本文選題：膝關(guān)節(jié)置換 + 3D打印技術(shù)�。� 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:利用正、逆向工程和3D打印技術(shù)設(shè)計(jì)膝關(guān)節(jié)置換截骨導(dǎo)向板,并進(jìn)行初步的臨床應(yīng)用研究。方法:選擇20例擬行全膝關(guān)節(jié)置換術(shù)的患者,隨機(jī)分為兩組,兩組各10例,3D打印截骨導(dǎo)向板組術(shù)前進(jìn)行骨盆到踝關(guān)節(jié)最低點(diǎn)的雙螺旋CT薄層掃描,利用計(jì)算機(jī)軟件重建患者骨骼模型,分析并計(jì)算截骨角度及截骨方向,從而設(shè)計(jì)截骨定位導(dǎo)航模板,制定手術(shù)方案及模擬手術(shù)操作。術(shù)中按照預(yù)先通過數(shù)字骨科技術(shù)設(shè)計(jì)的截骨角度進(jìn)行截骨并置入膝關(guān)節(jié)假體。傳統(tǒng)機(jī)械定位手術(shù)組采用髓內(nèi)定位法進(jìn)行。術(shù)后通過CT掃描及三維重建分析比較兩組手術(shù)的準(zhǔn)確性。統(tǒng)計(jì)術(shù)后2周膝關(guān)節(jié)HSS評(píng)分、膝關(guān)節(jié)活動(dòng)度、下肢力線角度等指標(biāo)來分析比較兩組手術(shù)的精準(zhǔn)性。結(jié)果:3D打印截骨導(dǎo)向板組術(shù)后2周HSS膝評(píng)分為(87.0±2.7)分,膝關(guān)節(jié)活動(dòng)度102.3°±3.3°,下肢力線角度(股骨與脛骨機(jī)械軸的夾角)為(2.0°±0.4°)。傳統(tǒng)機(jī)械定位手術(shù)組術(shù)后2周HSS膝評(píng)分為(86.3±2.6)分,膝關(guān)節(jié)活動(dòng)度101.6°±4.2°,下肢力線角度(股骨與脛骨機(jī)械軸的夾角)為(2.5°±0.5°)。3D打印截骨導(dǎo)向板組與傳統(tǒng)機(jī)械定位手術(shù)組患者的術(shù)后2周膝關(guān)節(jié)HSS評(píng)分、膝關(guān)節(jié)活動(dòng)度比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05),而兩者之間下肢力線角度比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:3D打印技術(shù)能夠使骨科醫(yī)生在術(shù)前直觀地了解膝關(guān)節(jié)的情況,精確指導(dǎo)制定手術(shù)方案,模擬手術(shù)操作,提高了手術(shù)的精準(zhǔn)性。
[Abstract]:Objective: to design the osteotomy guide plate for knee arthroplasty by orthoengineering, reverse engineering and 3D printing, and to carry out a preliminary clinical application study. Methods: twenty patients with total knee arthroplasty were randomly divided into two groups: 10 patients in each group underwent double helical CT scanning from pelvis to the lowest point of ankle joint before operation in each group. The bone model of patients was reconstructed by computer software. The angle and direction of osteotomy were analyzed and calculated. Osteotomy was performed according to the angle of osteotomy designed by digital orthopedic technique and knee prosthesis was implanted. The traditional mechanical localization group was performed by intramedullary localization. The accuracy of operation was compared by CT scan and three-dimensional reconstruction. To compare the accuracy of the two groups, HSS score, knee motion and lower extremity force line angle were analyzed and compared 2 weeks after operation. Results the knee score was 87.0 鹵2.7 in the 2 weeks after operation, the range of knee motion was 102.3 擄鹵3.3 擄, and the angle of force line of lower extremity (the angle between femur and tibial mechanical axis) was 2.0 擄鹵0.4 擄. In the traditional mechanical positioning group, the score of HSS knee was 86.3 鹵2.6 at 2 weeks after operation. The range of motion of knee joint was 101.6 擄鹵4.2 擄, and the angle of force line of lower extremity (the angle between femur and tibia mechanical axis) was 2.5 擄鹵0.5 擄路3D printed osteotomy guide plate group and traditional mechanical positioning group. The score of knee joint HSS was 2 weeks after operation. There was no significant difference in the range of knee motion between the two groups (P 0.05), but there was a significant difference in the angle of the lower limb force line between the two groups (P 0.05). Conclusion the technique of 3 D printing can make orthopedic doctors know the knee joint situation intuitively before operation, guide the operation plan accurately, simulate the operation, and improve the accuracy of the operation.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.4

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