Clinical study of 3D printed personalized prosthesis in the treatment of bone defect after pelvic tumor resection

Xu, Lin; Qin, Hao; Tan, Jia; Cheng, Zhilin; Luo, Xiang; Tan, Hua-Qiao; Huang, Wenhua

doi:10.1016/j.jot.2021.05.007

Cited by 37 publications

(22 citation statements)

References 21 publications

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“…Materials are widely applied in medical practice including bone defect, joint replacement, and dental implant [ 111 – 113 ]. The underlying mechanisms are closely related to biological responses especially immune responses.…”

Section: Advances In Antiosteoporosis Drugs and Biomaterialsmentioning

confidence: 99%

Insights into the Role of Macrophage Polarization in the Pathogenesis of Osteoporosis

Wang

Liu

et al. 2022

Oxidative Medicine and Cellular Longevity

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Millions of people worldwide suffer from osteoporosis, which causes bone fragility and increases the risk of fractures. Osteoporosis is closely related to the inhibition of osteogenesis and the enhancement of osteoclastogenesis. In addition, chronic inflammation and macrophage polarization may contribute to osteoporosis as well. Macrophages, crucial to inflammatory responses, display different phenotypes under the control of microenvironment. There are two major phenotypes, classically activated macrophages (M1) and alternatively activated macrophages (M2). Generally, M1 macrophages mainly lead to bone resorption, while M2 macrophages result in osteogenesis. M1/M2 ratio reflects the “fluid” state of macrophage polarization, and the imbalance of M1/M2 ratio may cause disease such as osteoporosis. Additionally, antioxidant drugs, such as melatonin, are applied to change the state of macrophage polarization and to treat osteoporosis. In this review, we introduce the mechanisms of macrophage polarization-mediated bone resorption and bone formation and the contribution to the clinical strategies of osteoporosis treatment.

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Section: Advances In Antiosteoporosis Drugs and Biomaterialsmentioning

confidence: 99%

Insights into the Role of Macrophage Polarization in the Pathogenesis of Osteoporosis

Wang

Liu

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…Advances in 3D printing technology revolutionized the surgical approach to large bone defects in musculoskeletal oncology and revision surgery; this technology allows reconstruction of wide areas after bone resection tailored to the patient, as an alternative to large allograft or modular prostheses, ensuring a better anatomical fit with much more stability and strength in body weight bearing, due to biomechanical properties of porous titanium [ 12 , 15 , 16 , 25 , 26 , 27 , 28 , 29 , 30 ]. For example, for specific skeletal segments, such as scapula, clavicle and pelvic bones, there are not any modular prostheses available and reconstruction with massive bone grafting is associated with several disadvantages, including the risk of mismatch, immune rejection, fracture and infection [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Three-Dimension-Printed Custom-Made Prosthetic Reconstructions in Bone Tumors: A Single Center Experience

et al. 2022

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Bone can be affected by different neoplastic conditions. Limb salvage surgery has become the preferred treatment strategy for most malignant tumors of the extremities. Advanced 3D printing technology has transformed the conventional view of oncological surgery. These types of implants are produced by electron beam melting (EBM) technology by sintering titanium powder in a scaffold shape designed following a project designed from HRCT and MRI. The aim of our study was to evaluate the outcomes and the mid-term follow-up of a population treated with 3D-printed custom-made prosthesis implantation in major oncological bone resection or after failure of primary implants. The primary outcome was the general patient satisfaction one year after surgery. The secondary outcomes were: mortality rate, treatment related complication rate, functional and clinical outcomes (KPS, ADL and IADL). Eight patients were included, five females and two males, with a mean age of 50.3 (±23.72) years at the surgery. The enrolled patients reported a mean satisfaction rate after surgery of 7.38 (±2) where 10 was the maximum value. There were no changes between pre- and postoperative mean KPS (81.43 +/-10.69). Mean preoperative ADL and IADL score was in both cases 4.86 (±1.07), while postoperative was 5 (±0.82), with a delta of 0.13 (p > 0.05). Custom-made prosthesis permits reconstructing bone defects caused by large tumor resection, especially in anatomically complex areas, restoring articular function.

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“…Especially for bone tumors, patient-specific resection guides based on preoperative imaging (patient-specific instrumentation) may possibly help to obtain precise and reliable resection results. Promising results have been reported for such an approach in pelvic bone tumors [ 112 , 113 , 114 , 115 ], a situation where clear margins are particularly difficult to achieve.…”

Section: Current Trends and Future Perspectivesmentioning

confidence: 99%

Surgical Treatment of Bone Sarcoma

Bläsius

Delbrück

Hildebrand

et al. 2022

Cancers

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Bone sarcomas are rare primary malignant mesenchymal bone tumors. The three main entities are osteosarcoma, chondrosarcoma, and Ewing sarcoma. While prognosis has improved for affected patients over the past decades, bone sarcomas are still critical conditions that require an interdisciplinary diagnostic and therapeutic approach. While radiotherapy plays a role especially in Ewing sarcoma and chemotherapy in Ewing sarcoma and osteosarcoma, surgery remains the main pillar of treatment in all three entities. After complete tumor resection, the created bone defects need to be reconstructed. Possible strategies are implantation of allografts or autografts including vascularized bone grafts (e.g., of the fibula). Around the knee joint, rotationplasty can be performed or, as an alternative, the implantation of (expandable) megaprostheses can be performed. Challenges still associated with the implantation of foreign materials are aseptic loosening and infection. Future improvements may come with advances in 3D printing of individualized resection blades/implants, thus also securing safe tumor resection margins while at the same time shortening the required surgical time. Faster osseointegration and lower infection rates may possibly be achieved through more elaborate implant surface structures.

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Clinical study of 3D printed personalized prosthesis in the treatment of bone defect after pelvic tumor resection

Cited by 37 publications

References 21 publications

Insights into the Role of Macrophage Polarization in the Pathogenesis of Osteoporosis

Insights into the Role of Macrophage Polarization in the Pathogenesis of Osteoporosis

Three-Dimension-Printed Custom-Made Prosthetic Reconstructions in Bone Tumors: A Single Center Experience

Surgical Treatment of Bone Sarcoma

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