Safety of 3D printed titanium alloy bone trabecular cup prosthesis combined with modified Kidney Tonifying and Blood Activating Decoction for elderly hip arthroplasty

doi:10.12307/2025.872

Abstract

Abstract: BACKGROUND: The titanium alloy bone trabecular bone socket cup prosthesis printed by 3D technology has superior biological characteristics, which helps to promote osteogenic differentiation of stem cells. The Kidney Tonifying and Blood Activating Decoction has the functions of tonifying the kidneys, strengthening tendons, promoting blood circulation, and relieving pain. However, the application of the combination of the two in elderly hip arthroplasty is rarely reported.
OBJECTIVE: To evaluate the application value and safety of 3D printed titanium alloy bone trabecular cup prosthesis combined with modified Kidney Tonifying and Blood Activating Decoction in elderly hip arthroplasty.
METHODS: A total of 200 elderly patients who received hip arthroplasty in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to January 2024 were selected and randomly divided into control group (n=100) and trial group (n=100). The control group underwent Pinnaele cup prosthesis hip arthroplasty combined with modified Kidney Tonifying and Blood Activating Decoction, while the trial group underwent 3D printed titanium alloy bone trabecular cup prosthesis hip arthroplasty combined with modified Kidney Tonifying and Blood Activating Decoction. The medication was taken continuously for 1 week before hip arthroplasty and for 4 weeks after arthroplasty. The differences in pain, swelling, hemorheology, inflammatory factors, bone metabolism, intra-articular stress, and hip abduction muscle strength were compared between the two groups to evaluate the clinical efficacy and safety of the two treatment options.
RESULTS AND CONCLUSION: (1) Four weeks after surgery, the pain visual analog scale score, limb swelling, whole blood viscosity, and plasma viscosity of the trial group were lower than those of the control group (P < 0.05). The interleukin-6 level of the trial group was lower than that of the control group, and the interleukin-10 level was higher than that of the control group (P < 0.05). The levels of type I collagen carboxyl terminal peptide β specific sequence and tartrate-resistant acid phosphatase 5b in the trial group were lower than those in the control group, while the levels of osteocalcin, bone-specific phosphatase and type I procollagen amino-terminal propeptide were higher than those in the control group (P < 0.05). The intra-articular stress and hip abduction muscle strength in the trial group were higher than that of the control group (P < 0.05). (2) Three months after surgery, the excellent and good treatment rate in the trial group was higher than that in the control group, and the incidence of safety evaluation events such as postoperative incision hematoma and infection was lower than that in the control group (P < 0.05). (3) It suggests that 3D printed titanium alloy trabecular acetabular cup prosthesis combined with modified Kidney Tonifying and Blood Activating Decoction can improve the blood rheology of elderly patients with hip arthroplasty, inhibit inflammatory response, reduce postoperative pain and swelling, and enhance bone metabolism, thereby promoting postoperative hip joint function recovery, and reducing the incidence of adverse events, with high safety.

Key words: elderly, hip arthroplasty, 3D printing, titanium alloy trabecular acetabular prosthesis, modified Kidney Tonifying and Blood Activating Decoction, orthopedic implants

CLC Number:

Wang Jiangjing, Zhao Na, Hu Xiaona, Zhao Na . Safety of 3D printed titanium alloy bone trabecular cup prosthesis combined with modified Kidney Tonifying and Blood Activating Decoction for elderly hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(3): 612-619.

Figures/Tables 10

References

[1] 李名桥,张明勇.全髋与半髋关节置换术治疗老年股骨颈骨折的疗效比较[J]. 临床骨科杂志,2023,26(1):33-37.
[2] LINDBERG-LARSEN M, VARNUM C, JAKOBSEN T, et al. Study protocol for discharge on day of surgery after hip and knee arthroplasty from the Center for Fast-track Hip and Knee Replacement. Acta Orthop. 2023;94(1):121-127.
[3] MA M, CAO Z, YANG M, et al. The invasiveness of robot-assisted total hip replacement is similar to that of conventional surgery. J Robot Surg. 2023;17(6):2987-2993.
[4] LI B, JU J, ZHAO J, et al. A nomogram to predict delirium after hip replacement in elderly patients with femoral neck fractures. Orthop Surg. 2022;14(12):3195-3200.
[5] 何振东,马才英,张维义,等.改良后外侧入路髋关节置换术治疗老年股骨颈骨折[J]. 临床骨科杂志,2023,26(1):28-32.
[6] 衡红全,杨渊,胡雪峰,等.前外侧入路半髋关节置换术治疗高龄股骨颈骨折的早期临床疗效[J]. 中华骨科杂志,2023,43(4):230-237.
[7] PERKINS TJ, KOP AM, WHITEWOOD C, et al. Dissociation of polyethylene liners with the Depuy Pinnacle cup: a report of 26 cases. Hip Int. 2023;33(1):28-33.
[8] 郭宇,王凌,丁育健,等.3D打印钛合金骨小梁金属臼杯联合植骨重建髋臼骨缺损的早期疗效[J]. 实用骨科杂志,2020,26(6):491-494.
[9] 熊福生,陈泽,周程林,等.补肾健骨活血汤对骨质疏松性人工髋关节置换术后假体周围骨密度及骨转化指标的影响[J]. 四川中医, 2022,40(9):147-150.
[10] 韩礼军,陈军,柯军宝.关节镜清理术联合补肾活血汤治疗对膝关节滑膜炎患者关节功能和血清骨代谢指标的影响[J]. 世界中西医结合杂志,2022,17(3):524-527,532.
[11] JIN Z, WANG L, QIN J, et al. Direct anterior approach versus posterolateral approach for total hip arthroplasty in the treatment of femoral neck fractures in elderly patients: a meta-analysis and systematic review. Ann Med. 2023;55(1):1378-1392.
[12] MIGLIORINI F, MAFFULLI N, TRIVELLAS M, et al. Total hip arthroplasty compared to bipolar and unipolar hemiarthroplasty for displaced hip fractures in the elderly: a Bayesian network meta-analysis. Eur J Trauma Emerg Surg. 2022;48(4):2655-2666.
[13] OUENDI N, AVRIL E, DERVAUX B, et al. Effectiveness of telerehabilitation programs in elderly with hip or knee arthroplasty: a systematic review. Telemed J E Health. 2024;30(6):1507-1521.
[14] 商广前,项帅,张鹏军,等. 3D打印骨小梁金属臼杯用于全髋关节置换翻修术的效果[J]. 中华创伤杂志,2021,37(7):628-634.
[15] 张欣,林文杰,贺彬,等. 髋臼内陷技术对成人DDH全髋关节置换术髋臼杯生物力学影响的有限元分析[J]. 医用生物力学,2024,39(3): 421-427.
[16] 郭宇,王凌,丁育健,等.3D打印钛合金骨小梁金属臼杯联合植骨重建髋臼骨缺损的早期疗效[J]. 实用骨科杂志,2020,26(6):491-494.
[17] 唐魁韩,孔令超,刘益宏,等.3D打印钛合金骨小梁杯联合抗骨质疏松治疗的早期临床疗效[J]. 生物骨科材料与临床研究,2020, 17(5):10-14,20.
[18] 周建敏,汪文玉,付晓玲,等. 3D打印个性化导航模板在初次髋关节置换后假体翻修术中的应用价值[J]. 中国老年学杂志,2022,42(8): 1860-1862.
[19] 冯坤,陆欧,吴小宝,等. 3D打印导板在髋关节置换中的应用[J]. 国际外科学杂志,2022,49(11):788-792.
[20] 刘晨,张克,杨滨. 标准化3D打印多孔钛合金髋臼杯全髋关节置换术的中期疗效[J]. 陆军军医大学学报,2022,44(15):1538-1541.
[21] FACCO G, GRECO L, MANDOLINI M, et al. Assessing 3-D printing in hip replacement surgical planning. Radiol Technol. 2022;93(3):246-254.
[22] HEALTHCARE ENGINEERING JO. Retracted: study on the application value of CT thin-layer scan data assisted 3D printing technology in hip and knee replacement. J Healthc Eng. 2023;23(1):9845406.
[23] ZHANG C, CHEN H, FAN H, et al. Carpal bone replacement using personalized 3D printed tantalum prosthesis. Front Bioeng Biotechnol. 2023;11(1):1234052.
[24] CHEN Y, ZHANG B. 3D printing-assisted total hip arthroplasty and internal fixation for the treatment of fresh acetabular fracture and femoral head necrosis: a case report. Medicine (Baltimore). 2023;102(52):e36832.
[25] 马宁,王聪,柳宁强,等.3D打印钛合金骨小梁金属臼杯在全髋关节置换中的稳定性[J]. 中国组织工程研究,2022,26(33):5278-5282.
[26] ZHANG H, GUAN JZ, ZHANG Z, et al. Restoring rotation center in total hip arthroplasty for developmental dysplasia of the hip with the assistance of three dimensional printing technology: a pilot study. Orthop Surg. 2022;14(1):119-128.
[27] LOU L, DING H, CHEN Y, et al. Application of 3D-printed acetabular lateral pad in primary total hip replacement: a case report and literature review. Asian J Surg. 2023;46(8):3195-3196.
[28] TU Q, DING HW, CHEN H, et al. Preliminary application of 3D-printed individualised guiding templates for total hip arthroplasty in crowe type IV developmental dysplasia of the hip. Hip Int. 2022;32(3): 334-344.
[29] RANZZI A, LUCENA RL, SCHWARTSMANN CR, et al. Comparative study with and without the use of 3D prototyping of an unconventional technique in the surgical planning of revision of total hip arthroplasty. Rev Bras Ortop (Sao Paulo). 2021;57(5):884-890.
[30] CHEN G, WANG CY, MA Z, et al. A prospective and consecutive study assessing short- term clinical and radiographic outcomes of Chinese domestically manufactured 3D printing trabecular titanium acetabular cup for primary total hip arthroplasty: evaluation of 236 cases. Front Surg. 2024;11(1):1279194.
[31] 张家金,黄文凭,曹勇,等. 补肾活血汤治疗肱骨近端骨折的效果[J]. 西北药学杂志,2024,39(4):135-138.
[32] 张海平. 补肾活血汤加味方联合正骨灵胶囊用于骨质疏松性骨折术后的效果分析[J]. 中国基层医药,2023,30(3):336-340.
[33] 施乐,张超,季文辉,等. 补肾活血汤治疗股骨头坏死的作用机制研究[J]. 世界中医药,2020,15(16):2377-2380.
[34] 詹云佳,金侠,王雪飞,等. 改良后路小切口髋关节置换术对老年股骨颈骨折患者髋关节功能及术后PINP、BAP、BGP水平的影响[J]. 临床和实验医学杂志,2022,21(3):320-324.
[35] 王斌,王波. 3D-精准构建臼杯和生物型臼杯系统在全髋关节置换手术中的应用效果及对患者骨特异性磷酸酶、骨钙素、Ⅰ型前胶原氨基端前肽水平的影响[J]. 陕西医学杂志,2023,52(5): 575-578,603.
[36] 李祎,李奎蒙,郑海. 不同手术对高龄股骨粗隆间骨折患者髋关节功能及术后恢复的影响[J]. 川北医学院学报,2024,39(4):461-464.
[37] 胡光辉,刘亚峰. 唑来膦酸注射液对行髋关节置换术患者骨代谢的影响[J]. 新乡医学院学报,2023,40(10):960-964
[38] 夏天卫,周国威,刘金柱,等. 基于网络药理学探究补肾活血汤治疗股骨头坏死的作用机制[J]. 山东中医杂志,2021,40(1):25-31.
[39] 熊福生,陈泽,周程林,等. 补肾健骨活血汤对骨质疏松性人工髋关节置换术后假体周围骨密度及骨转化指标的影响[J]. 四川中医,2022,40(9):147-150.
[40] 赵红星,张超,陶金刚,等. 不同入路的髋关节置换术的早期疗效和炎性应激研究[J]. 中华实验外科杂志,2023,40(6):1171-1174.
[41] 刘源,刘金豹,许波,等. 补肾活血汤治疗股骨头坏死的分子靶点及机制:网络药理学及蛋白模块分析[J]. 中国组织工程研究,2021, 25(17):2703-2710.