3D 打印个体化导板在踝关节镜下关节融合术中的应用
Application of 3D-Printed Personalized Guide in Arthroscopic Ankle Arthrodesis.
机构信息
Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.
Chongqing Institute of Optics and Machines, Chongqing 401122, China.
出版信息
Biomed Res Int. 2018 Sep 12;2018:3531293. doi: 10.1155/2018/3531293. eCollection 2018.
OBJECTIVE
To accurately drill the Kirschner wire with the help of the 3D-printed personalized guide and to evaluate the feasibility of the 3D technology as well as the outcome of the surgery.
METHODS
Patients' DICM data of ankle via CT examinations were introduced into the MIMICS software to design the personalized guides. Two 2mm Kirschner wires were drilled with the help of the guides; the C-arm fluoroscopy was used to confirm the position of the wires before applying the cannulated screws. The patients who underwent ankle arthrodesis were divided into two groups. The experimental group adopted the 3D-printed personalized guides, while the control group received traditional method, i.e., drilling the Kirschner wires according to the surgeon's previous experience. The times of completing drilling the Kirschner wires to correct position were compared between the two groups. Regular follow-ups were conducted to statistically analyze the differences in the ankle fusion time and AOFAS scores between the two groups.
RESULTS
3D-printed personalized guides were successfully prepared. A total of 29 patients were enrolled, 15 in the experimental group and 14 in the control group. It took 2.2 ± 0.8 minutes to drill the Kirschner wires to correct position in the experimental group and 4.5 ± 1.6 minutes in the control group (=0.001). No obvious complications occurred in the two groups during and after surgery. Postoperative radiographs confirmed bony fusion in all cases. There were no significant differences in the fusion time (=0.82) and AOFAS scores at 1 year postoperatively between the two groups (=0.55).
CONCLUSIONS
The application of 3D-printed personalized guide in assisting the accurate drilling of Kirschner wire in ankle arthrodesis can shorten the operation time and reduce the intraoperative radiation. This technique does not affect the surgical outcome.
TRIAL REGISTRATION NUMBER
This study is registered on www.clinicaltrials.gov with NCT03626935.
目的
借助 3D 打印的个性化导板准确钻入克氏针，并评估 3D 技术的可行性及手术结果。
方法
将踝关节 CT 检查的患者 DICM 数据导入 MIMICS 软件，设计个性化导板。在导板的帮助下钻入 2 根 2mm 克氏针，在应用空心螺钉前用 C 臂透视确认导丝位置。将接受踝关节融合术的患者分为两组，实验组采用 3D 打印的个性化导板，对照组采用传统方法，即根据术者既往经验钻入克氏针。比较两组完成钻入克氏针至纠正位置的时间。对两组患者进行定期随访，统计分析两组踝关节融合时间和 AOFAS 评分的差异。
结果
成功制备了 3D 打印的个性化导板。共纳入 29 例患者，实验组 15 例，对照组 14 例。实验组钻入克氏针至纠正位置的时间为 2.2±0.8 分钟，对照组为 4.5±1.6 分钟（=0.001）。两组患者术中及术后均无明显并发症。术后 X 线片证实所有患者均发生骨融合。两组患者术后融合时间（=0.82）和术后 1 年 AOFAS 评分（=0.55）差异无统计学意义。
结论
3D 打印个性化导板在辅助踝关节融合术中准确钻入克氏针，可缩短手术时间，减少术中辐射，不影响手术效果。
注册号
本研究在 www.clinicaltrials.gov 注册，注册号为 NCT03626935。
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