Personalized three-dimensional printed polyether-ether-ketone prosthesis for reconstruction after subtotal removal of chronic clavicle osteomyelitis

Abstract

Rationale: Three-dimensional (3D) printing has attracted wide attention for its potential and abilities in the assistance of surgical planning and the development of personalized prostheses. We herewith report a unique case of chronic clavicle osteomyelitis treated with a two-stage subtotal clavicle reconstruction using a 3D printed polyether-ether-ketone (PEEK) prosthesis. Patient concerns: A 23-year-old Chinese female presented to our clinic complaining about a progressive pain of her right clavicle for about 1 year. Diagnoses: Chronic clavicle osteomyelitis confirmed by percutaneous biopsy and lesion biopsy. Interventions: This patient accepted a long-term conservative treatment, which did not gain satisfactory outcomes. Thus, a subtotal removal and two-stage reconstruction of the right clavicle with a 3D-printed polyether-ether-ketone prosthesis stabilized by screw fixation system was performed. Outcomes: At 2-year follow-up, complete pain relief and satisfactory functional recovery of her right shoulder were observed. Lessons: Personalized 3D printed prosthesis is an effective and feasible method for reconstruction of complex bone defects.

Case report: Intraosseous hemangioma of the lateral clavicle treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis

“…Meanwhile, in our case, after the subtotal clavicle resection, fixation of the bone cement modeling might be difficult, and postoperative complications such as dislocation might occur. To our best knowledge, there were three studies regarding the use of 3D-printed prosthesis to reconstruct clavicle ( Fan et al, 2015 ; Abdalbary et al, 2021 ; Chen et al, 2021 ), and among them only one study reported reconstruction of the lateral clavicle similar to our patient ( Abdalbary et al, 2021 ). However, the implant was a tubular prosthesis, covering the medial clavicle stump.…”

“…With regard to the treatment, surgical resection is recommended for tumor local control. However, the resulting cosmetic and functional impairment of clavicle resection may be significant with sloped shoulder, limited motion of the shoulder joint, and restriction of daily activities ( Chen et al, 2021 ). Therefore, reconstruction of the clavicle is suggested to maintain the normal shoulder joint function and prevent adverse outcomes.…”

Clinical Applications of Three-Dimensional Printing in Upper Extremity Surgery: A Systematic Review

“…Additionally, 3D-printed radial head implants seem to be a potential treatment alternative for an irreparable radial head in chronic elbow instability [ 52 ]. Chen et al reported a successful treatment of a patient suffering from chronic clavicle osteomyelitis by clavicle replacement using a 3D-printed polyether–ether–ketone implant, which provides a promising alternative due to its antibacterial properties [ 53 ]. Further, 3D-printed custom-made prostheses may also become more important in trauma-related and congenital malformations of the hand.…”

Functional engineering strategies of 3D printed implants for hard tissue replacement

“…The as-fabricated PEEK perfectly matched and easily embedded into the defect area to achieve individualized reconstruction in one-stage surgery. Another case was reported as reconstruction of complex bone defects in a patient suffering from chronic clavicle osteomyelitis [ 305 ]. Three-dimensional-printed PEEK prosthesis was properly fixed into the acromial end and the medullary cavity of the sternal stalk.…”

“…Reproduced with permission from Ref. [ 305 ] Copyright 2021 Wolter’s Kluwer Health. Inc. C : PEEK prosthesis for scapular reconstruction.…”