3D打印胫骨隧道导航模块辅助前交叉韧带重建的临床研究

doi:10.13418/j.issn.1001-165x.2019.01.021

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (1): 102-106.doi: 10.13418/j.issn.1001-165x.2019.01.021

3D打印胫骨隧道导航模块辅助前交叉韧带重建的临床研究

陈国立^1,2，　胡洪新²，　吴献伟²，　林妹³，　戴玉林²，　林海滨²

1.莆田学院临床学院，福建莆田 351100；　2.莆田学院附属医院骨科，福建莆田 351100；
3.莆田学院附属医院手术室，福建莆田 351100

收稿日期:2018-04-23 出版日期:2019-01-25 发布日期:2019-02-20
通讯作者: 胡洪新，E-mail：445751820@qq.com
作者简介:陈国立（1974-），男，副主任医师，副教授，研究方向：运动医学、关节外科，Tel：13599011122, E-mail：ggllchen@163.com
基金资助:
福建省中青年教师教育科研项目（JAT170517）

Clinical study on anterior cruciate ligament reconstruction assisted by 3D-printed navigational templates of tibial tunnel

CHEN Guo-li ^1,2, HU Hong-xin ², WU Xian-wei², LIN Mei³, DAI Yu-lin ², LIN Hai-bin ²

1.Medical College of Putian University, Putian 351100, China; 2.Department of Orthopaedics, Affiliated Hospital of Putian University, Putian 351100, China; 3.Operating Room, Affiliated Hospital of Putian University, Putian 351100, China

Received:2018-04-23 Online:2019-01-25 Published:2019-02-20

摘要/Abstract

摘要：

目的　探讨3D打印胫骨隧道导航模块辅助前交叉韧带重建的可行性及疗效评价。方法　选取2015年1月至2016年5月就诊于莆田学院附属医院骨科，符合标准，行前交叉韧带重建的56例患者，随机分为两组：3D打印组和对照组，评估两组手术时间、术中定位的次数、术后6、9个月IKDC膝关节功能评分、术后6、9个月Lysholm评分以及术后9个月膝关节活动度。计数资料采用卡方检验分析，计量资料采用两独立样本t检验分析。结果　最终52例患者进入统计学分析，对照组27例，3D打印组25例。对照组和3D打印组的手术时间及胫骨隧道的定位次数差异有统计学意义（t=4.186，P<0.05；t=3.069，P<0.05）。术后3个月、术后9个月IKDC膝关节功能评分、Lysholm评分以及术后9个月的膝关节活动度，两组比较差异均无统计学意义（P>0.05）。结论　3D打印胫骨隧道导航模块辅助前交叉韧带重建存在可行性。

关键词: 膝, 　前交叉韧带, , , , 重建, 　打印, 三维

Abstract:

Objective　To investigate the feasibility and effect of 3D-printed navigational templates of tibial tunnel on the anterior cruciate ligament reconstruction.　Methods　56 patients of anterior cruciate ligament reconstruction from January 2015 to May 2016 in the orthopaedics department of the Affiliated Hospital of Putian University were selected and randomized into two groups: the control group and the 3D-printed group. The surgical duration and the number of intraoperative tibial tunnel location were recorded and analyzed. The IKDC knee function score, the Lysholm score on the postoperative 6th and 9th months, and the range of motion(ROM) of knee 9 months after operation were examined. The data were analyzed by chi-square test and two-sample t-tests.　Results　Fifty-two patients were included in the analysis(27 case in control group and 25 cases in the 3D-printed group). There were significant differences in the surgical duration and the number of intraoperative tibial tunnel location（t=4.186，P<0.05；t=3.069，P<0.05）. The IKDC knee function score ,the Lysholm score on the postoperative 6th and 9th months, and ROM of knee 9 months after operation showed no significant difference between the two groups（P>0.05）.　Conclusion　It was a viable alternative to use the 3D-printed navigational template of tibial tunnel for anterior cruciate ligament reconstruction.

Key words: Knee, 　Anterior cruciate ligament, 　Reconstruction, 　Printing, three-dimensional

陈国立,胡洪新,吴献伟,林妹,戴玉林,林海滨 . 3D打印胫骨隧道导航模块辅助前交叉韧带重建的临床研究[J]. 中国临床解剖学杂志, 2019, 37(1): 102-106.

CHEN Guo-li, HU Hong-xin, WU Xian-wei, LIN Mei, DAI Yu-lin, LIN Hai-bin. Clinical study on anterior cruciate ligament reconstruction assisted by 3D-printed navigational templates of tibial tunnel[J]. Chinese Journal Of Clinical Anatomy, 2019, 37(1): 102-106.

参考文献

[1] Kim HS, Seon JK, Jo AR. Current trends in anterior cruciate ligament reconstruction[J]. Knee Surg Relat Res，2013, 25(4):165-173.
[2] Samuelsson K, Andersson D, Ahldén M, et al. Trends in surgeon preferences on anterior cruciate ligament reconstructive techniques[J]. Clin Sports Med，2013, 32(1):111-126.
[3] Wang B, Lee KT. Results of revision anterior cruciate ligament reconstruction using a transportal technique[J]. Acta Orthop Belg，2015, 81(4):752-758.
[4] Vander Bracht H, Goubau L, Stuyts B, et al. Surgical management of anterior cruciate ligament injuries in Belgiumanno 2013[J]. Acta Orthop Belg，2015,81(4):738-746.
[5] Nguyen DT, Ramwadhdoebe TH, van der Hart CP, et al. Intrinsic healing response of the human anterior cruciate ligament: an histological study of reattached ACL remnants[J]. J Orthop Res，2014, 32(2):296-301.
[6] Wong TM, Jin J, Lau TW, et al. The use of three-dimensional printing technology in orthopaedic surgery[J]. J Orthop Surg(Hong Kong)，2017, 25(1):2309499016684077.
[7] Riboh JC, Hasselblad V, Godin JA, et al. Transtibial versus independent drilling techniques for anterior cruciate ligament reconstruction: a systematic review, meta-analysis, and meta-regression[J]. Am J Sports Med，2013,41:2693-2702.
[8] 徐丛, 陈永良, 吕永明, 等. ACL断裂单束重建及胫骨隧道扩大的临床研究[J]. 中国临床解剖学杂志，2016, 34(5):572-576.
[9] 周波, 白希壮, 郜玉忠, 等. 三维重建CT与X线测量前交叉韧带重建后骨道位置对比研究[J]. 中国运动医学杂志，2008, 27(3):290-293.
[10]Samitier G, Marcano AI, Alentorn-Geli E, et al. Failure of anterior cruciate ligament reconstruction[J]. Arch Bone Jt Surg, 2015, 3(4):220-240.
[11]Kraeutler MJ, Welton K, McCarty EC, et al. Revision anterior cruciate ligament reconstruction[J]. JBJS, 2017, 99(19):1689-1696.
[12]Wilde J, Bedi A, Altchek DW. Revision anterior cruciate ligament reconstruction[J]. Sports Health, 2014, 6(6):504-518.
[13]Brown GA, Firoozbakhsh K, DeCoster TA, et al. Rapid prototyping: the future of trauma surgery? [J]. J Bone Joint Surg Am, 2003, 85(Suppl 4):49-55.
[14]Paiva WS, Amorim R, Bezerra DA, et al. Aplication of the stereolithography technique in complex spine surgery[J]. Arq Neuropsiquiatr, 2007, 65(2B):443-445.
[15]Doornberg JN, Rademakers MV, van den Bekerom MP, et al. Two-dimensional and three-dimensional computed tomography for the classification and characterisation of tibial plateau fractures[J]. Injury, 2011, 42(12):1416-1425.
[16]林海滨, 黄文华, 陈宣煌, 等. 基于3D打印和接骨板标准件库数字化的股骨远端骨折内固定[J]. 中华医学杂志, 2016, 96(5):344-348.

3D打印胫骨隧道导航模块辅助前交叉韧带重建的临床研究

Clinical study on anterior cruciate ligament reconstruction assisted by 3D-printed navigational templates of tibial tunnel

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