Kleyer Arnd, Beyer Laura, Simon Christoph, Stemmler Fabian, Englbrecht Matthias, Beyer Christian, Rech Jürgen, Manger Bernhard, Krönke Gerhard, Schett Georg, Hueber Axel J
Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
Department of Internal Medicine 3 and Institute for Clinical Immunology, University of Erlangen-Nuremberg, Ulmenweg 18, 90154, Erlangen, Germany.
Arthritis Res Ther. 2017 Feb 10;19(1):34. doi: 10.1186/s13075-017-1234-z.
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) result in severe joint destruction and functional disability if left untreated. We aim to develop tools that help patients with RA and PsA to understand and experience the impact of inflammatory joint disease on the integrity of their (juxta-articular) bone and increase adherence to medical treatment. In this study, we used high-resolution peripheral quantitative computed tomography (HR-pQCT) to develop 3D prototypes of patients' finger joints.
HR-pQCT (XtremeCT, Scanco) measurements were performed in healthy individuals and patients with inflammatory joint disease, followed by a 3D print using the objet30 printer. Healthy participants (n = 10), and patients (n = 15 with RA and 15 with PsA) underwent a detailed, standardized interview with demonstration of printed joints.
Utilizing HR-pQCT images of metacarpophalangeal (MCP) heads, high quality and exact 3D prints as prototypes were created. Erosions in different sizes and the trabecular network printed in detail were visualized, demonstrating structural reduction in arthritic vs. healthy bone. After demonstration of 3D prints (healthy vs. erosive joint, visual and haptic) 26/39 (66%) participants (including healthy volunteers) were deeply affected, often quoting "shock". Of the patients with RA and PsA, 13/15 (86%) and 11/15 (73%), respectively, stated that they would rethink their attitude to medication adherence. More importantly, 21/24 patients with RA or PsA (87.5%) expressed that they would have wished to see such 3D prints during their first disease-specific conversations.
Using arthro-haptic 3D printed prototypes of joints may help to better understand the impact of inflammatory arthritides on bone integrity and long-term damage.
类风湿关节炎（RA）和银屑病关节炎（PsA）若不治疗会导致严重的关节破坏和功能残疾。我们旨在开发工具，帮助RA和PsA患者了解并体验炎性关节疾病对其（关节周围）骨骼完整性的影响，并提高药物治疗的依从性。在本研究中，我们使用高分辨率外周定量计算机断层扫描（HR-pQCT）来制作患者手指关节的3D原型。
对健康个体和炎性关节疾病患者进行HR-pQCT（XtremeCT，Scanco）测量，随后使用objet30打印机进行3D打印。健康参与者（n = 10）以及患者（n = 15例RA患者和15例PsA患者）接受了详细的标准化访谈，并观看打印关节的展示。
利用掌指（MCP）关节头部的HR-pQCT图像，制作出了高质量、精确的3D打印原型作为模型。不同大小的侵蚀以及详细打印出的骨小梁网络清晰可见，显示出关节炎骨骼与健康骨骼的结构差异。在展示3D打印模型（健康关节与侵蚀性关节，视觉和触觉）后，26/39（66%）的参与者（包括健康志愿者）深受触动，常表示“震惊”。在RA和PsA患者中，分别有13/15（86%）和11/15（73%）表示他们会重新思考对药物治疗依从性的态度。更重要的是，21/24例RA或PsA患者（87.5%）表示他们希望在首次进行疾病相关谈话时就能看到这样的3D打印模型。
使用关节的触觉3D打印原型可能有助于更好地理解炎性关节炎对骨骼完整性和长期损害的影响。
