目的:翻修全髋关节置换术(rTHA)的主要挑战是骨丢失的治疗和术前计划。3D打印模型可以增强术前规划。该研究的目的是比较计划使用3D打印模型的Poprosky3型rTHA与使用常规成像技术(X射线和CT扫描)完成的手术中和围手术期结果和成本。
方法:在2014年至2021年期间,72例Poprosky3型缺损患者接受了rTHA。52名患者接受了标准计划治疗,20名患者计划使用3D打印模型。手术时间,术中失血,输血单位数,术后住院天数,比较两组髋臼环的使用情况。还进行了成本比较。
结果:3D打印组显示手术时间减少(101.8分钟(SD27.7)与146.1min(SD49.5),p<0.001)和总住院天数(9.3天(SD3.01)与12.3天(SD6.01),p=0.009)。手术费用明显低于对照组,调整后的差额为4183欧元(p=0.004)。输血总数和失血量以及髋臼环的数量没有显着差异。
结论:3D打印模型的使用导致了有意义的成本节约。复杂RTHA的3D打印术前计划似乎可以有效减少手术时间,住院时间和总成本。
The main challenges in revision total hip arthroplasty (rTHA) are the treatment of the bone loss and the pre-operative planning. 3D-printed models may enhance pre-operative planning. The aim of the study is to compare the intra- and peri-operative results and costs for Paprosky type 3 rTHAs planned with 3D-printed models to ones accomplished with the conventional imaging techniques (X-rays and CT scan).
Seventy-two patients with Paprosky type 3 defect underwent rTHA between 2014 and 2021. Fifty-two patients were treated with standard planning and 20 were planned on 3D-printed models. Surgical time, intra-operative blood loss, number of transfused blood units, number of post-operative days of hospitalization, and use of acetabular rings were compared between the two groups. A costs comparison was also performed.
The 3D-printed group showed reduced operative time (101.8 min (SD 27.7) vs. 146.1 min (SD 49.5), p < 0.001) and total days of hospitalization (9.3 days (SD 3.01) vs. 12.3 days (SD 6.01), p = 0.009). The cost of the procedures was significantly lower than the control group, with an adjusted difference of 4183 euros (p = 0.004). No significant differences were found for the number of total transfused blood units and blood loss and the number of acetabular rings.
The use of 3D-printed models led to a meaningful cost saving. The 3D-printed pre-operative planning for complex rTHAs seems to be effective in reducing operating time, hospital stay and overall costs.