Zhao Dewei, Li Junlei, Ying Jiawei, Wang Linbao, Liu Yuchens, Ma Zhijie, Wang Feng, Wang Fuyang, Zhang Yu, Zhang Tianwei, Liu Baoyi, Cheng Liangliang
Orthopaedic of Department, Affiliated ZhongShan Hospital of Dalian University, Dalian, China.
J Arthroplasty. 2025 May 12. doi: 10.1016/j.arth.2025.05.024.
The purpose of our study was to investigate the clinical efficacy of a three-dimensional printed integrated acetabular prosthesis (IAP) in total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) with different Crowe types.
A total of 85 patients (106 hips) who had DDH (Crowe types I to IV) and who underwent THA at the Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, were retrospectively analyzed. All the operations were successfully completed, and the postoperative follow-up time was 26.8 months (range, 16.5 to 31.8). A series of IAPs was designed and printed for each Crowe type. The bilateral horizontal center of rotation difference and the bilateral vertical center of rotation difference before and after operation were measured and compared. Cup inclination and anteversion angle were measured. The Harris Hip Score and the Short Form 36 questionnaire were used to evaluate hip function and quality of life, respectively, at 3 months after the operation and at the last follow-up.
The bilateral vertical center of rotation difference decreased from 14.5 ± 13.8 to 3.8 ± 3.7 mm, and the bilateral horizontal center of rotation difference decreased from 11.4 ± 7.7 to 2.0 ± 2.2 mm. The cup inclination and anteversion angle have been satisfactorily restored. The Harris Hip Score was 82.6 ± 5.7 points at 3 months after the operation and 90.4 ± 3.3 points at the last follow-up. The Short Form 36 questionnaire was 625 ± 45 points at 3 months after the operation and 748 ± 32 points at the last follow-up.
The use of three-dimensional-printed porous tantalum IAP in THA in the treatment of various types of DDH can fully ensure the acetabulum's coverage, accurately restoring the rotation center of the hip, which is helpful for the recovery of hip joint function. The early clinical efficacy is satisfactory.
本研究旨在探讨三维打印一体化髋臼假体(IAP)在不同Crowe分型的发育性髋关节发育不良(DDH)全髋关节置换术(THA)中的临床疗效。
回顾性分析大连大学附属中山医院骨科收治的85例(106髋)DDH(Crowe I至IV型)患者行THA的临床资料。所有手术均顺利完成,术后随访时间为26.8个月(范围16.5至31.8个月)。针对每种Crowe分型设计并打印了一系列IAP。测量并比较手术前后双侧水平旋转中心差异和双侧垂直旋转中心差异。测量髋臼杯倾斜度和前倾角。分别在术后3个月和末次随访时,采用Harris髋关节评分和简明健康状况调查量表(SF-36)评估髋关节功能和生活质量。
双侧垂直旋转中心差异从14.5±13.8mm降至3.8±3.7mm,双侧水平旋转中心差异从11.4±7.7mm降至2.0±2.2mm。髋臼杯倾斜度和前倾角恢复满意。术后3个月Harris髋关节评分为82.6±5.7分,末次随访时为90.4±3.3分。术后3个月SF-36量表评分为625±45分,末次随访时为748±32分。
三维打印多孔钽IAP用于THA治疗各类DDH,能充分保证髋臼覆盖,准确恢复髋关节旋转中心,有助于髋关节功能恢复。早期临床疗效满意。