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3D 打印个体化髋关节植入物治疗犬髋关节发育不良的手术技术。

Surgical Technique of the 3-Dimensional-printed Personalized Hip Implant for the Treatment of Canine Hip Dysplasia.

机构信息

Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University; Research and Academic Service, Faculty of Veterinary Medicine, Kasetsart University.

Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University.

出版信息

J Vis Exp. 2024 Apr 19(206). doi: 10.3791/66005.

Abstract

Hip dysplasia causes major disability in dogs. Treatment options are limited to palliative treatment (e.g., pain relief, physical exercise, lifestyle changes, and weight control) or invasive surgeries such as pelvic osteotomies and total hip arthroplasty. Hence, a strong unmet need exists for an effective and dog-friendly solution that enhances the quality of life of man's best friend. We fill this treatment gap by offering a minimally traumatic and extraarticular, dog-specific, 3-dimensional-printed, hip implant (3DHIP) that restores hip joint stability. The surgical treatment using a 3DHIP implant is less invasive than osteotomies and can be performed bilaterally in one surgical session. The 3DHIP implant extends the dorsal acetabular rim of the dysplastic hip joint thereby increasing coverage of the femoral head and inhibiting joint subluxation with fast recovery. Sufficient access to the dorsal acetabular rim and ventral border of the iliac body together with optimal fitting and fixation of the implant are key steps for a successful 3DHIP implantation and imply the need for a specific approach. The present article aims to showcase this innovative surgical technique with tips and tricks as a surgical manual for implantation of the 3DHIP implant in dogs affected by hip dysplasia.

摘要

髋关节发育不良会导致犬只严重残疾。治疗选择仅限于姑息治疗(例如,缓解疼痛、体育锻炼、生活方式改变和体重控制)或侵入性手术,如骨盆截骨术和全髋关节置换术。因此,非常需要一种有效且对犬友好的解决方案,以提高人类最好朋友的生活质量。我们通过提供一种微创、关节外、针对犬类的、三维打印的髋关节植入物(3DHIP)来填补这一治疗空白,该植入物可恢复髋关节稳定性。使用 3DHIP 植入物的手术治疗比截骨术的侵入性更小,并且可以在一次手术中双侧进行。3DHIP 植入物延伸了发育不良髋关节的背侧髋臼缘,从而增加了股骨头的覆盖范围,并通过快速恢复抑制关节半脱位。充分接触背侧髋臼缘和髂体的腹侧边界,以及植入物的最佳适配和固定是 3DHIP 植入成功的关键步骤,这意味着需要一种特定的方法。本文旨在展示这种创新的手术技术,并提供一些技巧,作为在患有髋关节发育不良的犬中植入 3DHIP 植入物的手术手册。

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