Reconstruction of the proximal radius with 3D-printed personalized prosthesis after tumor resection: case series

Li, Zhuangzhuang; Lu, Minxun; Zhang, Yuqi; Gong, Taojun; Wang, Jie; Luo, Yi; Zhou, Yong; Chang, Qing; Lin, Jingqi; Min, Li; Tu, Chongqi

doi:10.1016/j.jse.2023.08.032

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…For functional outcomes, the achievement of satisfactory results can be attributed to four key factors: i) Precise Implantation: The use of custom-designed prostheses and cutting guides ensures an anatomically precise fit, overcoming challenges associated with aligning modular pelvic prostheses with diverse defects [ 11 , 53 ]. ii) Secure Fixation: Effective prosthesis fixation promotes initial stability, crucial for osseointegration and preventing early aseptic loosening [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Advanced Pelvic Girdle Reconstruction with three dimensional-printed Custom Hemipelvic Endoprostheses following Pelvic Tumour Resection

Hu,

Lu,

Wang

et al. 2024

International Orthopaedics (SICOT)

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Purpose Resection of pelvic bone tumours and subsequent pelvic girdle reconstruction pose formidable challenges due to the intricate anatomy, weight-bearing demands, and significant defects. 3D-printed implants have improved pelvic girdle reconstruction by enabling precise resections with customized guides, offering tailored solutions for diverse bone defect morphology, and integrating porous surface structures to promote osseointegration. Our study aims to evaluate the long-term efficacy and feasibility of 3D-printed hemipelvic reconstruction following resection of malignant pelvic tumours. Methods A retrospective review was conducted on 96 patients with primary pelvic malignancies who underwent pelvic girdle reconstruction using 3D-printed custom hemipelvic endoprostheses between January 2017 and May 2022. Follow-up duration was median 48.1 ± 17.9 months (range, 6 to 76 months). Demographic data, imaging examinations, surgical outcomes, and oncological evaluations were extracted and analyzed. The primary endpoints included oncological outcomes and functional status assessed by the Musculoskeletal Tumor Society (MSTS-93) score. Secondary endpoints comprised surgical duration, intraoperative bleeding, pain control and complications. Results In 96 patients, 70 patients (72.9%) remained disease-free, 15 (15.6%) had local recurrence, and 11 (11.4%) succumbed to metastatic disease. Postoperatively, function improved with MSTS-93 score increasing from 12.2 ± 2.0 to 23.8 ± 3.8. The mean operating time was 275.1 ± 94.0 min, and the mean intraoperative blood loss was 1896.9 ± 801.1 ml. Pain was well-managed, resulting in substantial improvements in VAS score (5.3 ± 1.8 to 1.4 ± 1.1). Complications occurred in 13 patients (13.5%), including poor wound healing (6.3%), deep prosthesis infection (4.2%), hip dislocation (2.1%), screw fracture (1.0%), and interface loosening (1.0%). Additionally, all patients achieved precise implantation of customized prosthetics according to preoperative plans. T-SMART revealed excellent integration at the prosthesis-bone interface for all patients. Conclusion The use of a 3D-printed custom hemipelvic endoprosthesis, characterized by anatomically designed contours and a porous biomimetic surface structure, offers a potential option for pelvic girdle reconstruction following internal hemipelvectomy in primary pelvic tumor treatment. Initial results demonstrate stable fixation and satisfactory mid-term functional and radiographic outcomes.

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Section: Discussionmentioning

confidence: 99%