3D打印技术联合全髋关节置换术治疗DDH的 疗效研究

Efficacy Study of 3D Printing Technology Combined with Total Hip Arthroplasty in the Treatment of Developmental Dysplasia of the Hip

摘要: 目的：探讨3D打印辅助全髋关节置换术治疗成人发育性髋关节发育不良的临床疗效。方法：回顾性分析2020年1月至2022年12月期间在六安市人民医院收治的30例因髋关节发育不良而行全髋关节置换术的患者，根据手术方式分为两组：3D打印技术辅助手术组(观察组) 15例；传统全髋关节置换术组(对照组) 15例。记录并比较两组的手术时间、术中出血量、术后随访的髋关节Harris评分，评估手术效果；同时对比髋臼假体置入的外展角、前倾角、垂直和水平距离与设计值的差异，评估髋臼假体置入的准确程度。结果：两组患者的基线资料(年龄、性别、身高体重指数)分析比较，差异无统计学意义(P > 0.05)；观察组在手术时间及术中出血量方面均优于对照组，差异有统计学意义(P < 0.05)；观察组术后髋臼假体外展角、前倾角及旋转中心水平、垂直距离的实际测量值与术前设计值的偏差绝对值均小于对照组，差异具有统计学意义(P < 0.05)；观察组术后髋关节Harris评分高于对照组，但无显著性意义(P > 0.05)，所有患者术后均未产生并发症。结论：借助3D打印技术，术前观察个性化3D模型增强术者对患髋解剖变异的认识，术中运用其导向作用，可提高髋臼假体安放精准度，缩短手术时间，减少术中出血量，有助于降低手术难度，减少术后并发症，促进患者切口愈合及髋关节功能恢复，改善手术疗效。

Abstract: Objective: Exploring the clinical efficacy of 3D printing-assisted total hip arthroplasty in treating adult developmental dysplasia of the Hip. Methods: A retrospective analysis was conducted on 30 patients who underwent total hip arthroplasty for hip dysplasia at the Lu’an People’s Hospital between January 2020 and December 2022. The patients were divided into two groups based on the surgical approach: a 3D printing-assisted surgery group (observation group, n = 15) and a conventional total hip arthroplasty group (control group, n = 15). The surgical outcomes were evaluated by recording and comparing the operation time, intraoperative blood loss, and postoperative Harris Hip Score during follow-up between the two groups. Furthermore, the accuracy of acetabular prosthesis placement was assessed by comparing the differences between the actual and designed values for the abduction angle, anteversion angle, vertical distance, and horizontal distance. Results: Analysis of baseline data (age, gender, body mass index) showed no statistically significant difference between the two groups (P > 0.05). The observation group demonstrated superior outcomes compared to the control group regarding operation time and intraoperative blood loss, with statistically significant differences (P < 0.05). The absolute deviations between the actual postoperative measurements and the preoperative design values for the acetabular prosthesis abduction angle, anteversion angle, and the horizontal and vertical distances of the rotation center were significantly smaller in the observation group than in the control group (P < 0.05). Although the postoperative Harris Hip Score was higher in the observation group compared to the control group, the difference was not statistically significant (P > 0.05). No postoperative complications occurred in any patient. Conclusion: Utilizing 3D printing technology allows for preoperative observation of personalized 3D models, enhancing the surgeon’s understanding of the patient’s hip anatomical variations. Employing its guiding function during surgery can improve the accuracy of acetabular prosthesis placement, shorten operation time, and reduce intraoperative blood loss. This approach helps lower surgical difficulty, minimize postoperative complications, promote incision healing and hip functional recovery, thereby improving the overall surgical outcome.