李俊豪　张帅　黄其志　孙小东　陈大乐　颜林飞

【摘要】 目的：探讨应用数字化设计结合3D打印技术人工全髋关节置换手术治疗先天性髋关节发育不良的临床效果。方法：选取2014年2月-2016年2月在本院治疗的成人先天性髋关节发育不良患者48例，其中21例接受数字化设计结合3D打印技术人工全髋关节置换手术治疗（3D组），27例接受常规人工全髋关节置换手术治疗（常规组），观察两组手术时间、术中出血量以及Harris评分等。结果：3D组手术时间和术中出血量均明显少于常规组，差异均有统计学意义（P<0.05）。两组术后下床活动时间和骨愈合时间比较，差异均无统计学意义（P>0.05）。术后1年，两组Harris评分均较术前明显提高，差异均有统计学意义（P<0.05）;但术后1年两组Harris评分比较，差异无统计学意义（P>0.05）。结论：数字化设计结合3D打印技术人工全髋关节置换手术治疗先天性髋关节发育不良，其效果与常规手术无明显区别，但其具有手术时间和术中出血量少的优点，值得临床推广使用。

【关键词】 3D打印技术; 人工全髋关节置换术; 先天性髋关节发育不良

【Abstract】 Objective：To explore the clinical effect of digital design and 3D printing technology total hip arthroplastyin the treatment of congenital hip dysplasia.Method：48 adult patients with congenital hip dysplasia treated in our hospital from February 2014 to February 2016 were selected，among them，21 patients underwent total hip arthroplasty with digital design and 3D printing technique（3D group），27 cases received conventional total hip arthroplasty（conventional group），the operation time，intraoperative blood loss and Harris score and so on of the two groups were observed.Result：The operative time and intraoperative blood loss in the 3D group were significantly less than those in the conventional group，with statistically significant differences（P<0.05）.There were no significant differences in postoperative activity time and bone healing time between the two groups（P>0.05）.1 year after surgery，Harris scores in both groups were significantly improved compared with those before surgery，the differences were statistically significant（P<0.05）;however，1 year after the operation，Harris score showed no significant difference between the two groups（P>0.05）.Conclusion：Treatment of congenital hip dysplasia with total hip arthroplasty by digital design and 3D printing technology，its effect is not significantly different from that of conventional surgery，however，it has the advantages of less operation time and less blood loss，is worthy of clinical application.

【Key words】 3D printing technique; Total hip arthroplasty; Congenital hip dysplasia

First-authors address：Yangjiang Traditional Chinese Medicine Hospital，Yangjiang 529500，China

doi：10.3969/j.issn.1674-4985.2019.08.001

先天性髖关节发育不良是一种常见的先天性畸形，主要是指股骨头在关节囊内丧失与髓臼的正常关系，导致不能正常发育，也是目前引起小儿跛行的常见原因之一[1-2]。成人髋关节发育不良大多是儿童期的误诊或漏治所致，其病理改变和临床表现已相当严重，若不能及时治疗，还会引起髓关节和脊柱产生疼痛及畸形，严重影响患者的生活质量[3-4]。

目前临床上对成人髋关节发育不良的治疗方式主要有间置关节囊关节形成术、关节周围截骨术、重定向截骨术和人工全髋关节置换术等，其中人工全髋关节置换术的治疗效果较好，但髓臼的修复难度较大[5-6]。……