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》2017年碩士論文

【摘要】：目的:利用正、逆向工程和3D打印技術(shù)設計膝關(guān)節(jié)置換截骨導向板,并進行初步的臨床應用研究。方法:選擇20例擬行全膝關(guān)節(jié)置換術(shù)的患者,隨機分為兩組,兩組各10例,3D打印截骨導向板組術(shù)前進行骨盆到踝關(guān)節(jié)最低點的雙螺旋CT薄層掃描,利用計算機軟件重建患者骨骼模型,分析并計算截骨角度及截骨方向,從而設計截骨定位導航模板,制定手術(shù)方案及模擬手術(shù)操作。術(shù)中按照預先通過數(shù)字骨科技術(shù)設計的截骨角度進行截骨并置入膝關(guān)節(jié)假體。傳統(tǒng)機械定位手術(shù)組采用髓內(nèi)定位法進行。術(shù)后通過CT掃描及三維重建分析比較兩組手術(shù)的準確性。統(tǒng)計術(shù)后2周膝關(guān)節(jié)HSS評分、膝關(guān)節(jié)活動度、下肢力線角度等指標來分析比較兩組手術(shù)的精準性。結(jié)果:3D打印截骨導向板組術(shù)后2周HSS膝評分為(87.0±2.7)分,膝關(guān)節(jié)活動度102.3°±3.3°,下肢力線角度(股骨與脛骨機械軸的夾角)為(2.0°±0.4°)。傳統(tǒng)機械定位手術(shù)組術(shù)后2周HSS膝評分為(86.3±2.6)分,膝關(guān)節(jié)活動度101.6°±4.2°,下肢力線角度(股骨與脛骨機械軸的夾角)為(2.5°±0.5°)。3D打印截骨導向板組與傳統(tǒng)機械定位手術(shù)組患者的術(shù)后2周膝關(guān)節(jié)HSS評分、膝關(guān)節(jié)活動度比較差異均無統(tǒng)計學意義(P0.05),而兩者之間下肢力線角度比較差異有統(tǒng)計學意義(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,精確指導制定手術(shù)方案,模擬手術(shù)操作,提高了手術(shù)的精準性。
[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.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

【參考文獻】

相關(guān)期刊論文 前9條

1 何姍姍;劉浩;唐月紅;;基于股骨三維多線外形計算頸干角的方法[J];中國生物醫(yī)學工程學報;2013年01期

2 甘煜東;徐達傳;陸聲;丁晶;徐永清;;數(shù)字化導航模板輔助全膝關(guān)節(jié)置換的模擬研究[J];中華骨科雜志;2011年09期

3 雷田;王岐本;鄺滿元;徐松;彭興華;;頸干角的大小與股骨頸骨折的關(guān)系[J];解剖與臨床;2011年02期

4 趙輝;趙子健;劉允才;吳宇黎;吳海山;;一種新型計算機輔助全膝關(guān)節(jié)置換手術(shù)系統(tǒng):華佗(WATO)[J];中國骨與關(guān)節(jié)外科;2009年04期

5 王黎明;喻忠;桂鑒超;徐杰;王鋼銳;鄭圣鼐;姚京東;侯明夫;徐燕;;計算機導航輔助下經(jīng)皮椎體成形術(shù)[J];中華骨科雜志;2006年10期

6 王大偉,Lo Nagi Nung,Yeo Seng Jing;全膝關(guān)節(jié)置換的放射學力線測量[J];中華骨科雜志;2005年09期

7 喻忠,王黎明;骨科手術(shù)導航系統(tǒng)研究現(xiàn)狀[J];國外醫(yī)學(骨科學分冊);2005年03期

8 張元智;陸聲;裴國獻;趙建民;李志軍;王大鵬;;應用三維重建與逆向工程技術(shù)確立成人正常下肢機械軸線[J];中華創(chuàng)傷骨科雜志;2013年08期

9 李曉輝;于建華;鄭得志;賈健;龔躍昆;卜延民;趙秀祥;;非影像依賴型計算機輔助全膝關(guān)節(jié)置換術(shù)的初步臨床觀察[J];中華骨科雜志;2009年06期

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