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使用 3D 打印钽髋臼增强物治疗全髋关节翻修术中的髋臼骨缺损。

Treatment of Acetabular Bone Defect in Revision of Total Hip Arthroplasty Using 3D Printed Tantalum Acetabular Augment.

机构信息

Zhongshan Hospital of Dalian University, Department of Orthopaedics, Dalian, China.

出版信息

Orthop Surg. 2023 May;15(5):1264-1271. doi: 10.1111/os.13691. Epub 2023 Mar 10.

Abstract

OBJECTIVE

The treatment of acetabular defects is one of the most difficult challenges of revision of total hip arthroplasty (RTHA), and tantalum is regarded as a promising bone substitute material. This study aims to investigate the effectiveness of 3D printed acetabular augment used in RTHA for the treatment of acetabular bone defect.

METHODS

A retrospective analysis of the clinical data of seven patients who had undergone RTHA was carried out using 3D printed acetabular augment from January 2017 to December 2018. The CT data of the patients were exported to Mimics 21.0 software (Materialise, Leuven, Belgium), and the acetabular bone defect augment were designed, printed and then implanted during operation. The postoperative Harris score, visual analogue scale (VAS) score and prosthesis position were observed to evaluate the clinical outcome. A I-test was used for preoperative and postoperative comparison of the paired-design dataset.

RESULTS

A firm attachment of the bone augment to the acetabulum during operation without any complications was found during the follow-up time 2.8-4.3 years. The VAS score of all patients was found 6.9 ± 1.4 before operation and was 0.7 ± 0.7 at the last follow-up (P ≤ 0.001), and the Harris hip scores, were 31.9 ± 10.3 and 73.3 ± 12.8 before operation, and at the last follow-up (P ≤ 0.001), respectively. Moreover, no loosening sign between the bone defect augment and the acetabulum was observed during the entire implantation period.

CONCLUSION

3D printed acetabular augment is effective in reconstructing the acetabulum following an acetabular bone defect revision, which enhances the hip joint function and eventually makes a satisfactory stable prosthetic.

摘要

目的

髋臼缺损的治疗是全髋关节翻修术(RTHA)最困难的挑战之一,而钽被认为是一种有前途的骨替代材料。本研究旨在探讨 3D 打印髋臼补块在 RTHA 中治疗髋臼骨缺损的疗效。

方法

回顾性分析 2017 年 1 月至 2018 年 12 月采用 3D 打印髋臼补块治疗的 7 例 RTHA 患者的临床资料。将患者的 CT 数据导出至 Mimics 21.0 软件(Materialise,比利时鲁汶),设计、打印髋臼骨缺损补块,并在术中植入。术后观察 Harris 评分、视觉模拟评分(VAS)和假体位置,评估临床疗效。采用配对设计资料的 I 检验对术前、术后进行比较。

结果

随访 2.8-4.3 年,术中发现骨补块与髋臼牢固结合,无任何并发症。所有患者的 VAS 评分术前为 6.9±1.4,末次随访时为 0.7±0.7(P≤0.001),Harris 髋关节评分术前为 31.9±10.3,末次随访时为 73.3±12.8(P≤0.001)。此外,整个植入期内未发现骨缺损补块与髋臼之间有松动迹象。

结论

3D 打印髋臼补块在重建髋臼骨缺损方面是有效的,可增强髋关节功能,最终获得满意的稳定假体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2e6/10157706/b4e53cb15515/OS-15-1264-g003.jpg

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