首页|巨大非包容距骨骨软骨损伤的新型治疗方法:个性化3D打印钴铬钼部分距骨

巨大非包容距骨骨软骨损伤的新型治疗方法:个性化3D打印钴铬钼部分距骨

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目的 评估采用新型的个性化3D打印钴铬钼合金对巨大距骨骨软骨损伤(osteochondral lesion of talus,OLT)进行修复的手术效果及安全性.方法 对 2021 年 10 月至 2023 年 4 月期间,本中心因距骨骨软骨损伤行 3D个性化部分置换的 12 例患者,进行三维建模制定个性化方案并手术植入假体,术后 3 个月、6 个月、1 年定期随访.评估踝关节功能及疼痛程度、术后复查X线检查假体位置以及是否存在假体周围透光线.结果 12 例患者平均病损表面积(252.5±91.1)mm2,平均病损体积(1 571.5±99.0)mm3,术后平均随访时间(21.7±5.6)个月,总体满意率 91.7%;美国足与踝关节协会(American Orthopedic Foot and Ankle Society,AOFAS)(后足)评分从术前平均(69.42±10.36)分提升至(89.83±6.89)分;足部功能指数(Foot Function Index,FFI)评分从术前(55.00±31.86)分降至(14.08±7.95)分;视觉模拟疼痛量表(Visual Analogue Scale,VAS)评分从平均(3.75±2.14)分降至(1.17±1.19)分,差异均具有统计学意义(P<0.01).患者均未出现感染、伤口愈合不良以及骨折不愈合等重大并发症.结论 针对巨大的距骨非包容性骨软骨损伤,3D个性化打印假体填充治疗技术在平均 21 个月时随访,手术效果满意度高,患者功能及疼痛均明显改善,且未观察到重大并发症,为治疗此类OLT提供了新型的临床解决方案.
A noval surgical treatment for large uncontained osteochondral lesion of talus:customized 3D printed cobalt-chromy-molybdenum partial talus
Objective To evaluate its surgical effect and surgical safety of customized 3D printing cobalt-chromy-molybdenum partial talus for large uncontained osteochondral lesions of talus(OLT).Methods From October 2021 to April 2023,patients with large uncontained talus osteochondral lesions underwent 3D customized partial talus replacement in our center were enrolled.The 3D modeling software helped to design customized plan and prostheses prototype.Regular follow-up visits were conducted at 3 month,6 months and 1 year after surgery.Ankle function and pain were assessed again,and postoperative X-rays,implant position,and presence of periprosthetic radiolucency lines were assessed.Results The average lesion surface area of 12 patients was(252.5±91.1)mm2 and the volume was(1 571.5±99.0)mm3.The mean follow-up time was(21.7±5.6)months.The overall satisfaction rate is 91.7%.American Orthopedic Foot and Ankle Society(AOFAS)score(hindfoot)increased from(69.42±10.36)to(89.83±6.89)分.Foot Function Index(FFI)score decreased from(55.00±31.86)to(14.08±7.95).The average pain Visual Analog Scale(VAS)score decreased from(3.75±2.14)to(1.17±1.19),with statistically significant differences.There were no major complications such as infection,poor wound healing,and non-union of fractures.Conclusion For large uncontained OLT,the 3D customized printing prosthesis treatment showed high satisfaction with surgical results,improved significantly the patient function,and relieve the pain.No major complications were observed during an average follow-up of 21 months.It provides a novel clinical solution for the treatment of such OLTs.

osteochondral lesion of taluscustomized 3D printingpartial talus replacement

李恒、赖良鹏、孙宁、杜辉、武勇

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首都医科大学附属北京积水潭医院足踝外科,北京 102208

距骨骨软骨损伤 3D定制化打印 部分距骨置换

北京市自然科学基金-海淀原始创新联合基金项目

L232004

2024

首都医科大学学报
首都医科大学

首都医科大学学报

CSTPCD北大核心
影响因子:1.511
ISSN:1006-7795
年,卷(期):2024.45(5)