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Three-dimensional virtual bone bank system for selecting massive bone allograft in orthopaedic oncology

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Abstract

Purpose

Although structural bone allografts have been used for years to treat large defects caused by tumour or trauma, selecting the most appropriate allograft is still challenging. The objectives of this study were to: (1) describe the establishment of a visual bone bank system and workflow of allograft selection, and (2) show mid-term follow-up results of patients after allograft implantation.

Methods

Allografts were scanned and stored in Digital Imaging and Communications in Medicine (DICOM) files. Then, image segmentation was conducted and 3D model reconstructed to establish a visual bone bank system. Based on the volume registration method, allografts were selected after a careful matching process. From November 2010 to June 2013, with the help of the Computer-assisted Orthopaedic Surgery (CAOS) navigation system, the allografts were implanted in 14 patients to fill defects after tumour resection.

Results

By combining the virtual bone bank and CAOS, selection time was reduced and matching accuracy was increased. After 27.5 months of follow-up, the mean Musculoskeletal Tumor Society (MSTS) 93 functional score was 25.7 ± 1.1 points. Except for two patients with pulmonary metastases, 12 patents were alive without evidence of disease at the time this report was written.

Conclusions

The virtual bone bank system was helpful for allograft selection, tumour excision and bone reconstruction, thereby improving the safety and effectiveness of limb-salvage surgery.

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Acknowledgments

We acknowledged the assistance of Prof. Luis Aponte Tinao (Ortopedia Oncologica, Hospital Italiano de Buenos Aires, Argentina) in virtual bone bank setup and manuscript preparation.

Conflict of interests

None.

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Author notes

    Authors and Affiliations

    1. Department of Orthopaedic Surgery, Xi-Jing Hospital, The Fourth Military Medical University, Xi’an, 710032, China

      Zhigang Wu, Jun Fu, Zhen Wang, Xiangdong Li, Jing Li, Yanjun Pei, Guoxian Pei, Dan Li, Zheng Guo & Hongbin Fan

    2. Department of Orthopaedic Surgery, Lanzhou General Hospital of Lanzhou Military Region, PLA, Lanzhou, 730050, China

      Zhigang Wu

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    1. Zhigang Wu
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    2. Jun Fu
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    3. Zhen Wang
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    7. Guoxian Pei
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    9. Zheng Guo
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    10. Hongbin Fan
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    Corresponding authors

    Correspondence to Zheng Guo or Hongbin Fan.

    Additional information

    Zhigang Wu and Jun Fu contributed equally to this work.

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    Wu, Z., Fu, J., Wang, Z. et al. Three-dimensional virtual bone bank system for selecting massive bone allograft in orthopaedic oncology. International Orthopaedics (SICOT) 39, 1151–1158 (2015). https://doi.org/10.1007/s00264-015-2719-5

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    • DOI: https://doi.org/10.1007/s00264-015-2719-5

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