New adjustable modular hemipelvic prosthesis replacement with 3D-print osteotomy guide plate used in periacetabular malignant tumors: a retrospective case series

Abstract

Background Periacetabular malignant tumor seriously endangers the life and health of patients. Hemipelvic replacement provides a good method for patients who want complete resection of the tumor while retaining or restoring the function of the affected limb. Objective To investigate the performance and clinical application of the new adjustable modular hemipelvic prosthesis and to compare the effects of three kinds of hemipelvic prosthesis. Methods In this study, 23 patients, with an average age of 44.6 years (21–75 years), were collected, who received hemipelvic replacement with new adjustable, modular, and screw-rod system hemipelvic prosthesis. Preoperative preparation was conducted on them, and operative complications were recorded. Postoperative functional follow-up was performed regularly. Results The average operation time was 319 min (170–480 min), and the average blood loss was 2813 ml (1000 mL-8000 ml). The incidence of complications was 47.8%, and type A (wound-related complications) had the highest incidence (34.8%). Postoperative dislocation occurred in 3 cases (13.0%), and no dislocation occurred in the new adjustable modular hemipelvic prosthesis group. The average MSTS score of the patients was 18.6 (10–23), and the average Harris score was 73.7 (53–87). Conclusions The new adjustable modular hemipelvic prosthesis has the feasibility of reconstruction and good functional outcome, making it ideal for periacetabular tumors. Furthermore, preoperative tumor-feeding artery embolization and abdominal aortic balloon implantation may be an effective choice to reduce intraoperative blood loss and facilitate the operation of tumor resection.

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

“…This field encompasses procedures such as massive pelvis allografts ( Matejovsky et al, 2006 ; Ayvaz et al, 2014 ) and extracorporeally irradiated autografts ( Wafa et al, 2014 ). Contemporary prosthetic options for reconstruction comprise ice-cream cone prostheses ( Barrientos-Ruiz et al, 2017 ; Fujiwara et al, 2021 ), saddle-shaped prostheses ( Aboulafia et al, 1995 ; Kitagawa et al, 2006 ; Danışman et al, 2016 ), modular hemipelvis prostheses ( Ji et al, 2010 ; Li et al, 2022 ), and three-dimensionally printed (3D-printed) prostheses ( Wang et al, 2020 ; Zhu et al, 2021 ; Guo et al, 2022 ). Most of these biological reconstruction techniques have yielded encouraging outcomes in subsequent assessments.…”