Comparison of customized 3D-printed prosthesis and screw-rod-cage system reconstruction following resection of periacetabular tumors

Abstract

Background and purposeVarious operative methods are used for reconstructing pelvic girdle after resection of primary malignant periacetabular tumor has been reported. The objective of this study was to evaluate the accuracy, effectiveness, and safety of customized three dimensional-printed prosthesis (3DP) in the reconstruction of bone defects compared with conventional reconstruction using the screw-rod-cage system.MethodsA retrospective case–control analysis of 40 patients who underwent pelvic tumor resection and reconstruction with a customized 3D-printed prosthesis (3DP), or screw-rod-cage system (SRCS) between January 2010 and December 2019 was performed. The minimum follow-up time for patients alive was 2 years. Blood loss, operation time, complications, surgical margin, local recurrence, distant metastases, status at time of latest follow-up, MSTS-93 score, Harris hip score, and postoperative radiographic parameters were recorded. Moreover, overall survival, tumor-free survival, and prosthesis survival rates in both groups were compared.ResultsCustomized 3DP reconstruction was performed in 15 patients, and SRCS reconstruction was done in 25 patients. The group of patients treated with customized 3DP reconstruction had significantly shorter operation time (323.7 ± 83.7 vs. 393.6 ± 98.8 min; P = 0.028) and more precise (all P < 0.05) radiographic reconstruction parameters than patients in the SRCS group. Fewer complications (P = 0.026), better MSTS score (P = 0.030), and better Harris hip score (P = 0.016) were achieved in the 3DP group. Furthermore, the survival rate of prosthesis was also significantly better in the 3DP group (P = 0.039). However, blood loss, surgical margin, local recurrence, distant metastases, and status at time of latest follow-up had no significant difference between two groups.ConclusionCompared with the screw-rod-cage system reconstruction, the customized 3D-printed prosthesis reconstruction is equally safe and effective, but it is more accurate and time-saving and is associated with fewer complications.

Biomechanical and clinical outcomes of 3D-printed versus modular hemipelvic prostheses for limb-salvage reconstruction following periacetabular tumor resection: a mid-term retrospective cohort study

“…When contrasted with the flexible, convenient, and rapid implantation process of modular prostheses, it becomes understandable why the follow-up results reveal a somewhat longer operation time and slightly increased blood loss during surgery in the 3D printing group. Nevertheless, it's reassuring that these differences remain within acceptable ranges [ 23 , 35 , 45 ].…”

Pelvic-girdle reconstruction with three-dimensional-printed endoprostheses after limb-salvage surgery for pelvic sarcomas: current landscape

“…An incomplete pelvic ring reconstructive endoprosthesis 25 , 30 , 31 , 35 , 60 , as the name implies, refers to an implant that does not prioritize the comprehensive reconstruction of the pelvic ring. Instead, its primary objective lies in restoring the functionality of the hip joint and facilitating the transmission of weight-bearing forces through the sciatic buttress to the sacroiliac joint and/or sacrum.…”

Design of 3D-printed prostheses for reconstruction of periacetabular bone tumors using topology optimization

“…Nevertheless, when addressing bone tumors situated in intricate locales, 3D-printed prostheses offer enhanced precision and temporal efficiency. Consequently, its application within the realm of pelvis tumor treatment has observed a progressive upsurge ( Wang et al, 2020 ; Guo et al, 2022 ; Zhu et al, 2022 ).…”