A novel three-dimensional-printed patient-specific sacral implant for spinopelvic reconstruction in sacral giant cell tumour

Lv, Zhaorui; Li, Jianmin; Zhang, Yang; Li, Xin; Li, ZhenFeng

doi:10.1007/s00264-023-05759-0

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…In certain cases, the use of 3D-printed patient-specific implants is on the rise for the reconstruction of severe tumor bone defects ( Kotrych et al, 2023 ). 3D-printed prostheses offer the advantage of a precise fit and good osseointegration ( Lee et al, 2022 ).The use of 3D-printed implants for sacral tumor resection reconstruction is safe, effective, and contributes to better functional outcomes, as we have previously reported ( Lv et al, 2020 ; Lv et al, 2023a ; Lv et al, 2023b ; Lv et al, 2023c ). We hypothesize that 3D-printed patient-specific implants may reduce implant failure rates.…”

Section: Introductionmentioning

confidence: 99%

A 3D-printed patient-specific modular implants for pelvic reconstruction of bone tumors involving the sacroiliac joint

Lv,

Li,

Yang

et al. 2023

Front. Bioeng. Biotechnol.

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Background: Current reconstruction methods of the pelvic ring after extensive resection of tumors involving the sacroiliac joint have a high incidence of failure. We aimed to study the effect of 3D-printed patient-specific implant reconstruction to show that this method is stable and has a low risk of failure.Methods: Between February 2017 and November 2021, six patients with bone tumors involving the sacroiliac joint (Enneking I + IV) who received 3D-printed patient-specific implants for pelvic reconstructive surgery were retrospectively analyzed. Two female and four male patients with a mean age of 41.83 years (range 25–65 years) were included. Two were osteosarcomas, two chondrosarcomas, one malignant fibrous histiocytoma, and one giant cell tumor of bone. For each patient, preoperative osteotomy guides were designed to ensure accurate tumor resection and individualized prostheses were designed to ensure a perfect fit of the bone defect. General, oncologic, and functional outcomes, implant status, and complications were retrospectively analyzed. The Visual Analog Scale (VAS) was used to assess pain and the Musculoskeletal Tumor Society (MSTS) score was used to assess hip function. Osseointegration was assessed by CT.Results: According to the preoperative design, complete resection of the entire tumor and reconstruction with a custom 3D-printed sacroiliac joint implant was completed without perioperative severe complications or deaths. Relatively satisfactory surgical margins were achieved. The mean operative time and intraoperative blood loss were 495 min (420–600 min) and 2533.33 mL (range, 1,200–3,500 mL), respectively. The mean follow-up was 49.83 months (range, 18–75 months). At the last follow-up, all four patients were disease-free, and the two patients who developed lung metastases were alive with tumors. All patients could walk unassisted. The mean VAS was 1.33 (range, 0–2). The mean MSTS score was 25.33 (range, 24–27). CT showed complete osseointegration of the implant to the ilium and sacrum.Conclusion: The 3D-printed custom prosthesis can effectively reconstruct pelvic stability after total sacroiliac joint resection with satisfactory clinical results.

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Section: Introductionmentioning

confidence: 99%

A 3D-printed patient-specific modular implants for pelvic reconstruction of bone tumors involving the sacroiliac joint

Lv,

Li,

Yang

et al. 2023

Front. Bioeng. Biotechnol.

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“…With the development of digital medicine, 3D printing technology provides new ideas for the precise elimination and individualized reconstruction of bone tumors. 4 , 5 , 6 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

3D‐printed Multifunctional Guide Plate for Fenestration and Screws Drill in Proximal Femoral Benign Tumor

Zhang,

Guo,

et al. 2024

Orthopaedic Surgery

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The accurate fenestration, screw implantation and assisting stabilizing‐plate placement in surgery of benign tumors in the proximal femur needs be defined easily. The aim of this study was to investigate the value of 3D printed multifunctional guides plate (3D‐MGP) based on computer aided design. Between January 2020 and June 2022, 17 patients (nine females and eight males) with benign proximal femoral tumor had lesion curettage and allograft combined with internal plate fixation using 3D‐MGP. In this study, the patients had CT scans and a technician reconstructed the 3D images of tumor and the femur, a doctor designed the location and margin of the fenestration and screws, and integrated different functions into MGP for benign proximal femoral lesions, which assisted in precise localization, fenestration and screw drilling. Musculoskeletal Tumor Society (MSTS) scoring was used to evaluate lower extremity function. Bone healing and the screws location was assessed with the radiographs. All patients underwent successful surgery with complete resection of the tumor and internal fixation with using the 3D‐MGP. The mean follow‐up was 16.4 months. The operative time was 126.47 ± 18.44 min, intraoperative bleeding was 198.23 ± 67.94 mL, intraoperative fluoroscopy was 6.47 ± 0.62, postoperative drainage was 223.82 ± 119.51 mL, and MSTS score was 27.29 ± 1.31 points. There were no unplanned fenestration and improper screw fixation. The 3D‐MGP enabled personalized and accurate location of tumor, fenestration, screw placement and assisted stabilizing‐plate placement for the treatment of benign tumor of the proximal femur. This technique has the potential to shorten operative times, decrease intraoperative bleeding, and reduce radiation exposure to patients.

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“…With the remarkable benefits of 3D-printed implants, musculoskeletal oncology centers worldwide have developed customized hemipelvic endoprostheses for pelvic girdle reconstruction [ 28 ]. Numerous early clinical follow-up studies have reported superior clinical outcomes compared to traditional reconstruction methods with higher Musculoskeletal Tumor Society Score (MSTS) ratings and decreased rates of postoperative implant loosening (Table 1 ) [ 17 , 18 , 22 , 24 , 29 – 37 ].…”

Section: Introductionmentioning

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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A novel three-dimensional-printed patient-specific sacral implant for spinopelvic reconstruction in sacral giant cell tumour

Cited by 4 publications

References 27 publications

A 3D-printed patient-specific modular implants for pelvic reconstruction of bone tumors involving the sacroiliac joint

A 3D-printed patient-specific modular implants for pelvic reconstruction of bone tumors involving the sacroiliac joint

3D‐printed Multifunctional Guide Plate for Fenestration and Screws Drill in Proximal Femoral Benign Tumor

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

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