3D打印技术在骨科膝关节置换术教学中的应用

doi:10.3760/cma.j.issn.1673-677X.2018.05.022

中华医学教育杂志 ›› 2018, Vol. 38 ›› Issue (5): 734-738.DOI: 10.3760/cma.j.issn.1673-677X.2018.05.022

3D打印技术在骨科膝关节置换术教学中的应用

李杨, 田华, 张克

100191北京大学第三医院骨科

收稿日期:2017-12-17 出版日期:2018-10-01 发布日期:2020-12-09
通讯作者: 田华, Email: tianhua@bjmu.edu.cn
基金资助:
2016年北京大学第三医院临床重点项目——培育探索项目(多科)(BYSY2016010);2017年北京大学医学部教育教学研究课题(2017YB11)

The application of 3D printing technique in the teaching of total knee arthroplasty

Li Yang, Tian Hua, Zhang Ke

Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, China

Received:2017-12-17 Online:2018-10-01 Published:2020-12-09
Contact: Tian Hua, Email: tianhua@bjmu.edu.cn
Supported by:
Peking University Third Hospital Clinical Key Project in 2016-Cultivation and Exploration Project (Multi-Department) (BYSY2016010); Peking University Health Science Center Education and Teaching Research Subject in 2017 (2017YB11)

摘要/Abstract

摘要： 目的探讨3D打印技术在骨科全膝关节置换教学中的优势,辅助年轻医生加深对解剖结构的理解,提高他们的手术操作能力。方法在全膝关节置换术中应用3D打印技术,通过3D打印模型辅助术前计划教学并进行手术预演,利用3D打印截骨导板在术中指导截骨,利用3D打印软件在术后进行回顾与评估。结果 3D打印模型可以为年轻医生更直观地展示真实的解剖结构,手术预演也提供了对真实病例的操作机会。术中3D打印截骨导板的使用,可以在保证手术精准的同时,锻炼年轻医生的操作水平。术后3D打印软件可以帮助年轻医生深入理解复杂病例和定制假体,还可以进行远程教学。结论 3D打印技术在骨科全膝关节置换教学中具有明显的优势,作为一种高效的教学工具,在对年轻医生的培训中发挥着重要的作用。

关键词: 3D打印, 模型, 全膝关节置换, 临床教学

Abstract: Objective To demonstrate the advantages of 3D printing as a teaching tool in total knee arthroplasty and the effectiveness of improving the understanding on anatomy and operative skills of young trainee surgeons. Methods 3D printing in TKA provides 3D printing models which could assisted pre-operative training of design and provided surgical rehearsals, 3D printing cutting block which could guided intra-operative osteotomy, and 3D printing software which could reviewed the patient-specific implants results. Results The 3D printing model can show the real anatomical structure to young trainee surgeons more intuitively, and the surgical rehearsal on the model provide the opportunities to operate real cases for the trainees. With the intra-operative usage of cutting block, young trainee surgeons are going to have exercise whilst ensuring there is no detriment to patient safety. At last, 3D printing software will help young trainee surgeons understand the complex cases and the patient-specific implants, as well as used for distance education. Conclusions 3D printing has a valuable role as a training tool to improve young trainee surgeons skills for it have tremendous teaching advantages in total knee arthroplasty.

Key words: 3D printing, Model, Total knee arthroplasty, Clinical teaching

李杨, 田华, 张克. 3D打印技术在骨科膝关节置换术教学中的应用[J]. 中华医学教育杂志, 2018, 38(5): 734-738.

Li Yang, Tian Hua, Zhang Ke. The application of 3D printing technique in the teaching of total knee arthroplasty[J]. Chinese Journal of Medical Education, 2018, 38(5): 734-738.

参考文献

[1] Schubert C, van Langeveld MC, Donoso LA. Innovations in 3D printing: A 3D overview from optics to organs[J].The British Journal of Ophthalmology, 2014,98(2):159-61.DOI:10.1136/bjophthalmol-2013-304446.
[2] Kostusiak M, Hart M, Barone DG, et al. Methodological shortcomings in the literature evaluating the role and applications of 3D training for surgical trainees[J]. Medical Teacher,2017,39(11):1168-1173.DOI:10.1080/0142159X. 2017.1362102.
[3] Eisenmenger LB, Wiggins RH, Fults DW, et al. Application of 3-dimensional printing in a case of osteogenesis imperfecta for patient education, anatomic understanding, preoperative planning, and intraoperative evaluation[J].World Neurosurgery,2017,107:1049e1-1049e7.DOI:10.1016/j. wneu.2017.08.026.
[4] Bagaria V, Chaudhary K. A paradigm shift in surgical planning and simulation using 3D graphy: Experience of first 50 surgeries done using 3D-printed biomodels[J].Injury,2017,48(11):2501-2508.DOI:10.1016/j.injury.2017.08.058.
[5] 周华,于淼,刘忠军.3D打印模型在脊柱侧凸教学中的辅助作用[J].中国医学教育技术,2017,31(1):67-69.DOI:10.13566/j.cnki.cmet.cn61-1317/g4.201701020.
Zhou H, Yu M, Liu ZJ. Auxiliary role of 3D printing technology applied in the teaching of scoliosis[J].China Medical Education Technology,2017,31 (1):67-69.DOI:10.13566/j.cnki.cmet.cn61-1317/g4.201701020.
[6] 李明,孙亮,马腾,等.3D打印快速成型技术在髋臼骨折分型及年轻医生培养中的应用[J].中华创伤骨科杂志,2017,19(2):140-145.DOI:10.3760/cma.j.issn.1671-7600.2017.02.010.
Li M,Sun L,Ma T,et al. 3D-printing rapid prototyping used in classification of acetabular fractures and education of young surgeons[J]. Chinese Journal of Orthopaedic Trauma,2017,19(2):140-145.DOI:10.3760/cma.j.issn.1671-7600.2017.02.010.
[7] 艾松涛,曲扬,范新东,等.3D打印模具在本科医学影像学教学中的应用[J].中华医学教育探索杂志,2017,16(9):904-908.DOI:10.3760/cma.j.issn.2095-1485.2017.09.010.
Ai ST,Qu Y,Fan XD,et al. Application of 3D printing models in undergraduate medical imaging teaching[J].Chin J Med Edu Res,2017,16(9):904-908.DOI:10.3760/cma.j.issn.2095-1485.2017.09.010.
[8] 施凤伟,付军,郭征.3D打印技术在骨科学肿瘤教学中的应用[J].中华医学教育杂志,2015,35(6):916-917,934.DOI:10.3760/cma.j.issn.1673-677X.2015.06.033.
Shi FW,Fu J,Guo Z.The application of 3D printing technique in the oncology teaching of orthopedics[J].Chin J Med Edu,2015,35(6):916-917,934.DOI:10.3760/cma.j.issn.1673-677X.2015.06.033.
[9] Ventola CL.Medical applications for 3D printing:Current and projected uses[J].P&T,2014,39(10):704-711.
[10] Patra S, Young V. A review of 3D printing techniques and the future in biofabrication of bioprinted tissue[J].Cell Biochemistry and Biophysics,2016,74(2):93-98.DOI:10.1007/s12013-016-0730-0.
[11] Santini AJ, Raut V. Ten-year survival analysis of the PFC total knee arthroplasty: A surgeon's first 99 replacements[J].International Orthopaedics,2008,32(4):459-465.DOI:10.1007/s00264-007-0351-8.
[12] Bathis H,Perlick L,Tingart M,et al.Intraoperative cutting errors in total knee arthroplasty[J].Archives of Orthopaedic and Trauma Surgery,2005, 125(1):16-20.DOI:10.1007/s00402-004-0759-1.
[13] Hodgson A,Helmy N,Masri BA,et al.Comparative repeatability of guide-pin axis positioning in computer-assisted and manual femoral head resurfacing arthroplasty[J].Proc Inst Mech Eng H,2007,221(7):713-724.DOI:10.1243/09544119JEIM284.
[14] Luring C, Tingart M, Beckmann J,et al.Surgical training in orthopaedic and trauma departments in Germany[J].Zeitschrift fur Orthopadie und Unfallchirurgie,2010,148(4):466-470.DOI:10.1055/s-0030-1249792.
[15] Mahaluxmivala J,Bankes MJ,Nicolai P,et al.The effect of surgeon experience on component positioning in 673 press fit condylar posterior cruciate-sacrificing total knee arthroplasties[J].The Journal of Arthroplasty,2001,16(5):635-640.DOI:10.1054/arth.2001.23569.
[16] Ritter MA,Faris PM,Keating EM,et al.Postoperative alignment of total knee replacement.Its effect on survival[J].Clinical Orthopaedics and Related Research,1994(299):153-156.
[17] Hochman JB,Kraut J,Kazmerik K,et al.Generation of a 3D printed temporal bone model with internal fidelity and validation of the mechanical construct[J].Otolaryngology-Head and Neck Surgery,2014,150(3):448-454. DOI:10.1177/0194599813518008.
[18] Jones DB,Sung R,Weinberg C,et al.Three-dimensional modeling may improve surgical education and clinical practice[J].Surgical Innovation,2016,23 (2):189-195.DOI:10.1177/1553350615607641.
[19] 茹江英,时代,徐饶,等.应用个体定制三维打印截骨导板辅助行人工全膝关节置换术[J].中华关节外科杂志(电子版),2017,11(5):484-490.DOI:10.3877/cma.j.issn.1674-134X.2017.05.008.
Ru JY,Shi D,Xu R,et al.Application of three dementional printed positioning guides with patient-specific cutting block technique in total knee arthroplasty[J].Chinese Journal of Joint Surgery (Electronic Edition), 2017,11(5):484-490.DOI:10.3877/cma.j.issn.1674-134X.2017.05.008.
[20] 刘峰,张勇,朱庭标,等.3D打印截骨导板辅助TKA治疗膝外翻畸形[J].中国骨与关节损伤杂志,2017,32(3):329-331.DOI:10.7531/j.issn.1672-9935.2017.03.043.

3D打印技术在骨科膝关节置换术教学中的应用

The application of 3D printing technique in the teaching of total knee arthroplasty

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	凡玉杰, 由由, 李峰, 王维民, 陈娟. 学生参与理论视角下临床医学专业学生学业成绩的影响因素分析[J]. 中华医学教育杂志, 2020, 40(8): 632-636.
[2]	王敏, 宋鑫, 柯松, 徐源. 3D打印技术辅助教学方式提高骨科学教育目标层次的效果[J]. 中华医学教育杂志, 2020, 40(5): 358-361.
[3]	刘宏芝, 肖映胜, 李植锋, 黄瑞虹, 许少伟, 张永渠, 张凡, 陈少斌, 陈蕾, 曾德. 微信支持下的Mini-CEX联合DOPS在肿瘤学临床教学考核中的应用[J]. 中华医学教育杂志, 2020, 40(5): 362-366.
[4]	卢燕, 张颖, 何惧, 邹杰文. 多面拉希模型在医师资格考试第一阶段临床基本技能考试中的应用[J]. 中华医学教育杂志, 2020, 40(4): 311-315.
[5]	尚力, 杨丽娜, 姚洁敏, 李明, 英洪友. 中医各家学说教学中强化学生临床辨证思维能力培养的探索[J]. 中华医学教育杂志, 2020, 40(10): 753-756.
[6]	陈韬, 黄馨, 何晓川, 苏子杨, 袁健瑜, 胡雯珺. 计算机三维可视化技术在医学教育中的应用价值[J]. 中华医学教育杂志, 2020, 40(10): 788-791.
[7]	伍涛, 肖志宏, 颜学亮. 3D打印技术在临床医学专业本科生脊柱外科学教学中的应用[J]. 中华医学教育杂志, 2020, 40(10): 792-795.
[8]	庄惠文, 任红苗, 刘敏, 熊观霞, 吴旋. 外耳道模型联合传统教学在耳内镜手术培训中的应用[J]. 中华医学教育杂志, 2019, 39(7): 513-515.
[9]	冯攀. 乡村全科执业助理医师资格考试医学综合笔试认知能力模型评价研究[J]. 中华医学教育杂志, 2019, 39(6): 466-469.
[10]	史宏涛, 刘达瑾, 段丽琴, 郭晓晶, 柴泉芳, 侯晓红, 韩清华. 基于问题学习结合学生标准化病人在临床实践能力培养中的应用[J]. 中华医学教育杂志, 2019, 39(5): 353-356.
[11]	刘敬, 布娟. 传统教学结合循证医学教学方法在小儿眼科学临床教学中的应用研究[J]. 中华医学教育杂志, 2019, 39(3): 166-169.
[12]	洪颖, 杨嘉瑞, 李学民, 张纯, 王斯雅, 王薇. 导师团队制在眼科学专业学位研究生培养中的应用研究[J]. 中华医学教育杂志, 2019, 39(3): 219-222.
[13]	刘婷, 刘青, 付晓丽, 王贺, 郝义彬, 张思森, 文民刚. 多学科协作教学模式在全科医师心肺复苏临床教学中的应用研究[J]. 中华医学教育杂志, 2019, 39(12): 901-904.
[14]	史丹晖, 陈莉丽, 孙伟莲, 柯婷, 雷利红. 多功能牙周手术教学模型在牙周病学实验课程教学中的应用[J]. 中华医学教育杂志, 2019, 39(12): 910-913.
[15]	张勉, 刘一帆, 张俊华, 刘晓东, 于世宾, 王美青. 3D打印模型牙在牙体形态学教学中的应用[J]. 中华医学教育杂志, 2019, 39(12): 914-917.