Wang Zonghan, Wang Ze, Gu Lingchuan, Zhang Ying, Su Tiao, Luo Jiangming, Huang Chengjun, Gong Xiaoyuan, Peng Yang, Chen Guangxing
Center for Joint Surgery, Intelligent Manufacturing and Rehabilitation Engineering Center, The First Affiliated Hospital of Army Medical University, Chongqing, China.
Chongqing Municipal Science and Technology Bureau Key Laboratory of Precision Medicine in Joint Surgery, Chongqing, China.
Front Bioeng Biotechnol. 2025 May 27;13:1557882. doi: 10.3389/fbioe.2025.1557882. eCollection 2025.
In cases of hip joint damage, such as osteoarthritis (OA), rheumatoid arthritis (RA), avascular necrosis, or hip fractures, total hip arthroplasty (THA) is a critical surgical intervention. For individuals whose hip abnormalities stem from congenital issues, injuries, or previous operations, this procedure can encounter considerable obstacles, including complex bone defects, soft tissue deficiencies, and an increased risk of infections, which may result in poor alignment, joint instability, and higher need for revisions. This study explored the application of personalized, three-dimensional (3D)-printed porous tantalum buttresses designed specifically for acetabular reconstruction. Renowned for its compatibility with human biology, tantalum facilitates superior integration with natural bone.
The development process started with the generation of meticulous computer-aided design (CAD) models, derived from preoperative imaging techniques such as computed tomography (CT) scans and (magnetic resonance imaging) MRIs, which allowed for the creation of components precisely matching each patient's unique anatomical structure. The 3D-printed porous tantalum buttresses were made by cutting-edge additive manufacturing methods. The porosity of the tantalum structure promoted the growth of new bone tissue into the implant, improving its stability and durability. During surgeries, the buttress was positioned to reconstruct the acetabulum, laying a solid foundation for the artificial hip joint.
The results of our study showed that all surgeries were successfully completed with no significant vascular or nerve damage. Postoperative evaluations showed that the buttress had excellent biomechanical function and firm fixation, with a large amount of bone ingrowth, improving the fitness and performance of the implant while reducing the possibility of subsequent problems such as loosening or dislocation.
This innovative technique has great potential in clinical practice for better outcomes and quality of life for patients with complex hip deformities.
在髋关节损伤的情况下，如骨关节炎（OA）、类风湿性关节炎（RA）、缺血性坏死或髋部骨折，全髋关节置换术（THA）是一种关键的外科手术干预措施。对于髋关节异常源于先天性问题、损伤或既往手术的个体，该手术可能会遇到相当大的障碍，包括复杂的骨缺损、软组织缺陷以及感染风险增加，这可能导致对位不良、关节不稳定以及更高的翻修需求。本研究探讨了专门为髋臼重建设计的个性化三维（3D）打印多孔钽支撑物的应用。钽因其与人体生物学的兼容性而闻名，有助于与天然骨实现更好的融合。
开发过程始于生成精确的计算机辅助设计（CAD）模型，该模型源自术前成像技术，如计算机断层扫描（CT）扫描和磁共振成像（MRI），这使得能够创建与每位患者独特解剖结构精确匹配的部件。3D打印多孔钽支撑物采用前沿的增材制造方法制成。钽结构的孔隙率促进了新骨组织向植入物内生长，提高了其稳定性和耐用性。在手术过程中，将支撑物放置到位以重建髋臼，为人工髋关节奠定坚实基础。
我们的研究结果表明，所有手术均成功完成，未出现明显的血管或神经损伤。术后评估显示，支撑物具有出色的生物力学功能和牢固的固定，有大量骨长入，提高了植入物的适配性和性能，同时降低了后续诸如松动或脱位等问题的可能性。
这项创新技术在临床实践中具有巨大潜力，可为复杂髋部畸形患者带来更好的治疗效果和生活质量。
