数字化导航模板辅助全膝关节置换的临床应用

doi:10.13418/j.issn.1001-165x.2015.06.018

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (6): 700-705.doi: 10.13418/j.issn.1001-165x.2015.06.018

数字化导航模板辅助全膝关节置换的临床应用

甘煜东¹，　丁晶¹，　侯春林²，　陆声¹，　徐永清¹

1. 成都军区昆明总医院附属骨科医院，昆明 650032； 2. 第二军医大学长征医院骨科，上海 200003

收稿日期:2015-03-24 出版日期:2015-11-25 发布日期:2015-12-18
通讯作者: 徐永清，教授，博士生导师， E-mail：xuyongqingkm@163.net
作者简介:甘煜东（1982-），男，山东青岛人，主治医师，博士后，主要从事关节外科方面的研究，Tel：15912466066，E-mail：gasbzh-1981@163.com
基金资助:
国家自然科学基金（81171428/H1815 ）；云南省青年自然科学基金（2014FD098）

Simulation study of total knee arthroplasty assisted by digital navigation templates

GAN Yu-dong¹，DING Jing¹，HOU Chun-lin²，LU Sheng¹，XU Yong-qing¹

1.The Affliated Orthopedics Hospital of Kunming General Hospital of Chengdu Military Region, Kunming 650032, China; 2.Department of Orthopedic, Changzheng Hospital, The Second Military Medical University, Shanghai 20003, China

Received:2015-03-24 Online:2015-11-25 Published:2015-12-18

摘要/Abstract

摘要：

目的　探讨临床数字化导航模板辅助全膝关节置换的可行性和准确性。方法　招募20例（男8例，女12例）膝骨性关节炎患者。采集患者下肢全长MRI扫描数据，利用逆向工程软件对MRI数据进行处理，计算机内设计得到一款与股骨远端和胫骨近端匹配的可定位截骨平面和外旋轴的导航模板，最后通过快速成型机制作模板实物用于临床手术操作。手术由同一位具有关节置换经验的骨科医生行全膝关节置换手术。术前观察导航模板与股骨髁和胫骨平台匹配性，术后通过CT扫描检测截骨的准确性。结果导航模板与股骨髁和胫骨平台贴合紧密，无明显移动；所有患者股骨远端和胫骨近端截骨面与下肢机械轴基本垂直，外旋轴定位精确，股骨后髁截骨面与通髁轴保持平行。结论数字化导航模板辅助全膝关节置换具有安全可行，手术操作简单，截骨力线准确。

关键词: 膝关节, 关节置换, 导航模板, 计算机辅助设计, 临床应用

Abstract:

Objective　To investigate the accuracy and feasibility of total knee arthroplasty assisted by the navigation templates in clinic. Methods Twenty patients (8 male, 12 female) with knee arthritis requiring arthroplasty were recruited. Volumetric MRI scan was performed on each desired lower limb and a 3D reconstruction model was generated from the scan data. Using reverse engineering technique, anavigational template is designed with a surface that matches the distal femur and proximal tibia. The templatewas manufactured using rapid prototyping technique for clinical use. The operation was designed by the same doctor with experience in joint replacement. The compatibility of the navigation template with tibial and femoral condyles was examined preoperatively. After surgery, the positions of the prosthesis were evaluated using CT scan. Results Each navigational template was found to fit its corresponding biomodel appropriately, and there was no significant free motion of the template. All the cut surfaces were nearly perpendicular to the mechanical alignment, the rotating axis was located accurately and resection of posterior surface was parallel to the transepicondylar axis. Conclusion Total knee replacement assisted digital navigation template is safe and feasible, simple in operation, and accurate in osteotomy

Key words: Knee, Arthroplasty, Navigation templates, Computer aided design, Clinical application

甘煜东,丁晶,侯春林,陆声,徐永清. 数字化导航模板辅助全膝关节置换的临床应用[J]. 中国临床解剖学杂志, 2015, 33(6): 700-705.

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数字化导航模板辅助全膝关节置换的临床应用

Simulation study of total knee arthroplasty assisted by digital navigation templates

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