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An innovative strategy to treat large metaphyseal segmental femoral bone defect using customized design and 3D printed micro-porous prosthesis: a prospective clinical study

  • Clinical Applications of Biomaterials
  • Original Research
  • Published:
Journal of Materials Science: Materials in Medicine Aims and scope Submit manuscript

Abstract

Five patients with segmental irregular-shaped bone defect of the femur were recruited in this study from 2017.12 to 2018.11. All patients were treated by customized design and 3D printed micro-porous prosthesis. And the procedure was divided into stages: radical debridement and temporary fixation (the first stage); the membrane formation and virtual surgery (intervening period for 6–8 weeks); definite reconstruction the defects (the second stage). Routine clinical follow-up and radiographic evaluation were done to assess bone incorporation and complications of internal fixation. The weight-bearing time and the joint function of the patients were recorded. The patients were followed up for an average of 16.4 months. The average length of bone defect and the distal residual bone was 12 cm and 6.5 cm. The average time of partial weight-bearing and full weight-bearing was 12.7 days and 2.6 months. X-ray demonstrated good osseous integration of the implant/bone interface. No complications occurred such as implant loosening, subsidence, loss of correction and infection. At the last follow-up, Harris score of hip joint was excellent in 2 cases, good in 2 cases, fair in 1 case; HSS score of knee joint was good in 4 cases, middle in 1 case. From our study, we concluded that meticulous customized design 3D printed micro-porous prosthesis combined with intramedullary nail may be a promising and an alternative strategy to treat metaphyseal segmental irregular-shaped femoral bone defect, especially for cases with massive juxta-articular bone loss.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

PMMA:

Polymethyl Methacrylate

CT:

computed tomography

EMR:

electronic medical record

IM:

intramedullary

ROM:

range of motion

A-P:

anterior-posterior

L:

length

T:

time

DRB:

distal residual bone

PWB:

partial weight bearing

TWB:

total weight bearing

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Acknowledgements

The authors would like to thank Changdong Qiu for the help of design the implant and Xiaoyan Niu, the secretary, for a lot of image preparation and data transmission work, which ensured the smooth progress of the project.

Funding

This study was supported by Beijing Municipal Science & Technology Commission (Project Z181100001718195).

Authors’ contributions

GJH and BCL were involved in designing the prosthesis, acquisition of data, drafting the manuscript. YT, ZJL and FZ designed the study, revised the manuscript critically and gave some important suggestions; YT, HQJ, ZSZ, YG and YL made contributions to conception and design and performed the surgeries; ZWY completed the follow-up and collected the data. All authors read and approve the final manuscript.

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Author notes

  1. These authors contributed equally: Guojin Hou, Bingchuan Liu

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Peking University Third Hospital, No 49, North Garden Rd, HaiDian District, 100191, Beijing, China

    Guojin Hou, Bingchuan Liu, Yun Tian, Zhongjun Liu, Fang Zhou, Hongquan Ji, Zhishan Zhang, Yan Guo, Yang Lv & Zhongwei Yang

  2. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, No 49, North Garden Rd, HaiDian District, 100191, Beijing, China

    Guojin Hou, Bingchuan Liu, Yun Tian, Zhongjun Liu, Fang Zhou, Hongquan Ji, Zhishan Zhang, Yan Guo, Yang Lv & Zhongwei Yang

  3. Tsinghua University, 100084, Beijing, China

    Peng Wen

  4. Peking University, 100871, Beijing, China

    Yufeng Zheng & Yan Cheng

Authors
  1. Guojin Hou
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Corresponding author

Correspondence to Yun Tian.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approval by Peking University Third Hospital Human Research Ethical Committees with the number M2018174.

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All patients were informed preoperatively regarding the surgical purpose, management protocol, possible complications and recovery period. And informed consent was obtained from all participants.

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Hou, G., Liu, B., Tian, Y. et al. An innovative strategy to treat large metaphyseal segmental femoral bone defect using customized design and 3D printed micro-porous prosthesis: a prospective clinical study. J Mater Sci: Mater Med 31, 66 (2020). https://doi.org/10.1007/s10856-020-06406-5

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  • DOI: https://doi.org/10.1007/s10856-020-06406-5

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