Customized three dimensional printed prosthesis as a novel intercalary reconstruction for resection of extremity bone tumours: a retrospective cohort study,International Orthopaedics

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Customized three dimensional printed prosthesis as a novel intercalary reconstruction for resection of extremity bone tumours: a retrospective cohort study
International Orthopaedics ( IF 2.0 ) Pub Date : 2022-09-09 , DOI: 10.1007/s00264-022-05559-y
Zhao Zhang ₁ , Yubo Shi ₁ , Jun Fu ₁ , Dong Liu ₁ , Dongze Zhu ₁ , Xincheng Liu ₁ , Jingyi Dang ₁ , Hongbin Fan ₁

Affiliation

Aims

The 3D-printed prosthesis (3DP) is a novel treatment for massive bone defect reconstruction after tumor resection. This study was aiming to explore the clinical efficacy of customized 3DP for intercalary reconstruction by comparing the clinical outcomes after implanting customized 3DP or conventional allograft in limb salvage surgery.

Methods

A total of 28 patients with extremity bone tumors who underwent customized 3DP or conventional allograft reconstruction between 2011 and 2018 at our institution were analyzed retrospectively. Among them, 14 cases received customized 3DP reconstruction (3DP group), and 14 cases received conventional allograft reconstruction (control group). Demographics, surgical outcomes, radiographical assessments, limb functions, and post-operative complications between these two groups were collected to evaluate clinical outcomes.

Results

No significant difference was observed in the demographics, mean intra-operative blood loss, MOSI scores, and MSTS scores between the two groups. Patients in 3DP group had a shorter operative time (157.9 vs 199.6 min, p = 0.03) and lesser number of fluoroscopy (4.1 vs 8.1, p < 0.001) compared to control group. The mean time to osseointegration at bone-implant interfaces in 3DP group was significantly earlier than that in control group (6.1 vs 12.2 months, p < 0.001). Moreover, the 3DP group had a significantly lower post-operative complication rate than the control group (7% vs 50%, p = 0.03).

Conclusions

The customized 3DP might provide a promising strategy for intercalary reconstruction in limb salvage surgery with more precise reconstruction, higher surgical efficiency, and comparable satisfactory clinical outcomes.

中文翻译：

定制的三维打印假体作为一种用于切除四肢骨肿瘤的新型介入重建：一项回顾性队列研究

宗旨

3D 打印假体 (3DP) 是一种用于肿瘤切除后大块骨缺损重建的新型治疗方法。本研究旨在通过比较在保肢手术中植入定制 3DP 或常规同种异体移植物后的临床结果，探讨定制 3DP 用于闰间重建的临床疗效。

方法

回顾性分析 2011 年至 2018 年在我院接受定制 3DP 或常规同种异体移植重建的 28 例肢体骨肿瘤患者。其中14例接受定制3DP重建（3DP组），14例接受常规同种异体移植重建（对照组）。收集这两组之间的人口统计学、手术结果、影像学评估、肢体功能和术后并发症以评估临床结果。

结果

两组间在人口统计学、平均术中失血量、MOSI 评分和 MSTS 评分方面未观察到显着差异。与对照组相比，3DP 组患者的手术时间更短（157.9 vs 199.6 分钟，p = 0.03），透视次数更少（4.1 vs 8.1，p < 0.001）。3DP 组骨-种植体界面骨整合的平均时间明显早于对照组（6.1 个月对 12.2 个月，p < 0.001）。此外，3DP 组的术后并发症发生率明显低于对照组（7% 对 50%，p = 0.03）。