背景：全腕关节置换术是治疗各种原因引起的终末期腕关节关节炎的有效方法。然而,腕关节假体在全腕关节置换术后仍容易出现假体松动、假体周围骨折等并发症。这可能是由于腕关节假体与患者的骨骼不精确匹配。在这项研究中,我们设计并开发了一种个性化的三维打印微孔钛人工腕关节假体（3DMT-Wrist），用于治疗终末期腕关节，并调查了其安全性和有效性。方法:2019年2月至2021年12月对14例关节炎患者采用3DMT-Wrist进行全腕关节置换术。术前术后视觉模拟量表评分,QuickDASH分数,手腕的运动范围，和手腕握力进行了评估。数据采用配对样本t检验进行统计分析。结果:随访19.7±10.7个月,视觉模拟量表从66.3±8.9下降到6.7±4.4，QuickDASH评分从47.4±7.3下降到28.2±7.6，握力从5.6±1.4上升到17.0±3.3kg。手掌屈曲时的运动范围显着提高（30.1°±4.9°至44.9°±6.5°），背伸(15.7°±3.9°至25.8°±3.3°),尺径偏差(12.2°±3.9°~20.2°±4.3°)和径向偏差(8.2°±2.3°~16.2±3.1)。未观察到假肢腕关节脱位或松动。结论：使用3DMT-Wrist的全腕关节置换术是治疗各种类型的终末期腕关节关节炎的安全有效的新方法；它提供了出色的疼痛缓解并保持了活动范围。
Background: Total wrist arthroplasty is an effective treatment for end-stage wrist arthritis from all causes. However, wrist prostheses are still prone to complications such as prosthesis loosening and periprosthetic fractures after total wrist arthroplasty. This may be due to the wrist prosthesis imprecise matching with patient\'s bone. In this study, we designed and developed a personalized three-dimensional printed microporous titanium artificial wrist prosthesis (3DMT-Wrist) for the treatment of end-stage wrist joint, and investigated its safety and effectiveness. Methods: Total wrist arthroplasty was performed using 3DMT-Wrist in 14 cases of arthritis between February 2019 and December 2021. Preoperative and postoperative visual analog scale scores, QuickDASH scores, wrist range of motion, and wrist grip strength were evaluated. Data were statistically analyzed using the paired samples t-test. Results: After 19.7 ± 10.7 months of follow-up, visual analog scale decreased from 66.3 ± 8.9 to 6.7 ± 4.4, QuickDASH scores decreased from 47.4 ± 7.3 to 28.2 ± 7.6, grip strength increased from 5.6 ± 1.4 to 17.0 ± 3.3 kg. The range of motion improved significantly in palmar flexion (30.1° ± 4.9° to 44.9° ± 6.5°), dorsal extension (15.7° ± 3.9° to 25.8° ± 3.3°), ulnar deviation (12.2° ± 3.9° to 20.2° ± 4.3°) and radial deviation (8.2° ± 2.3° to 16.2 ± 3.1). No dislocation or loosening of the prosthetic wrist joint was observed. Conclusion: Total wrist arthroplasty using 3DMT-Wrist is a safe and effective new treatment for various types of end-stage wrist arthritis; it offers excellent pain relief and maintains the range of motion.
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