Evaluation of Clinical Performance of TiNi-Based Implants Used in Chest Wall Repair after Resection for Malignant Tumors

Abstract

In this study, we assessed the outcomes after surgical treatment of thoracic post-excision defects in 15 patients, using TiNi knitted surgical meshes and customized artificial TiNi-based ribs. Methods: Eight patients were diagnosed with advanced non-small cell lung cancer (NSCLC) invading the chest wall, of which five patients were T3N0M0, two were T3N1M0, and one was T3N2M0. Squamous cell carcinoma was identified in three of these patients and adenocarcinoma in five. In two cases, chest wall resection and repair were performed for metastases of kidney cancer after radical nephrectomy. Three-dimensional CT reconstruction and X-ray scans were used to plan the surgery and customize the reinforcing TiNi-based implants. All patients received TiNi-based devices and were prospectively followed for a few years. Results: So far, there have been no lethal outcomes, and all implanted devices were consistent in follow-up examinations. Immediate complications were noted in three cases (ejection of air through the pleural drains, paroxysm of atrial fibrillation, and pleuritis), which were conservatively managed. In the long term, no complications, aftereffects, or instability of the thoracic cage were observed. Conclusion: TiNi-based devices used for extensive thoracic lesion repair in this context are promising and reliable biomaterials that demonstrate good functional, clinical, and cosmetic outcomes.

Repair of Large-Scale Rib Defects Based on Steel-Reinforced Concrete-Designed Biomimetic 3D-Printed Scaffolds with Bone-Mineralized Microenvironments

“…The soft tissue could be easily reconstructed by covering with the surrounding muscles or transmyocutaneous flaps . However, the bony structure is difficult to reconstruct, especially for large-scale rib defects, owing to the lack of satisfactory bone repair materials. , At present, artificial materials such as steel plates or ceramics are mainly used in clinics. ,, However, clinical requirements have not yet been fully satisfied by artificial materials because of the lack of biological activity and physiological functions and the possibility of complications such as foreign body rejection and infection. , …”

“…6,7 At present, artificial materials such as steel plates or ceramics are mainly used in clinics. 6,8,9 However, clinical requirements have not yet been fully satisfied by artificial materials because of the lack of biological activity and physiological functions and the possibility of complications such as foreign body rejection and infection. 10,11 Currently, tissue engineering based on seed cells and biodegradable scaffolds is considered a promising strategy for physiological bone regeneration and functional reconstruction.…”

Successful reconstruction of the chest wall frame with superelastic nickel-titanium 3D modules in a patient with multiple locally recurrent leiomyosarcoma

“…Для предотвращения этих патологических состояний необходима реконструкция каркаса грудной стенки с использованием специальных материалов, имитирующих функцию ребер или грудины. Кроме опорной функции для покровных и мягких тканей, функции защиты органов грудной полости такая реконструкция должна также обеспечивать восста -новление биомеханики дыхания [9,10]. Вопрос выбора материала и формы армирующего имплантата с заданными медико-техническими характеристиками остается актуальным.…”

“…В то же время жесткая фиксация пластинами, спицами, цементными и композитными изделиями, особенно на большой площади, приводит либо к ригидности грудной клетки и тяжелым рестриктивным нарушениям дыхания, либо к закономерному расшатыванию и нестабильности имплантированных конструкций, их миграции и повреждению прилежащих органов и анатомических структур. Кроме того, недостаточная биосовместимость имплантатов приводит к излишней воспалительной реакции и их отторжению [9][10][11].…”

“…В настоящее время используют различные материалы и способы закрытия дефектов грудной стенки. Для реконструкции жесткого каркаса широко применяют пластины Gore-Tex, костный цемент в сочетании с полипропиленовой сеткой или сосудистыми протезами и армирующими металлическими спицами, титановые конструкции (системы STRATOS, SYNTHES), набирающие популярность 3D-титановые индивидуальные изделия на основе аддитивных технологий, а также никелид-титановые сетки, протезы ребер и их комбинации [3,[7][8][9][10][12][13][14][15][16][17].…”