3D打印导板在以SuperPATH技术行老年髋关节置换中的应用价值：回顾性研究和文献检索证据分析

文题释义： 3D打印技术：是一种利用数字模型，使用金属粉末或者塑料等可黏合材料，逐层打印来构造物体的技术。 微创 SuperPATH入路的优势：微创SuperPATH入路可保留患者关节囊，避免外旋肌群受损，有助于患者术后及早进行功能训练，促进关节功能恢复。 背景：髋关节置换目前成为了解决老年股骨颈骨折问题的有效有段，但存在创伤大、术后易出现关节错位及术后并发症发生率高的风险。 目的：采用回顾性研究结合文献检索的方法探讨3D 打印导板在老年髋关节置换中的应用价值。 方法：①文章回顾性分析2017 年2月至2018年10月辽宁省金秋医院骨外科股骨颈骨折进行髋关节置换的老年患者25例的临床资料，患者13例术中应用3D打印导板辅助行关节置换设为导板组，12例术中未用打印导板设为未用导板组，以此观察3D打印导板行SuperPATH技术在老年髋关节置换中的应用价值；②由第一作者用计算机检索万方数据库，检索词为“3D、髋关节”，检索时间2000至2019年，按纳入标准选择31篇文献分析探讨3D打印导板在老年髋关节置换中的应用价值。 结果与结论：①回顾性分析结果显示，导板组手术时间、术中X射线透视次数少于未用导板组(P < 0.05)，两组术中出血量、末次随访时髋关节功能Harris评分差异无显著性意义(P > 0.05)；②文献检索结果表明，3D导板应用于髋关节置换中能够弥补手术的一些缺陷。目前实施关节置换有多种入路方式，常规和微创入路都有直接前侧入路和后外侧入路方式，经多篇文献分析得出，直接前外侧入路能够减少创伤，而微创入路能够降低手术风险；③上述结果显示，老年髋关节置换中采用3D打印导板辅助可减少手术时间及术中X射线透视次数，疗效较好。3D导板应用在髋关节置换上具有应用价值，与微创技术相结合更具有优势。 ORCID: 0000-0001-6017-8386(赵维彪) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Application value of 3D printing guide plate in SuperPATH technology for elderly hip arthroplasty:retrospective study and evidence analysis of literature retrieval

BACKGROUND:Hip arthroplasty is now an effective method of effectively solving the problem of femoral neck fracture in the elderly,but there is a risk of big trauma,high joint dislocation and postoperative complications.OBJECTIVE:To explore the application value of 3D printing guide plate in hip arthroplasty in the elderly by retrospective study and literature retrieval.METHODS:(1) Clinical data of 25 elderly patients with femoral neck fracture undergoing hip arthroplasty from February 2017 to October 2018 in Liaoning Jinqiu Hospital were retrospectively analyzed.In the guide plate group,13 patients received hip arthroplasty using 3D printing guide plate.In the non-guide plate group,printing guide plate was not used in 12 cases.The application value of SuperPATH technique with 3D printing guide plate in hip arthroplasty in the elderly was observed.(2) Wanfang database was retrieved by the first author for studies published from 2000 to 2019.The key words were "3D,hip".According to the inclusion criteria,31 articles were selected to analyze the application value of 3D printing guide plate in hip arthroplasty in the elderly.RESULTS AND CONCLUSION:(1) The results of retrospective analysis showed that the operation time and the times of X-ray fluoroscopy were less in the guide plate group than those in the non-guide plate group(P <0.05).Intraoperative blood loss and Harris score of hip function at the final follow-up were not significantly different between the two groups(P> 0.05).(2) Literature search results showed that 3D guide plates could be used to compensate for some defects of surgery in hip arthroplasty.There are many approaches to implement joint arthroplasty.Both conventional and minimally invasive approaches have direct anterior approach and posterolateral approach.According to several literature analysis,direct anterolateral approach can reduce trauma,and minimally invasive approach can reduce the risk of surgery.(3) The above results show that the use of 3D printing guide plate in elderly hip arthroplasty can reduce the operation time and the times of intraoperative X-ray fluoroscopy,and the effect is better.3D guide plate has application value in hip arthroplasty,and it has advantages in combination with minimally invasive techniques.