Custom-Made 3D-Printed Implants as Novel Approach to Reconstructive Surgery after Oncologic Resection in Pediatric Patients

Abstract

Recently, custom-made 3D-printed prostheses have been introduced for limb salvage surgery in adult patients, but their use has not been described in pediatric patients. A series of 11 pediatric patients (mean age 10.8 years; range 2–13) with skeletal tumors treated with custom-made implants for the reconstruction of bony defects is described. Patients were followed up every 3 months. Functional results were evaluated by the Musculoskeletal Tumor Society Score (MSTS) for upper and lower limbs. The mean follow-up was 25.7 months (range 14–44). Three patients died after a mean of 19.3 months postoperatively—two because of disease progression and the other from a previous malignancy. Three patients experienced complications related to soft tissues. One patient required device removal, debridement, and antibiotic pearls for postoperative infection. Partial osseointegration between grafts and host bone was observed within a mean of 4 months. At the final follow-up, mean MSTS score was 75%. 3D prostheses may yield biological advantages due to possible integration with the host bone and also through the use of vascularized flaps. Further research is warranted.

Surgical Outcomes and Complications of Custom-Made Prostheses in Upper Limb Oncological Reconstruction: A Systematic Review

“…In articles regarding both upper and lower limbs, data were extracted and sorted by the different bone districts [19][20][21] (Table 1). The studies counted 145 patients overall, 59.31% of patients (86) were male and 40.69% (59) were female.…”

The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals—Cross-Sectional Multispecialty Review

“…The custom implants seemed to yield benefits, but some patients were lost due to the progression of the disease, and in one case, removal of the implant was necessary due to infection. However, the results were promising [ 40 ].…”

Application of 3-dimensional printing implants for bone tumors

“…However, long-term results are needed to properly evaluate clinical outcomes and complications (Table 1). 15,[18][19][20][35][36][37][38][39] Concerns about 3D implants are longevity related to the mechanical properties of the metal products made by a new fabrication method, metal powder-based AM. Clinical evidence for implant longevity is limited in previous studies due to the short follow-up period.…”

“…Compared to limb salvage surgery using conventional implants, 3D-implant surgery does not cause unexpected new complications or a high complications rate. However, long-term results are needed to properly evaluate clinical outcomes and complications ( Table 1 ) [ 15 , 18 - 20 , 35 - 39 ].…”