Types of surgery for cancer treatment using 3D-printed implants

Abstract

Introduction. Routine endoprosthesis production does not have ready solutions for such rare locations as forearm bones, scapula, and breastbone. In the last decade, 3D printing of personalized implants has been actively developing. Its benefits are accurate anatomical compliance with the resected segment, quick manufacturing time, and low cost. Oncoortopedics finds use of more additional technologies.Aim. To show through clinical observations the advantages of qualitatively new biologically and mechanically compatible implants used to replace bone defects in anatomically complex locations and to promote the use of such endoprosthesis in clinical practice.Materials and methods. Organ-saving treatment using personalized implants manufactured using 3D printing technology was performed in 7 patients with bone tumors: 3 with primary bone tumors (sarcomas) and 4 with metastases. Tumor lesions were localized in the humerus in 2 cases, in the scapula in 2 cases, in the breastbone in 2 cases, and in the distal part of the radius in 1 case. The implants were designed based in the spiral computed tomography data. For implant manufacturing, direct metal laser sintering (DMLS) was used. Titanium alloy Ti6Al4V certified for production of medical implants was used as the material. Design and manufacturing took 3 weeks.Results. Morphological examination showed negative tumor resection margin in all patients. All 7 patients are alive. No intraoperative complications were reported. Follow up varied between 1 and 8 months. During follow up, disease progression was not observed. Mean functional score per the Musculoskeletal Tumour Society score (MSTS) was 80 % (between 72 and 94 %).Conclusion. Development of qualitatively new Russian oncological implants using 3D-printing technology is one of the most important areas in bone pathology.