Filling the gap: a series of 3D-printed titanium truss cages for the management of large, lower limb bone defects in a developing country setting

Gamieldien, Hammaad; Ferreira, Nando; Birkholtz, Franz; Hilton, Thomas L.; Campbell, Neil; Laubscher, Maritz

doi:10.1007/s00590-022-03434-5

Cited by 10 publications

(16 citation statements)

References 34 publications

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“…Zhao [ 11 ] used a porous prosthesis combined with a locking plate in 14 patients; none of whom developed implant-related complications at the final follow-up. Hammaa [ 34 ] used custom 3D-printed titanium truss cages combine with intramedullary nails also achieved favorable clinical outcomes with no occurrences of implant loosening. The formation of the bone bridge and the distance of infiltration into the implant may contribute to prosthesis stability.…”

Section: Discussionmentioning

confidence: 99%

3D-printed titanium porous prosthesis combined with the Masquelet technique for the management of large femoral bone defect caused by osteomyelitis

Chen,

Xing,

et al. 2024

BMC Musculoskelet Disord

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Background The treatment of infected bone defects remains a clinical challenge. With the development of three-dimensional printing technology, three-dimensional printed implants have been used for defect reconstruction. The aim of this study was to investigate the clinical outcomes of three-dimensional printed porous prosthesis in the treatment of femoral defects caused by osteomyelitis. Methods Eleven patients with femoral bone defects following osteomyelitis who were treated with 3D-printed porous prosthesis at our institution between May 2017 and July 2021, were included. Eight patients were diagnosed with critical-sized defects, and the other three patients were diagnosed with shape-structural defects. A two-stage procedure was performed for all patients, and the infection was eradicated and bone defects were occupied by polymethylmethacrylate spacer during the first stage. The 3D-printed prosthesis was designed and used for the reconstruction of femoral defects in the second stage. Position of the reconstructed prostheses and bone growth were measured using radiography. The union rate, complications, and functional outcomes at the final follow-up were assessed. Results The mean length of the bone defect was 14.0 cm, union was achieved in 10 (91%) patients. All patients showed good functional performance at the most recent follow-up. In the critical-sized defect group, one patient developed a deep infection that required additional procedures. Two patients had prosthetic dislocations. Radiography demonstrated good osseous integration of the implant–bone interface in 10 patients. Conclusion The 3D printed prostheses enable rapid anatomical and mechanically stable reconstruction of extreme femur bone defects, effectively shortens treatment time, and achieves satisfactory clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

3D-printed titanium porous prosthesis combined with the Masquelet technique for the management of large femoral bone defect caused by osteomyelitis

Chen,

Xing,

et al. 2024

BMC Musculoskelet Disord

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“…In particular, there is an interest in strategies that allow separate bone marrow harvesting and thus the possibility of controlled transplantation in combination with bone chips [ 21 ]. This is the rationale behind advancing research into these strategies of intramedullary BG harvesting as an integral part of evolving the SGBR concept [ 1 , 5 , 7 , 36 , 39 ]. It is noteworthy that many attempts to induce or enhance bone formation with patient-derived cells, growth factors, and cytokines alone or in combination with 3D-printed implants have failed clinically [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, its rather small total cell pool [ 70 ] and limited capacity for controlled release of osteogenic proteins [ 21 ] provide clues as to why we also observed greater variability in bone regeneration in the ScARA group compared to the ScRIA2 and ScRA groups in this study. This also demonstrates why BGs with high bone chip content rather than bone marrow are used in the current clinical cases of SGBR [ 2 , 3 , 7 , 39 ] and why further development of concepts of intramedullary harvesting of endosteal bone chips (such as the ARA intramedullary harvesting concept [ 21 ]) are highly relevant.…”

Section: Discussionmentioning

confidence: 99%

An innovative intramedullary bone graft harvesting concept as a fundamental component of scaffold-guided bone regeneration: A preclinical in vivo validation

Laubach,

Herath,

Suresh

et al. 2024

Journal of Orthopaedic Translation

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“…Another option for treatment of extensive diaphyseal and metaphyseal bone defects, emerging for the latest 20 years, is presented by 3D printed scaffolds for hard tissue replacement [ 56 , 57 ]. This technique gives an alternative method to repair bone defects caused by osteomyelitis or trauma [ 58 , 59 ]. Materials for large bone defect reconstruction required to ensure high resistance to mechanical load.…”

Section: Discussionmentioning

confidence: 99%

Long Bone Defect Filling with Bioactive Degradable 3D-Implant: Experimental Study

et al. 2023

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Previously, 3D-printed bone grafts made of titanium alloy with bioactive coating has shown great potential for the restoration of bone defects. Implanted into a medullary canal titanium graft with cellular structure demonstrated stimulation of the reparative osteogenesis and successful osseointegration of the graft into a single bone-implant block. The purpose of this study was to investigate osseointegration of a 3D-printed degradable polymeric implant with cellular structure as preclinical testing of a new technique for bone defect restoration. During an experimental study in sheep, a 20 mm-long segmental tibial defect was filled with an original cylindrical implant with cellular structure made of polycaprolactone coated with hydroxyapatite. X-ray radiographs demonstrated reparative bone regeneration from the periosteum lying on the periphery of cylindrical implant to its center in a week after the surgery. Cellular structure of the implant was fully filled with newly-formed bone tissue on the 4th week after the surgery. The bone tissue regeneration from the proximal and distal bone fragments was evident on 3rd week. This provides insight into the use of bioactive degradable implants for the restoration of segmental bone defects. Degradable implant with bioactive coating implanted into a long bone segmental defect provides stimulation of reparative osteogenesis and osseointegration into the single implant-bone block.

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Filling the gap: a series of 3D-printed titanium truss cages for the management of large, lower limb bone defects in a developing country setting

Cited by 10 publications

References 34 publications

3D-printed titanium porous prosthesis combined with the Masquelet technique for the management of large femoral bone defect caused by osteomyelitis

3D-printed titanium porous prosthesis combined with the Masquelet technique for the management of large femoral bone defect caused by osteomyelitis

An innovative intramedullary bone graft harvesting concept as a fundamental component of scaffold-guided bone regeneration: A preclinical in vivo validation

Long Bone Defect Filling with Bioactive Degradable 3D-Implant: Experimental Study

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