CAJ | 학술논문

目的：评估3D打印钛合金骨小梁金属(titanium trabecular metal，TTM）臼杯在初次全髋关节置换术（total hip arthroplasty, THA）中应用的短期疗效。方法2012年5月至2013年6月，选取19例（20髋）进行初次全髋关节置换术的患者按采用臼杯类型不同分为TTM组和Pinnacle组。TTM组9例（10髋），男7例，女2例；年龄54~65岁，平均（61.0±3.5）岁。Pinnacle组10例（10髋），男6例，女4例；年龄51~67岁，平均（61.3±4.8）岁。术后6、12和24周进行随访，通过影像学检查评估髋臼假体的稳定性和髋臼表面与骨界面的骨长入能力；采用SF-36健康调查量表、WOMAC健康调查表和Harris髋关节功能评分评估患者关节功能。结果 TTM组术后6个月，Harris髋关节功能评分由术前平均（48.2±5.5）分提高到（89.5±4.0）分，SF-36健康调查量表分值由术前（329.1±86.7）分提高到（763.8±15.1）分，WOMAC健康调查表分值由（18.8±11.0）分改善到（1.3±0.9）分，差异均有统计学意义。与Pinnacle组（术后6个月）比较，Harris髋关节功能评分、SF-36健康调查量表分值、WOMAC健康调查表分值两组的差异均无统计学意义。两组术后影像学评估显示术后臼杯稳定，无松动及移位；所有患者均未出现进行性增加的透亮线。TTM组2例髋臼假体植入后存在透亮线，均位于2区和3区，术后6个月随访时透亮线消失；1例髋臼后壁存在骨缺损，行股骨头骨块植骨后髋臼假体稳定，随访过程中植骨块与臼杯接触紧密，未出现松动现象。结论全髋关节置换术中采用3D打印钛合金骨小梁金属臼杯的初始稳定性好、早期骨长入良好，短期疗效满意；长期效果有待于进一步随访结果。
목적：평고3D타인태합금골소량금속(titanium trabecular metal，TTM）구배재초차전관관절치환술（total hip arthroplasty, THA）중응용적단기료효。방법2012년5월지2013년6월，선취19례（20관）진행초차전관관절치환술적환자안채용구배류형불동분위TTM조화Pinnacle조。TTM조9례（10관），남7례，녀2례；년령54~65세，평균（61.0±3.5）세。Pinnacle조10례（10관），남6례，녀4례；년령51~67세，평균（61.3±4.8）세。술후6、12화24주진행수방，통과영상학검사평고관구가체적은정성화관구표면여골계면적골장입능력；채용SF-36건강조사량표、WOMAC건강조사표화Harris관관절공능평분평고환자관절공능。결과 TTM조술후6개월，Harris관관절공능평분유술전평균（48.2±5.5）분제고도（89.5±4.0）분，SF-36건강조사량표분치유술전（329.1±86.7）분제고도（763.8±15.1）분，WOMAC건강조사표분치유（18.8±11.0）분개선도（1.3±0.9）분，차이균유통계학의의。여Pinnacle조（술후6개월）비교，Harris관관절공능평분、SF-36건강조사량표분치、WOMAC건강조사표분치량조적차이균무통계학의의。량조술후영상학평고현시술후구배은정，무송동급이위；소유환자균미출현진행성증가적투량선。TTM조2례관구가체식입후존재투량선，균위우2구화3구，술후6개월수방시투량선소실；1례관구후벽존재골결손，행고골두골괴식골후관구가체은정，수방과정중식골괴여구배접촉긴밀，미출현송동현상。결론전관관절치환술중채용3D타인태합금골소량금속구배적초시은정성호、조기골장입량호，단기료효만의；장기효과유대우진일보수방결과。
Objective To explore the early-term efficacy of porous titanium trabecular metal acetabular (TTM) compo-nents produced by E-beam technology in total hip arthroplasty(THA). Methods From May 2012 to JUN 2013, nineteen primary THA patients (20 hips) were devided into observation group of porous TTM acetabular prosthesis produced by E-beam technology and control group of Pinnacle acetabular prosthesis. TTM group had nine patients (10 hips), including 7 males and 2 females, with the mean age of 61.0 years. Pinnacle group had ten patients (10 hips), including 6 males and 4 females, with the mean age of 58.6 years. The patients were followed up at the 6,12,24 weeks after operation. X-rays were taken at the follow-ups. Acetabular compo-nent stability and osseointegration were assessed through radiograph. Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Osteoarthritis index were recorded before and after operation to evaluate clinical effects of surgery. Results In TTM group, the Harris score improved from 48.2 ± 5.5 preoperatively to 89.5 ± 4.0 postoperatively, SF-36 scores from 329.1 ± 86.7 to 763.8 ± 15.1, and WOMAC index from 18.8 ± 11.0 to 1.3 ± 0.9. No cases suffered aseptic loosening and migration. After 24 weeks, There was no significant difference regarding Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Os-teoarthritis index between two groups. In TTM group, two hips had a radiolucent line postoperatively, which occurred in 2 and 3 zone. The lines were disappeared 24 weeks later. Conclusion In THA, the initial stability of TTM produced by E-beam tech-nology was fine, which can facilitate bone ingrowth in early stage. However, the long-term follow-up effect still needs to be con-firmed.