摘要
目的:应用计算机辅助及逆向工程技术设计个性化导航模板,指导髋臼发育不良关节置换髋臼假体精确安放。方法:16例髋成人发育性髋关节发育不良病人应用全髋关节置换,男9例,女7例,年龄34～52岁,Crowe分期Ⅰ期10髋;Ⅱ期2髋;Ⅲ期2髋;Ⅳ期2髋。Harris髋关节功能评分在62～24分,平均42.6分。通过术前CT扫描的三维数据,设计髋臼旋转中心,建立发育不良髋臼的计算机数据模型,通过逆向工程技术制做与病人髋臼解剖完全吻合的导航模板,并应用于全髋关节置换手术。同时行术前、术后影像学及临床评估及术后随访。结果:16例病人术后的髋臼位置良好,外翻角在42°～55°,前倾角为12°～22°,下肢延长2～6CM,术后Harris髋关节功能评分在80.3分,无股神经和坐骨神经损伤等并发症。结论:计算机辅助快速成形导航模板应用于髋臼发育不良的全髋关节置换,能精确的控制髋臼假体的安放,对髋臼假体的前倾角和外翻角能精确的控制,并取得较好的疗效。
Objective： To achieve acetabular dysplasia acetabular joint replacement prosthesis placement accuracy using rapid prototyping navigational template. Methods：16 cases of hip dysplasia of the hip patients with total hip replacement, including 9 males and 7 fe/nale, age 34 ~ 52 years old. The grade by Crowe hip stages Ⅰ is 10, Ⅱ 2hip; Ⅲ 2hip;Ⅳ 2hip,whose Harris hip function score in the 62 ~ 24 points, an average of 42.6 points. Preoperative CT scan through the three- dimensional data,the design of acetabular center of rotation, the establishment of acetabular dysplasia model of computer data. And production in patients with acetabular anatomy and the exact template, template guide with center hole, the center hole location for the acetabular center of rotation, Via acetabular ante- version control and valgus angle and the actual template used in surgery. Surgery, we will follow the template in acetabular surface, along the Via template,in Kirschner wire placed on the acetabulum, the use of hollow file acetabular acetabular deepening along the Kirschner wire, according to thepreoperative plan to place the acetabular cup and internal fixation. System, patients will be carried out preoperative and postoperative imaging and clinical assessment and postoperative follow-up. Results： All the 16 cases of acetabular are good position,valgus angle 42 ~ 55, and the anteversion angle 12 ~ 22, the extension of lower extremities 2 ~ 6 cm, postoperative Harris hip function score at 80.3 points, and no femoral nerve and sciatic nerve injury complications. Conclusions： The template by rapid prototyping technology in acetabular dysplasia of total hip replacement can be precise control of acetabular prosthesis placement of the acetabular prosthesis anteversion and valgus angle and it is effective approach.
出处
《内蒙古医科大学学报》
2013年第1期47-51,共5页
Journal of Inner Mongolia Medical University
基金
国家自然科学基金资助项目(81160229)
内蒙古医科大学科技百万工程项目(NY2011BW012)
关键词
全髋关节置换
髋臼发育不良
快速成形
total hip arthroplasty
developmental dysplasia of hip
rapid prototyping
