数字化快速成型技术在全膝关节置换术中应用

目的探究数字化快速成型技术在全膝关节置换术(TKA)中应用的可行性及临床疗效。方法选择1例需行TKA的骨性关节炎患者,通过三维重建得到患者膝关节的DICOM格式数据;借助于医学影像控制系统Mimics 15.0和三维工程设计软件Unigraphics NX 9.0进行计算分析、图像处理等操作,建立与患者股骨髁和胫骨平台三维互补的膝关节截骨导向板的数字模型;然后,依靠快速成型技术打印制作的截骨导向板实物模型,通过截骨导航模板与膝关节紧密贴合,按照预先设计的截骨通道进行膝关节截骨。结果患者截骨操作顺利,TKA手术时间115 min,术中出血约450 ml;术后X线影像显示,膝关节假体在位正常,关节间隙变宽,膝关节外翻畸形完全矫正;术后2周膝关节HSS功能评分为89.6。结论数字化快速成型技术在TKA的个体治疗中,具有快速性、个体化、精确性高及损伤小等优点,临床疗效确切。

Clinical application of digital rapid prototyping technology on total knee replacement surgery

Objective To explore the feasibility and clinical efficacy of digital rapid prototyping technology in total knee replacement ( TKA) surgery. Methods One case of patient with knee osteoarthritis was selected in this study. DICOM data of the affected knee was obtained via 3D reconstruction,then the data and image were processed via Mimics 15. 0 and Unigraphics NX 9. 0,to establish the nav-igation template of digital model of knee. After that,rapid prototyping technology was performed to produce the navigation template,and osteotomy was carried out when the affected knee was affixed with the template as designed. Results The TKA surgery was success-ful,in which operation time was 115 minutes and intraoperative bleeding was 450 ml. Postoperative X-ray image showed that knee pros-thesis was in position with wider joint space,and eversion of the knee was inversed. HSS score was 89. 6 at 2 weeks postoperative-ly. Conclusion Navigation template is a feasible approach for arthroplasty assisted with rapid prototyping technology,with such ad-vantages as less operation time,individual treatment,high precision and minimally invasive. It has definite clinical effect.