1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Foot Ankle Int. 2018 Aug;39(8):916-921. doi: 10.1177/1071100718770133. Epub 2018 Apr 12.
The advancement of 3D printing technology has allowed for the use of custom-designed implants for difficult-to-treat foot and ankle pathologies. This study reports on the radiographic and functional outcomes of a case series of patients treated with patient-specific 3D-printed titanium implants.
Fifteen consecutive patients treated with custom-designed 3D-printed implant cages for severe bone loss, deformity correction, and/or arthrodesis procedures were included in this study. A minimum of 1 year of clinical and radiographic follow-up was required. No patients were lost to follow-up. Patients completed a visual analog scale for pain, the Foot and Ankle Ability Measure Activities of Daily Living score, and the American Orthopaedic Foot & Ankle Society Score outcomes questionnaires preoperatively and at most recent follow-up. All patients had postoperative radiographs and computed tomography (CT) scans to assess bony incorporation. The mean age was 53.3 years (range, 22-74 years) with a mean follow-up of 22 months (range, 12-48 months) for these 15 patients.
Radiographic fusion verified by CT scan occurred in 13 of 15 patients. There was significant improvement in pain and all functional outcome score measures. All patients who went on to fusion were satisfied with their surgery. There were 2 failures, consisting of 1 infection and 1 nonunion, with an overall clinical success rate of 87%.
These patients demonstrated the successful use of patient-specific 3D-printed titanium implants to treat complex large bony defects, deformities, and arthrodesis procedures. These implants offer surgeons a novel and promising approach to treat both lower extremity pain and deformity that is not always available with current techniques.
Level IV, retrospective case series.
3D 打印技术的进步使得使用定制设计的植入物来治疗治疗棘手的足部和踝关节病变成为可能。本研究报告了一系列采用患者特异性 3D 打印钛植入物治疗的患者的影像学和功能结果。
本研究纳入了 15 例连续接受定制设计 3D 打印植入物笼治疗严重骨丢失、畸形矫正和/或融合术的患者。需要至少 1 年的临床和影像学随访。无患者失访。患者在术前和最近随访时完成了疼痛视觉模拟量表、足踝能力日常生活活动评分和美国矫形足踝协会评分的评估。所有患者均接受术后 X 线和计算机断层扫描（CT）扫描，以评估骨融合情况。15 例患者的平均年龄为 53.3 岁（范围，22-74 岁），平均随访时间为 22 个月（范围，12-48 个月）。
15 例患者中有 13 例通过 CT 扫描证实了影像学融合。疼痛和所有功能评分均有显著改善。所有融合的患者均对手术结果满意。有 2 例失败，包括 1 例感染和 1 例骨不连，总体临床成功率为 87%。
这些患者成功地使用了患者特异性 3D 打印钛植入物来治疗复杂的大骨缺损、畸形和融合术。这些植入物为外科医生提供了一种新颖而有前途的方法来治疗下肢疼痛和畸形，而这些问题并非总是可以通过现有技术解决。
IV 级，回顾性病例系列。
