Clinical Study Of 3D Printing Assisted Crowe Type ? DDH Total Hip Arthroplasty

Objective:To explore the clinical efficacy of 3D printing technology in the treatment of total hip arthroplasty in patients with Crowe type III hip dysplasia undergoing total hip arthroplasty,and to study its clinical application value in preoperative surgical design and surgical simulation,intraoperative prosthesis implantation accuracy,operation time and blood loss,postoperative hip function improvement and complications.Method:A retrospective analysis was made on 31 patients(36 hips)who were scheduled to undergo total hip arthroplasty in the first orthopaedic District of Chenzhou NO.1 people's hospital.They were diagnosed as congenital hip dysplasia by X-ray,CT,etc.in the orthopaedic department of our hospital and whose Crowe classification was type III.The patients were divided into two groups according to whether 3D printing technology was used or not: the experimental group used 3D printing technology to make the solid model of the affected hip for surgical protocol design and simulated surgery,with a total of 13 cases(16 hips);the control group used traditional imaging data for surgical protocol design,with a total of 18 cases(20 hips).The operation time of acetabular reconstruction,accuracy of acetabular prosthesis implantation,blood loss,VAS score before and after operation,hip abduction,hip flexion,hip Harris score,incidence of postoperative complications and other indicators were observed in the two groups.Result: A total of 31 cases were followed up for 12-24 months,with an average of(17.74 ± 3.60)months.From the intraoperative process,the acetabular reconstruction time and blood loss in the experimental group were less than those in the control group(P < 0.05),indicating that the application of 3D printing technology assisted total hip replacement could greatly shorten the operation time.In the comparison of preoperative estimated prosthesis models,the matching rate of the experimental group was 100% higher than that of the control group.In terms of the accuracy of acetabular prosthesis implantation,statistical analysis of the deviation of vertical distance and horizontal distance of hip joint rotation center as well as the anteversion angle and abduction angle of acetabular cup between the experimental group and the control group showed statistical significance(P < 0.05),indicating that the implantation position of acetabular cup in the experimental group was more consistent with the position of rotation center,with higher accuracy.In the evaluation of surgical efficacy,the Harris hip score and VAS pain score of the two groups were significantly improved after operation,with statistical significance(P < 0.05);however,the Harris hip score of the experimental group and the control group was significantly improved after operation,with statistical significance(P > 0.05),indicating that the joint function and pain were significantly improved after hip replacement in the two groups.The difference between the two groups needs further study and comparison.Statistical analysis of hip abduction and flexion degree showed that the postoperative hip abduction and flexion of the two groups were significantly improved compared with those before operation,with statistical significance(P < 0.05);there was statistical significance in the comparison of postoperative hip abduction degree between the experimental group and the control group(P < 0.05);however,there was no statistical significance in the comparison of postoperative hip flexion angle between the two groups(P > 0.05),indicating that the acetabular prosthesis implantation accuracy was better in the experimental group,which was more advantageous to the improvement of hip range of motion.No corresponding complications occurred during the postoperative follow-up period in both groups.Conclusion:The application of 3D printing technology in assisting total hip arthroplasty for the treatment of patients with Crowe type III hip dysplasia has certain advantages in terms of preoperative design of surgical plan,prediction of prosthesis model,intraoperative shortening of surgical duration and improvement of prosthesis implantation accuracy.With the "individualized" and "precise" diagnosis and treatment concept required by the development of medical field,3D printing technology,as a new auxiliary technology,is worthy of being widely popularized in clinical practice.