Clinical effects of 3D printed porous titanium-alloy prosthesis in repairing aseptic large bone defects in the limbs
10.3760/cma.j.cn121113-20230330-00179
- VernacularTitle:3D打印多孔钛合金假体植入修复四肢长骨无菌性大段骨缺损
- Author:
Bingchuan LIU
1
;
Xingcai LI
;
Zhuo CHEN
;
Zhongjun LIU
;
Fang ZHOU
;
Yun TIAN
Author Information
1. 北京大学第三医院骨科，北京 100191
- Keywords:
Fractures, ununited;
Prosthesis implantation;
Printing, three-dimensional;
Bone defect
- From:
Chinese Journal of Orthopaedics
2023;43(24):1648-1654
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical feasibility and effectiveness of using 3D printed porous titanium-alloy prosthesis to repair aseptic large bone defects in the limbs.Methods:A retrospective analysis was performed on 13 patients with aseptic bone defects of long limbs treated with 3D printed porous titanium alloy prosthesis from December 2017 to December 2022, including 7 males and 6 females, aged 52.6±11.5 years (range, 35-72 years). The bone defect locations included 2 humerus, 1 radius, 5 femur, and 6 tibia. One patient suffered both femoral and tibial defects. All 13 patients suffered from bone nonunion due to internal fixation surgery, including 5 cases of hypertrophic nonunion and 8 cases of atrophic nonunion. The interval between internal fixation surgery and this treatment was 20.1±3.6 months (range, 16.5-26.6 months). The clinical treatment effect was evaluated through parameters such as gross observation, imaging evaluation, disability of arm shoulder and hand (DASH), lower extremity functional scale (LEFS), and patient satisfaction evaluation.Results:The length of bone defect after debridement in 13 patients was 11.7±4.5 cm (range, 6.0-20.6 cm), and the length of implant was 12.9±5.3 cm (range, 6.1-22.9 cm). Partial or complete weight-bearing began at 14.8±6.5 days (range, 2-22 days) after surgery. All 13 cases were followed up for 18.3±12.5 months (range, 13-58 months). The X-ray images showed that the prosthesis and the internal fixation were stable, and the new bone gradually grew gradually from the bone defect section and formed stable bone integration with the prosthesis surface, and no prosthesis displacement or fracture occurred. At the last follow-up, the DASH scores of 3 patients with upper limb bone defect were 8.9, 10.5, and 11.2 points, respectively, and the LEFS scores of 10 patients with lower limb bone defect were 49.6±5.9 points (range, 38-56 points). No significant subsidence or loosening of all prosthetics was observed. Patient satisfaction was 9.8±0.1 points (range, 9.6-9.9).Conclusion:After the application of 3D printed porous titanium alloy prosthesis to repair the aseptic large bone defect of the limbs, the patients can carry weight and function exercise in the early stage, and the function of the affected limbs can recover significantly, and the patients have high satisfaction.
