A report of 8 osteosarcoma resection patients with 3D printing prosthesis replacement and preservation of autologous joint for reconstruction of limb function
CHEN Guo-jing
LI Ming-hui
XIAO Xin
LU Ya-jie
WANG Feng-wei
WANG Zhen
JI Chuan-lei
LI Jing
Abstract：Objective To explore the clinical effect of complex autologous joint-preserving osteosarcoma resection and reconstruction using 3D-printed prosthesis.Methods A retrospective study was performed on 8 patients with osteosarcoma of the lower extremity in our institution from January 2017 to December 2019.The locations of the osteosarcomas were as follows:two cases in the distal femur,four cases in the distal tibia and four case in the proximal tibia.The 8 included patients ranged in age from 6 to 30 years(mean:11.8 years).The tumor appeared without involvement of the epiphysis and epiphyseal plates.3D printable templates of patients were designed virtually from preoperative thin-layer CT data.The tumor was excised with preservation of the articular surface(≤1 cm in 5 cases)and 3D printed prostheses were used to repair the bone defects.Clinical and radiographic findings were evaluated postoperatively at regular follow-up visits.The stability of the prostheses was analyzed.Limb function was assessed using the Musculoskeletal Tumor Society Scoring system(MSTS).The oncological outcomes and prostheses complications were recorded in detail.Results The mean follow-up time was 43.5 months(36-60 months).7 patients remained alive without tumor recurrence or metastasis at the last follow-up.One patient developed lung metastasis at 36 months.No complications such as prosthesis loosening and breakage were observed in 7 cases.Prosthesis breakage was observed at the last follow-up.Osseointegration was formed in the bone-implant interfaces.Bone ingrowth was found around the bone-implant interfaces and wrapped prosthesis to form"welding"osseointegration with increasing follow-up time.The average functional score according to MSTS score was 93.81%(91.81%-96.87%)at the last follow-up.Conclusions The application of customized 3D printed prosthesis in the revision of complex autologous joint-preserving osteosarcoma resection and reconstruction achieves satisfactory results.With the standardization of the manufacturing and quality control of prosthesis,this technique can provide a new option for patients of autologous joint-preserving after malignant tumor resection.
Keywords：PrintingThree-dimensionalOsteosarcomaProsthesis implantationOrthopedic procedures
Publication Date：2023-12-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 889-895 )