Arthrodesis reconstruction of distal tibia by 3D-printed porous prosthesis after malignant tumor resection
10.3760/cma.j.cn121113-20200718-00455
- VernacularTitle:胫骨下段3D打印踝关节融合型肿瘤假体在骨肉瘤广泛切除术中的应用
- Author:
Tianli NIU
1
;
Yi YANG
;
Haijie LIANG
;
Zhiye DU
;
Jie ZANG
;
Xingyu LIU
;
Wei GUO
Author Information
1. 北京大学人民医院骨与软组织肿瘤治疗中心，北京 100044
- Keywords:
Osteosarcoma;
Tibia;
Ankle joint;
Prosthesis design;
Bone remodeling
- From:
Chinese Journal of Orthopaedics
2022;42(5):272-280
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and short-term clinical postoperative functional outcomes of a novel 3D-printed porous prosthesis of the distal tibia for the bone defect after tumorectomy.Methods:From December 2017 to December 2019, a total of eight patients diagnosed with malignant bone tumor of the distal tibia were enrolled in this study. All cases received standard preoperative chemotherapy, after which osteosarcoma resection was performed and ankle arthrodesis was reconstructed using a 3D-printed prosthesis developed by our medical center. The contact surface between the distal part of the prosthesis and the talus is a 3D-printed porous surface, which is conducive to ankle fusion. The length of the prosthesis is adjusted by the conical mounting part of the modular prosthesis. The proximal part of the prosthesis can be fixed either biologically or with bone cement. At postoperative follow-up, the function of the fused ankle was assessed by radiographs and the monthly Musculoskeletal Tumor Society (MSTS) score.Results:Of the 8 patients, 5 were male and 3 were female, aged 8-29 years (mean 16.1±7.4 years), including 7 osteoblastic osteosarcomas and 1 telangiectatic osteosarcoma. Among the procedures, the mean length of osteotomy was 16 cm (11-20 cm). The method of fixation of the proximal part of the prosthesis included one case with 3D-printing of trabecular metal bone, one case with autogenous fibular graft, and six cases with bone cement. All patients were followed up for 7-39 months (mean 15.6±10.5 months). The distal prosthesis and talus were completely fused in all cases. The mean fusion duration was 4.3±0.7 months. The mean MSTS score was 84.2%±3.0% (mean 80%-90%). No tumor recurrence, wound complications, or prosthesis loosening were observed during the follow-up period.Conclusion:The novel 3D-printed distal tibial prosthesis is a safe and effective technique for reconstruction of a massive bone defect after tumorectomy of a malignant bone tumor, with high fusion rate, few complications, and satisfactory postoperative function.
