机断层扫描,并用于测量术后图像与术前计划生成的图像的符合程度。

结果

数字模板定位顺利且易于适配,准确地指导了骨修整和假体植入。此外,在手术过程中未损伤重要解剖结构,如颅底和下牙槽神经血管束。术后与术前计算机断层扫描合并结果显示,假体位置与术前设计相当准确地对应,误差为1.139±0.183毫米。

结论

数字模板可准确指导Biomet全异体关节置入所需的骨修整。同样,这些模板有助于将假体放置在理想位置,增强稳定性,并避免损伤颅底和下牙槽神经血管束。

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