Custom-made 3D-printed prosthesis and free vascularised fibula for humeral reconstruction after osteosarcoma resection in a 13-year-old patient

Abstract

Surgical reconstruction after humeral resection represents a challenging issue in orthopaedic oncology. Particularly in paediatric patients, the main concerns are maintaining limb function and reconstruction longevity. We describe a novel strategy of humeral reconstruction based on the use of a three-dimensional-printed custom-made prosthesis in a 13-year-old patient diagnosed with osteosarcoma. The implant was specifically designed to sustain the native head, which was spared, as it was not involved by the neoplastic tissue. The mechanical support the prosthesis provided was associated with the biological stimulus of a free vascularised fibular graft to obtain an anatomic, functional and stable construct. This solution has had good longevity, and after 3 years of follow-up, the patient still shows excellent limb function and personal satisfaction.

Surgical Outcomes and Complications of Custom-Made Prostheses in Upper Limb Oncological Reconstruction: A Systematic Review

“…After full-text screening, five articles were excluded. Thus, 21 studies meeting the inclusion criteria were finally included in this review, following the PRISMA flow chart [ 8 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] ( Figure 1 ).…”

“…MST score was calculated in 112 patients (77%), with a mean value of 59.35%. Among these, patients of five articles [ 20 , 23 , 26 , 35 , 36 ] had an MST score inferior to 50%. All such patients had high-grade osteosarcoma or bone metastases, and complications were reported.…”

Biological Prosthesis (Hollow 3D-Printed Titanium Custom-Made Prosthesis and Bone Graft) for Humeral Reconstruction in Pediatric Oncologic Patients: Surgical Indications and Results

“…Beltrami et al have proposed innovative hollow 3D-printed custom-made prostheses with porous coatings filled with bone grafts for oncological resections, combining the benefits of 3D custom-made prostheses with the biological properties of bone grafts and microsurgical flaps [30,31]. This technique is groundbreaking, as it can potentially combine the advantages of 3D-printed custom-made prostheses with the biological properties of bone grafts and microsurgical flaps.…”

A multifunctional ionic liquid coating on 3D-Printed prostheses: Combating infection, promoting osseointegration

“…Currently, customized 3D-printed porous titanium alloy (pTi) implants have achieved great success in anatomical reconstruction and functional recovery. Clinical studies have reported that personalized 3D-printed implants match bone defects perfectly, promote bone ingrowth, provide stable mechanical support, and improve functional scores with fewer complications [ [14] , [15] , [16] ].…”