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采用放射立体分析法评估 3D 打印全膝关节置换术:评估胫骨基板的高多孔生物固定和金属背衬髌骨组件。

Evaluation of a 3D-printed total knee arthroplasty using radiostereometric analysis: assessment of highly porous biological fixation of the tibial baseplate and metal-backed patellar component.

机构信息

Rush University Medical Centre, Chicago, Illinois, USA.

Halifax Biomedical Inc., Mabou, Canada.

出版信息

Bone Joint J. 2019 Jul;101-B(7_Supple_C):40-47. doi: 10.1302/0301-620X.101B7.BJJ-2018-1466.R1.

Abstract

AIMS

Our intention was to investigate if the highly porous biological fixation surfaces of a new 3D-printed total knee arthroplasty (TKA) achieved adequate fixation of the tibial and patellar components to the underlying bone.

PATIENTS AND METHODS

A total of 29 patients undergoing primary TKA consented to participate in this prospective cohort study. All patients received a highly porous tibial baseplate and metal-backed patella. Patient-reported outcomes measures were recorded and implant migration was assessed using radiostereometric analysis.

RESULTS

Patient function significantly improved by three months postoperatively (p < 0.001). Mean difference in maximum total point motion between 12 and 24 months was 0.021 mm (-0.265 to 0.572) for the tibial implant and 0.089 mm (-0.337 to 0.758) for the patellar implant. The rate of tibial and patellar migration was largest over the first six postoperative weeks, with no changes in mean tibia migration occurring after six months, and no changes in mean patellar migration occurring after six weeks. One patellar component showed a rapid rate of migration between 12 and 24 months.

CONCLUSION

Biological fixation appears to occur reliably on the highly porous implant surface of the tibial baseplate and metal-backed patellar component. Rapid migration after 12 months was measured for one patellar component. Further investigation is required to assess the long-term stability of the 3D-printed components and to determine if the high-migrating components achieve fixation. Cite this article: 2019;101-B(7 Supple C):40-47.

摘要

目的

我们旨在研究新的 3D 打印全膝关节置换术(TKA)的高度多孔生物固定表面是否能使胫骨和髌骨组件充分固定在其下方的骨上。

患者和方法

共有 29 例接受初次 TKA 的患者同意参与这项前瞻性队列研究。所有患者均接受了高度多孔胫骨基板和金属背衬髌骨。记录患者报告的结果测量值,并使用放射立体测量分析评估植入物迁移。

结果

患者功能在术后三个月显著改善(p < 0.001)。胫骨植入物在 12 至 24 个月之间的最大总点运动的平均差异为 0.021 毫米(-0.265 至 0.572),髌骨植入物为 0.089 毫米(-0.337 至 0.758)。胫骨和髌骨的迁移率在术后前六周最大,术后 6 个月胫骨平均迁移无变化,术后 6 周髌骨平均迁移无变化。一个髌骨组件在 12 至 24 个月之间表现出快速迁移率。

结论

生物固定似乎可靠地发生在胫骨基板和金属背衬髌骨组件的高度多孔植入物表面上。在 12 个月后测量到一个髌骨组件的快速迁移。需要进一步研究以评估 3D 打印组件的长期稳定性,并确定高迁移组件是否实现固定。

2019 年;101-B(7 增刊 C):40-47.

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