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计算机辅助设计和 3D 打印个体化肱骨头假体复合垫块在肱骨近端假体翻修中的应用：技术要点

Computer-aided Design and 3D-printed Personalized Stem-plate Composite for Precision Revision of the Proximal Humerus Endoprosthetic Replacement: A Technique Note.

机构信息

Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.

Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, China.

出版信息

Orthop Surg. 2023 Nov;15(11):3000-3005. doi: 10.1111/os.13857. Epub 2023 Sep 18.

DOI:10.1111/os.13857
PMID:37723892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10622279/
Abstract

BACKGROUND

Aseptic loosening is considered to be a rather uncommon complication in proximal humerus endoprosthetic replacement (PHER). However, patients with aseptic loosening often suffer severe bone loss, which poses a great challenge in following revision. Under this situation, a standard stemmed endoprosthesis is unavailable for revision limb salvage. Computer-aided design and 3D-printed personalized implants are an emerging solution for reconstructing complex bone defects.

CASE PRESENTATION

Here, we present a 67-year-old male who underwent PHER after tumor resection and developed aseptic loosening with severe periprosthetic osteolysis around the stem. Computer-aided design and 3D-printed personalized stem-plate composite was used for the precision revision of this patient. During the follow-up, encouraging results were observed, with good endoprosthetic stability and satisfactory limb function.

CONCLUSION

Computer-aid design and 3D-printed personalized stem-plate composite used in the present case could help to achieve good endoprosthetic stability and satisfactory limb function. This 3D-printed personalized stem-plate composite seems to be an effective method for the precise revision of PHER in patients with severe periprosthetic osteolysis. In addition, it also provides a novel method for similar revision surgery of other joints or primary endoprosthetic replacement with severe bone defects.

摘要

背景

无菌性松动被认为是肱骨近端假体置换（PHER）中一种相当罕见的并发症。然而，无菌性松动的患者常伴有严重的骨质丢失，这给后续的翻修带来了极大的挑战。在这种情况下，标准的柄式假体无法进行翻修保肢。计算机辅助设计和 3D 打印的个性化植入物是重建复杂骨缺损的新兴解决方案。

病例介绍

这里，我们介绍了一位 67 岁男性，他在肿瘤切除后接受了 PHER，并因假体周围严重的骨溶解而发生无菌性松动。计算机辅助设计和 3D 打印的个性化假体用于该患者的精确翻修。在随访期间，观察到了令人鼓舞的结果，假体具有良好的稳定性和满意的肢体功能。

结论

本病例中使用的计算机辅助设计和 3D 打印的个性化假体有助于实现良好的假体稳定性和满意的肢体功能。3D 打印的个性化假体似乎是治疗假体周围严重骨溶解的 PHER 精确翻修的有效方法。此外，它还为其他关节或严重骨缺损的初次假体置换的类似翻修手术提供了一种新的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/c92733335571/OS-15-3000-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/22b9148098af/OS-15-3000-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/6e8e489b3085/OS-15-3000-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/c91499585bfe/OS-15-3000-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/85232b50384b/OS-15-3000-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/c92733335571/OS-15-3000-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/22b9148098af/OS-15-3000-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/6e8e489b3085/OS-15-3000-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/c91499585bfe/OS-15-3000-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/85232b50384b/OS-15-3000-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70fa/10622279/c92733335571/OS-15-3000-g006.jpg

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