Woo Seong-Hwan, Sung Myung-Jin, Park Kyung-Soon, Yoon Taek-Rim
Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Hip Pelvis. 2020 Mar;32(1):1-10. doi: 10.5371/hp.2020.32.1.1. Epub 2020 Feb 26.
The use of three-dimensional (3D) printing is becoming more common, including in the field of orthopaedic surgery. There are currently four primary clinical applications for 3D-printing in hip and pelvic surgeries: (i) 3D-printed anatomical models for planning and surgery simulation, (ii) patient-specific instruments (PSI), (iii) generation of prostheses with 3D-additive manufacturing, and (iv) custom 3D-printed prostheses. Simulation surgery using a 3D-printed bone model allows surgeons to develop better surgical approaches, test the feasibility of procedures and determine optimal location and size for a prosthesis. PSI will help inform accurate bone cuts and prosthesis placement during surgery. Using 3D-additive manufacturing, especially with a trabecular pattern, is possible to produce a prosthesis mechanically stable and biocompatible prosthesis capable of promoting osseointergration. Custom implants are useful in patients with massive acetabular bone loss or periacetabular malignant bone tumors as they may improve the fit between implants and patient-specific anatomy. 3D-printing technology can improve surgical efficiency, shorten operation times and reduce exposure to radiation. This technology also offers new potential for treating complex hip joint diseases. Orthopaedic surgeons should develop guidelines to outline the most effective uses of 3D-printing technology to maximize patient benefits.
三维(3D)打印的应用越来越普遍,包括在骨科手术领域。目前,3D打印在髋关节和骨盆手术中有四种主要临床应用:(i)用于手术规划和模拟的3D打印解剖模型;(ii)定制的患者专用器械(PSI);(iii)通过3D增材制造生产假体;(iv)定制的3D打印假体。使用3D打印骨模型进行模拟手术可让外科医生制定更好的手术方案,测试手术程序的可行性,并确定假体的最佳位置和尺寸。PSI有助于在手术过程中准确进行骨切割和假体植入。采用3D增材制造,尤其是带有小梁结构的制造方式,能够生产出机械稳定性好且具有生物相容性、能够促进骨整合的假体。定制植入物对于髋臼大量骨质流失或髋臼周围恶性骨肿瘤患者很有用,因为它们可以改善植入物与患者特定解剖结构的适配性。3D打印技术可以提高手术效率,缩短手术时间并减少辐射暴露。这项技术还为治疗复杂的髋关节疾病提供了新的潜力。骨科医生应制定指南,概述3D打印技术的最有效用途,以最大程度地为患者带来益处。