Objective: To evaluate the feasibility of arthroplasty with varisized three-dimensional(3D) printing lunate prosthesis for the treatment of advanced Kienböck's disease (KD).Methods: From 2016 November to 2018 September, a retrospective study was performed for the patients of KD in our hospital. Five patients (two males, three females) were included in this study. The mean age of the patients at the time of surgery was 51.6 years (range, 37-64 years). Varisized prosthesis identical to the live model in a ratio of 1:0.85, 1:1, and 1:1.1 were fabricated by 3D printing. All patients (one in Lichtman IIIA stage, two in Lichtman IIIB stage, one in Lichtman IIIC stage, and one in Lichtman IV stage) were treated with lunate excision and 3D printing prosthetic arthroplasty. Visual analog scale score (VAS), the active movement of wrist (extension, flexion) and strength were assessed preoperatively and postoperatively. The Mayo Modified Wrist Score (MMWS), Disabilities of the Arm, Shoulder and Hand (DASH) Score, and patient's satisfaction were evaluated during the follow-up.Results: Prosthesis identical to the live model in a ratio of 1:0.85 or 1:1 were chosen for arthroplasty. The mean operation time (range, 45 to 56 min) was 51.8 AE 4.44 min. Follow-up time ranged from 11 months to 33 months with the mean value of 19.4 months. The mean extension range of the wrist significantly increased from preoperative 44 AE 9.6 to postoperative 60 AE 3.5 (P < 0.05). The mean flexion range of the wrist significantly increased from preoperative 40 AE 10.6 to postoperative 51 AE 6.5 (P < 0.05). The active movement of wrist and strength were improved significantly in all patients. VAS was significantly reduced from 7.3 preoperatively to 0.2 at the follow-up visit (P < 0.05). The mean DASH score was 10 (range, 7.2-14.2), and the mean MMWS was 79 (range, 70-90). There were no incision infection. All patients were satisfied with the treatment.Conclusions: For patients suffering advanced Kienböck's disease, lunate excision followed by 3D printing prosthetic arthroplasty can reconstruct the anatomical structure of the carpal tunnel, alleviate pain, and improve wrist movement.

mPI and mLSA can better describe the pelvic morphology and local deformity of pediatric high-grade L5 spondylolisthesis, and mLSA can serve as a useful index for correcting lumbosacral kyphosis, rebalancing the sagittal spinal profile and predicting clinical outcomes.

The digitalization of medicine promises great advances for global health. Combined with three-dimensional (3D) printing technology, noncontact optical scanner, and computer-aided design, we can make personalized 3D printing scoliosis orthosis for patients across the country - with better diagnostics, personalized treatments, and early disease prevention. We hope optimize the production process of scoliosis orthotics, improve the production efficiency of orthotics, and promote the clinical transformation of 3D-printed scoliosis orthosis. To standardize the design, manufacture, materials, and clinical applications of 3D printing technology in the scoliosis orthosis, Chinese experts in relevant fields were organized to formulate this expert consensus.