A novel revision strategy for intramedullary stem fractures of the tumor megaprostheses in distal femur using personalized 3D printed

Yi YANG; Ran WEI; Jichuan WANG; Xiaowei LI; Haijie LIANG; Xingyu LIU; Jun WANG; Xiaodong TANG; Wei GUO

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A novel revision strategy for intramedullary stem fractures of the tumor megaprostheses in distal femur using personalized 3D printed "sleeves" element

VernacularTitle:3D打印钛合金"套袖"组件用于股骨远端肿瘤型假体柄折断翻修的早期临床疗效
Author: Yi YANG ¹ ; Ran WEI ¹ ; Jichuan WANG ¹ ; Xiaowei LI ¹ ; Haijie LIANG ¹ ; Xingyu LIU ¹ ; Jun WANG ¹ ; Xiaodong TANG ¹ ; Wei GUO ¹
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
Publication Type:Journal Article
Keywords: Femoral neoplasms; Prosthesis design; Reoperation; Printing, three-dimensional
From: Chinese Journal of Orthopaedics 2025;45(11):752-756
CountryChina
Language:Chinese
Abstract: This study evaluates the safety and early clinical outcomes of a novel 3D-printed titanium alloy "sleeve" component for revising fractured femoral stem prostheses in distal femoral megaprostheses without removing the fractured stem. The six patients included 2 males and 4 females, with an age range of 8-57 years. They were treated at Peking University People's Hospital between August 2020 and December 2023 and underwent revision surgery using the customized sleeve. A self-designed 3D-printed titanium alloy "sleeve" component was used for revision without removing the fractured stem, in the form of an external sleeve around the stem. Postoperative imaging was performed every three months to assess implant stability and bone integration. Functional outcomes were evaluated using the Musculoskeletal Tumor Society (MSTS)-93 score. All six patients successfully completed the surgery and follow-up, with surgical durations ranging from 120 to 230 minutes and intraoperative blood loss ranging from 150 to 800 ml. The follow-up period ranged from 6 to 46 months. At three months postoperatively, X-ray and CT imaging showed cortical bridging between the host bone and the "sleeve" component. By six months, full integration of the host cortical bone with the metal trabecular interface of the "sleeve" was observed. At the final follow-up, MSTS-93 scores ranged from 26 to 29 points, with no complications such as wound healing issues, implant loosening, fracture, infection, or degenerative arthritis. These findings suggest that 3D-printed titanium "sleeve" provide an effective, bone-preserving solution for femoral stem revision in oncologic megaprostheses, leading to favorable early stability and functional recovery.