背景:自体组织工程化骨髓间充质干细胞移植是治疗早期股骨头坏死最常用方法之一,目前尚无专用的移植器具,该手术移植过程耗时、费力、繁琐,不利于该手术临床推广。目的:研制一种配套、高效、专用的移植器,解决股骨头髓芯减压过程中干细胞移植困难的问题。方法:利用计算机辅助设计软件对该专用移植器实体建模,3D快速打印出实物。于股骨头髓芯减压联合骨髓间充质干细胞移植术中测试该专用移植器性能,比较使用专用移植器与使用传统器械手术的手术时间、术中出血量、干细胞/生物纤维胶原复合物遗漏量目测类比评分、医生满意度评分。结果与结论:(1)利用3D打印技术快速研制出了一款专用移植器;(2)与对照组比较,试验组手术时间、术中出血量、干细胞/生物纤维胶原复合物遗漏量目测类比评分、医生满意度评分均显著改善,差异有显著性意义(P〈0.05);(3)计算机辅助设计软件及3D打印技术是适合一线临床医生自主研发的高效手段。研制的专用移植器较完美的解决了细胞/生物纤维胶原复合物移植耗时、费力、繁琐的问题。
BACKGROUND:Autologous tissue-engineered bone marrow mesenchymal stem cel s (BMSCs) transplantation is one of the most common methods of treating early osteonecrosis of femoral head, but now there is stil no any special-purpose grafter available in the market. Such surgical transplantation is a laborious, time-consuming and tedious process, which goes against its clinical promotion. OBJECTIVE:To develop a supporting, efficient, special-purpose grafter, to solve the difficulty in stem cel s transplantation during core decompression of femoral head. METHODS:CAD software was used to perform solid modeling for this special-purpose grafter and print them by three-dimensional (3D) fast printing technology. The performance of this special-purpose grafter was tested by femoral head core decompression combined with BMSCs transplantation. It was compared with traditional surgical instrument in terms of duration of operation, intraoperative blood loss, visual analogue scale (VAS) of stem cel/biological fiber col agen complex omission amount and doctor’s satisfaction score. RESULTS AND CONCLUSION:(1) A kind of special-purpose grafter was developed by 3D printing technology rapidly. (2) Compared with the control group, duration of operation, intraoperative blood loss, VAS scores and doctor’s satisfaction scores were significantly improved in the trial group (P〈0.05). (3) CAD software combined with 3D printing technology is a highly efficient means for front-line clinicians to perform independent development. The research and development of this special-purpose grafter provides a perfect solution to the laborious, time-consuming and tedious process of cel/biological col agen fiber transplantation.