3D printing guide plate for accurate hemicortical bone tumor resection in metaphysis of distal femoral: a technical note

Abstract

Background Surgical resection and reconstruction for low-grade bone sarcoma in the metaphysis of the distal femur remain challenging. We hypothesized that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function. Methods From January 2017 to August 2019, five patients diagnosed with low-grade bone sarcoma in the metaphysis of the distal femur were treated with hemicortical resection using 3D printing guide plate. Autologous bone graft was inactivated in a high-temperature water bath and re-implanted in situ fixed with plate and screw. Patients were followed up from 17 to 33 months. The Musculoskeletal Tumor Society Score was used to evaluate the joint function. X-ray was used to evaluate the bone union. Results One patient was paracorticular osteosarcoma, and four cases had highly differentiated chondrosarcoma. All cases were involved in the metaphysis of the distal femur. Patients were followed up from 13 to 33 months, with an average of 23.6 months. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society Score averaged at 28.1, while the International Society of Limb Salvage imaging score examination averaged 89.8%. Conclusions Here, we demonstrate that the 3D printing osteotomy guide plate-assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of the distal femur and retained satisfied joint function.

Oncological and Functional Outcomes after Hemicortical Resection and Biological Reconstruction Using Allograft for Parosteal Osteosarcoma of the Distal Femur

“…While hemicortical resection and allograft of the PAO of the posterior aspect of the distal femur avoid complications associated with wide distal femur resection and reconstruction such as endoprosthesis, drawbacks such as a higher risk of a positive margin or recurrence should be addressed. Currently, three-dimensional measurements on the tumor before surgical resection using computer technology and establishing a 3-dimensional model and a 3D printing osteotomy guide plate could assist in accurately resecting the tumor lesion [ 23 ].…”

3D printing personalized guide plate in the management of recurrent intramuscular venous malformations: A single center experience

“…It was also used in tumor resection and reconstruction in the field of thoracic surgery, which promoted surgeons' understanding of thoracic wall tumor location, morphology, and invasion range. 31 Wu et al 32 Abbreviations: M: male; F: female.…”

“…It was also used in tumor resection and reconstruction in the field of thoracic surgery, which promoted surgeons’ understanding of thoracic wall tumor location, morphology, and invasion range. 31 Wu et al 32 introduced a technique using 3D printing osteotomy guide plate as a safe and effective strategy to lower both complication risk and recurrence rate after hemibone resection.…”

Custom design and biomechanical clinical trials of 3D‐printed polyether ether ketone femoral shaft prosthesis

“…In order to obtain a better view of the tumor and design prosthesis accurately, Mimics 22.0 (Materialize, Leuven, Belgium) was used to construct a 3D model of the left femur. We planned resection of the tumor and the corresponding femur bone tissues under the premise of a negative margin of 2–3 cm 13 . Considering a large vertical and torsional stress will be loaded on the conjunction of the prosthesis and the residual bone, a femoral intramedullary nail was implanted to enhance the fixation.…”

“…One month later, the patient felt severe pain in the left leg and diagnosed with a pathological femur fracture (Figure 1D). In order to obtain a better view of the tumor and design prosthesis accurately, 13 Considering a large vertical and torsional stress will be loaded on the conjunction of the prosthesis and the residual bone, a femoral intramedullary nail was implanted to enhance the fixation.…”