Clinical Efficacy Evaluation and Complication Analysis of 3D-Printed Porous Titanium Implants Combined with Flap Reconstruction for the Treatment of Open Bone Defects in Lower Extremities: A Retrospective Study

Abstract

Objective To retrospectively analyze the clinical efficacy and complications of flap combined with 3D-printed microporous titanium prosthesis in treating open lower limb bone defects, and to evaluate the feasibility and safety of this innovative method. Methods This study is a retrospective, single-center, non-randomized controlled clinical study. Thirty patients with open lower limb bone defects treated with flap combined with 3D-printed microporous titanium prosthesis were included. Patient demographics, bone defect location and length, follow-up time, radiographic evaluation, Lower Extremity Functional Scale (LEFS) scores, complications, prosthesis failure, and patient satisfaction were recorded. Kaplan-Meier survival analysis was used to assess the cumulative survival rate of the prostheses. Results A total of 30 patients were included, comprising 21 males and 9 females, with a mean age of 45.5 years (range: 13–67 years). Bone defects were located in the tibia (n = 17), femur (n = 11), and metatarsal bones (n = 2). The defect length ranged from 41 to 211 mm, with a mean of 101.9 mm. The follow-up period ranged from 1.23 to 61.7 months, with a mean of 13.95 months. The mean LEFS score at the final follow-up was 47.4. Seven patients (23.3%) developed infectious complications, all leading to prosthesis failure requiring revision. The mean patient satisfaction score was 3.8 out of 5. Kaplan-Meier survival analysis showed a 2-year cumulative prosthesis survival rate of 76.67%. Conclusion Flap combined with 3D-printed microporous titanium prosthesis for treating open lower limb bone defects can achieve satisfactory bone healing, functional recovery, and patient satisfaction. However, the complication rate is relatively high. Further optimization of surgical protocols and prosthesis design is needed to reduce infection risk and improve prosthesis survival. Prospective, large-sample, long-term follow-up studies are recommended for a more comprehensive evaluation of the efficacy and safety of this method.