Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
Medical School of Chinese PLA, 100048, Beijing, China.
J Orthop Traumatol. 2022 Aug 6;23(1):37. doi: 10.1186/s10195-022-00656-5.
With the development of radiology and three-dimensional (3D) printing technology, custom-made 3D-printed titanium augments have been more widely used. However, the radiological and clinical outcomes of custom-made augments lack reports. To better understand the clinical effect of using 3D-printed titanium augments and the significance of accurate placement, the aim of this study was to assess the outcomes when using custom-made 3D-printed titanium augments and to validate the idea that surgical simulation should be done before designing custom-made augments.
A retrospective review was conducted on 31 surgical simulations and revision total hip arthroplasties using custom-made 3D-printed titanium augments. The safe zone, cup position, and hip rotation center were measured on anteroposterior radiographs. Clinical outcomes were assessed with a mean 21.1 months of follow-up.
All patients were positioned within the safe zone, and none of the acetabular cups nor the custom-made augments had any evidence of migration at the latest follow-up. A strong correlation was found between the planned cup position and the postoperative position. The average vertical position of the center of rotation was significantly increased from 3.55 cm to 2.35 cm. The mean Harris Hip Score was increased from 40.81 preoperatively to 65.46 postoperatively. Complications included gait abnormality, groin pain, fracture of the greater trochanter, and partial palsy of the sciatic nerve. However, patient satisfaction reached 92.3%.
Surgical simulations help to design custom-made augments accurately and improve surgical plans. Acetabular components supported with custom-made 3D-printed augments is a useful method to bridge severe bone deficiencies. In this study, both the radiologic results and clinical outcomes were favorable.
Level 4.
随着放射学和三维（3D）打印技术的发展，定制的 3D 打印钛增强物已得到更广泛的应用。然而，定制增强物的放射学和临床结果缺乏报告。为了更好地了解使用 3D 打印钛增强物的临床效果以及准确放置的意义，本研究旨在评估使用定制 3D 打印钛增强物的结果，并验证在设计定制增强物之前进行手术模拟的想法。
对 31 例使用定制 3D 打印钛增强物的手术模拟和翻修全髋关节置换术进行回顾性研究。在前后位 X 线片上测量安全区、杯位置和髋关节旋转中心。临床结果在平均 21.1 个月的随访中进行评估。
所有患者均位于安全区内，在最新随访时，髋臼杯和定制增强物均未出现移位。计划杯位置与术后位置之间存在很强的相关性。旋转中心的平均垂直位置从 3.55cm 显著增加到 2.35cm。术前平均 Harris 髋关节评分从 40.81 分增加到术后 65.46 分。并发症包括步态异常、腹股沟疼痛、大转子骨折和坐骨神经部分麻痹。然而，患者满意度达到 92.3%。
手术模拟有助于准确设计定制增强物，改进手术计划。使用定制 3D 打印增强物支撑髋臼部件是一种有用的方法，可以弥补严重的骨缺损。在本研究中，放射学结果和临床结果均良好。
4 级。
