3-D 打印技术辅助人工全髋关节置换术治疗 Crowe <b>Ⅳ</b> 型髋关节发育不良合并股骨近段畸形一例 _Chinese Journal of Reparative and Reconstructive Surgery

Authors：

王百盛 ¹ ,  张敬东 ² , 韩文锋 ² , 刘欣伟 ² , 王宁 ² , 刘海立 ¹ , 李如珍 ¹

1. ;
2. ;

Corresponding author：

张敬东, Email: 87527670@163.com

Keywords：

髋关节发育不良; 股骨近段畸形; 人工全髋关节置换术; 3-D 打印

DOI：

10.7507/1002-1892.201705015

Video：

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目的介绍 3-D 打印技术辅助人工全髋关节置换术（total hip arthroplasty，THA）治疗 1 例 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形的临床经验。方法 2017 年 2 月，收治 1 例 40 岁 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形的女性患者。术前采用 Mimics 软件建立患侧髋关节三维数字模型，3-D 打印患侧股骨模型，根据模型设计股骨假体截骨位置及截骨大小。采用 Magics 19.0 软件设计制作个性化股骨截骨导板三维模型，并 3-D 打印。THA 术中应用截骨导板进行股骨截骨矫形。结果手术时间 98 min。术后第 2 天髋关节正侧位 X 线片检查示，髋臼假体安放、螺钉植入角度及位置均理想，恢复髋臼正常旋转中心，股骨截骨两端对位良好，下肢力线恢复正常。患者获随访 6 个月，Harris 评分为 95 分，较术前（38 分）明显提高；疼痛视觉模拟评分（VAS）为 0 分，较术前（7 分）明显下降。随访期间未发生假体松动、感染、血栓形成等并发症。结论 3-D 打印技术辅助 THA 治疗 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形，能简化手术操作、提高手术准确度、减少组织损伤、降低手术风险，取得满意临床疗效。

Citation： 王百盛, 张敬东, 韩文锋, 刘欣伟, 王宁, 刘海立, 李如珍. 3-D 打印技术辅助人工全髋关节置换术治疗 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形一例 . Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(1): 125-127. doi: 10.7507/1002-1892.201705015 Copy

1.	Rakow A, Simon P, Perka C. Hip arthroplasty in the presence of proximal femoral deformity. Orthopade, 2015, 44(7): 510-522.
2.	彭建平, 王旭义, 朱俊峰, 等. 发育性髋关节发育不良患者股骨近端畸形特点的研究. 中华关节外科杂志 (电子版), 2017, 11(3): 228-233.
3.	Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1): 15-23.
4.	Sen C, Bilsel K, Elmadag M, et al. Acetabuloplasty at the anatomic centre for treating Crowe class Ⅲ and Ⅳ developmental hip dysplasia: a case series. Hip Int, 2016, 26(4): 360-366.
5.	Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type IV developmental dysplasia. J Arthroplasty, 2012, 27(9): 1629-1635.
6.	Li L, Yu M, Yang C, et al. Total hip arthroplasty (S-ROM stem) and subtrochanteric osteotomy for Crowe type Ⅳ developmental dysplasia of the hip. Indian J Orthop, 2016, 50(2): 195-200.
7.	Greber EM, Pelt CE, Gililland JM, et al. Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip.J Arthroplasty, 2017, 32(9S): S38-S44.
8.	Papagelopoulos PJ, Trousdale RT, Lewallen DG. Total hip arthroplasty with femoral osteotomy for proximal femoral deformity. Clin Orthop Relat Res, 1996, (332): 151-162.

1. Rakow A, Simon P, Perka C. Hip arthroplasty in the presence of proximal femoral deformity. Orthopade, 2015, 44(7): 510-522.
2. 彭建平, 王旭义, 朱俊峰, 等. 发育性髋关节发育不良患者股骨近端畸形特点的研究. 中华关节外科杂志 (电子版), 2017, 11(3): 228-233.
3. Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg (Am), 1979, 61(1): 15-23.
4. Sen C, Bilsel K, Elmadag M, et al. Acetabuloplasty at the anatomic centre for treating Crowe class Ⅲ and Ⅳ developmental hip dysplasia: a case series. Hip Int, 2016, 26(4): 360-366.
5. Hasegawa Y, Iwase T, Kanoh T, et al. Total hip arthroplasty for Crowe type IV developmental dysplasia. J Arthroplasty, 2012, 27(9): 1629-1635.
6. Li L, Yu M, Yang C, et al. Total hip arthroplasty (S-ROM stem) and subtrochanteric osteotomy for Crowe type Ⅳ developmental dysplasia of the hip. Indian J Orthop, 2016, 50(2): 195-200.
7. Greber EM, Pelt CE, Gililland JM, et al. Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip.J Arthroplasty, 2017, 32(9S): S38-S44.
8. Papagelopoulos PJ, Trousdale RT, Lewallen DG. Total hip arthroplasty with femoral osteotomy for proximal femoral deformity. Clin Orthop Relat Res, 1996, (332): 151-162.

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Chinese Journal of Reparative and Reconstructive Surgery

3-D 打印技术辅助人工全髋关节置换术治疗 Crowe Ⅳ 型髋关节发育不良合并股骨近段畸形一例

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