摘要目的 评价3D打印钛金属加强块重建全髋关节翻修术中髋臼骨缺损的近期临床疗效.方法 采用回顾性研究方法,回顾性分析首都医科大学附属北京友谊医院骨科2016年3月-2017年9月因全髋关节翻修术中骨缺损需要进行3D打印钛金属加强块重建髋臼缺损的21例患者.其中男性9例,女性12例;年龄(58.9±6.3)岁,年龄范围51 ～67岁;体重指数(23.8±2.9) kg/m2.术前根据髋关节CT结果,设计3D打印个性化的钛金属加强块.记录所有患者的X线上髋关节旋转中心和泪滴间线的垂直距离、术前髋关节Harris评分、术后末次随访髋关节Harris评分以及并发症情况,门诊随访11.8～19.6个月.计量资料以均数±标准差(Mean±SD)的形式表示,术前和术后比较采用t检验.结果 X线检查,术前和术后髋关节旋转中心和泪滴间线的垂直距离分别为(6.1±1.2)cm和(2.8±0.7)cm,差异有统计学意义(P＜0.01).髋关节Harris评分由术前(47.5±6.4)分提高至末次随访的(84.6±5.9)分,差异有统计学意义(P＜0.01).术后随访X线显示髋臼假体和加强块稳定,没有髋关节脱位等、假体周围感染和髋臼假体松动等并发症.结论 3D打印钛金属加强块能够重建严重髋臼骨缺损同时恢复髋关节的旋转中心.

abstractsObjective To evaluate the short-term clinical efficacy of three dimension printed titanium augments for the reconstruction of acetabular bone defects in revision total hip arthroplasty.Methods The retrospective study was conducted.To retrospectively analyze clinical data of 21 patients who were underwent revision total hip arthroplasty with severe acetabular bone defects reconstructed by three dimension printed titanium augment from March 2016 to September 2017 from Department of Orthopaedics,Beijing Friendship Hospital,Capital Medical University.There were 9 males and 12 females,age (58.9 ± 6.3) years,51-67 years,body mass index (23.8 ± 2.9) kg/m2.According preoperative CT scan of hip joints,three dimension printed titanium augments were designed for acetabular defects personality.The data including the vertical distance from centre of rotation to the interteardrop line in X-ray examination,preoperative Harris score,final follow-up Harris score of hip postoperatively,and complications were recorded.Outpatient visits ranged from 11.8 to 19.6 months.Measurement data were expressed as (Mean ± SD),and t test was used before and after surgery.Results For X-ray examination,the average vertical distance from centre of rotation to the interteardrop line was (6.1 ± 1.2) cm preoperatively and (2.8 ± 0.7) cm postoperatively,and the difference was statistically significant (P ＜ 0.01).The hip Harris score increased from preoperative (47.5 ± 6.4) scores to the last follow-up (84.6 ± 5.9) scores,and the difference was statistically significant (P ＜ 0.01).The final follow-up data showed the acetabular prosthesis and augments were stable,while there were no hip joint dislocation,periprosthetic joint infection,loosening of acetabular components and other complications.Conclusion Three dimension printed augments can reconstruct severe acetabular bone defects and restore the hip rotation centre.