Research On Clinical Applicat Ion Of Computer Aided Design And Rapid Prototype In The Treatment Of Osteonecrosis Of The Femoral Head With Surgical Hip Dislocation

Objective:By using computer aided dotsign and rapid prototype(CAD-RP)for the preoperative surgical design and auxiliary surgery of surgicall hip dislocation(SHD),to treat(osteonecrosis of the femoral head(ONFH)with autologous iliac bone graft,exploring the feasibility of its cli nical application and confirming its superiority.Methods:We collected and sorted 100 patients of ONFH stag Ⅰ13,ⅠC,Ⅱ13,ⅡC,Ⅲ B and Ⅲ C by the association research circulation osseuse(ARGO).The patients were admitted by Guangzhou Orthopedichospi tal from January 2016 to March 2018 and were divided into observation group and control group of 50 each by random number table method.The observation group was treated with SHD leading by 3D printing guidance template,while the control group was treated with simple SHD.Within 9 months after the operation,perioperative i ndicators,imaging evaluation,Harris score and visual analogue scale(VAS)were used to evaluate the treatment effeet of two groups.And SISS 20.0 stati stical software was used to analyze and compare the evaluation data.Results:The re were no exi ted and detached cases.There was no significant difference between control group and observation group in baseline data(P>0.05),surgery time(P=0.425>0.05),surgical blood loss(P=0.473>0.05)and postoperative complications and healing of mouth(P=0.749,P=0.926,all>0.05).Harris score,X-ray progress score,total clinical efficacy score and VAS score were normally distributed between control group and observation group,but with significant differences(P<0.05).Harris score,X-ray progress score and total clinical efficacy score in observation group were higher than those in the control group,while VAS score was lower than them.The distance between the apex of the iliac crest flap and the top subchondral bone in the necrotic area in control group and observation group did not conform to the normal distribution(P=0.001,P<0.001)with significantly differences(P<0.05),which indicated that the distance between the apex of the iliac crest flaps and the top subchondral bone in the necrotic area in observation group was shorter than that in control group.Conclusion:This study shows that digital design combined with 3D printing navigation template guided Ganz surgical dislocation treatment has better prognosis and pain relief;3D printing navigation template guided can accurately locate the femoral head necrosis area,while effectively avoiding penetrating the articular surface in the removal of lesions,improving the safety of surgery.