Using 3D models in orthopedic oncology: presenting personalized advantages in surgical planning and intraoperative outcomes

Abstract

BackgroundThree Dimensional (3D) printed models can aid in effective pre-operative planning by defining the geometry of tumor mass, bone loss, and nearby vessels to help determine the most accurate osteotomy site and the most appropriate prosthesis, especially in the case of complex acetabular deficiency, resulting in decreased operative time and decreased blood loss.MethodsFour complicated cases were selected, reconstructed and printed. These 4 cases were divided in 3 groups of 3D printed models. Group 1 consisted of anatomical models with major vascular considerations during surgery. Group 2 consisted of an anatomical model showing a bone defect, which was intended to be used for substantial instrumentation, pre-operatively. Group 3 consisted of an extra-compartmental bone tumor which displayed a deteriorated cortical outline; thus, using CT and MRI fused images to reconstruct the model accurately. An orthopedic surgeon created the 3D models of groups 1 and 2 using standard segmentation techniques. Because group 3 required complex techniques, an engineer assisted during digital model construction.ResultsThese models helped to guide the orthopedic surgeon in creating a personalized pre-operative plan and a physical simulation. The models proved to be beneficial and assisted with all 4 cases, by decreasing blood loss, operative time and surgical incision length, and helped to select the appropriate acetabular supporting ring in complex acetabular deficiency, pre-operatively.ConclusionQualitatively, using 3D printing in tumor cases, provides personalized advantages regarding the various characteristics of each skeletal tumor.

Three‐dimensional printing in orthopaedic preoperative planning improves intraoperative metrics: a systematic review

“…Case series focused on subjective measures. Clinical outcomes in all cases were satisfactory, with some of that success attributed to the use of 3D models.…”

Quantitative Musculoskeletal Tumor Imaging

“…A variety of printer types are commercially available that differ in technology, cost, materials available, and print time. Although not a quantitative imaging acquisition technique, postprocessing allows for generation of quantitative information that can be used to plan osteotomy sites, select the allograft prosthesis, determine the volume of a surgical defect, and aid in determining surgical reconstruction options for patients with MSK tumors [108][109][110][111][112] (►Fig. 7).…”

Combining Augmented Reality and 3D Printing to Display Patient Models on a Smartphone

“…In the case of AR, its interaction with virtual 3D models and the real environment benefits physicians in regards to education and training 1,2,3 , communication and interactions with other physicians 4 , and guidance during clinical interventions 5,6,7,8,9,10 . Likewise, 3DP has become a powerful solution for physicians when developing patient-specific customizable tools 11,12,13 or creating 3D models of a patient's anatomy, which can help improve preoperative planning and clinical interventions 14,15 .…”