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Customized three dimensional printed prosthesis as a novel intercalary reconstruction for resection of extremity bone tumours: a retrospective cohort study

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Abstract

Aims

The 3D-printed prosthesis (3DP) is a novel treatment for massive bone defect reconstruction after tumor resection. This study was aiming to explore the clinical efficacy of customized 3DP for intercalary reconstruction by comparing the clinical outcomes after implanting customized 3DP or conventional allograft in limb salvage surgery.

Methods

A total of 28 patients with extremity bone tumors who underwent customized 3DP or conventional allograft reconstruction between 2011 and 2018 at our institution were analyzed retrospectively. Among them, 14 cases received customized 3DP reconstruction (3DP group), and 14 cases received conventional allograft reconstruction (control group). Demographics, surgical outcomes, radiographical assessments, limb functions, and post-operative complications between these two groups were collected to evaluate clinical outcomes.

Results

No significant difference was observed in the demographics, mean intra-operative blood loss, MOSI scores, and MSTS scores between the two groups. Patients in 3DP group had a shorter operative time (157.9 vs 199.6 min, p = 0.03) and lesser number of fluoroscopy (4.1 vs 8.1, p < 0.001) compared to control group. The mean time to osseointegration at bone-implant interfaces in 3DP group was significantly earlier than that in control group (6.1 vs 12.2 months, p < 0.001). Moreover, the 3DP group had a significantly lower post-operative complication rate than the control group (7% vs 50%, p = 0.03).

Conclusions

The customized 3DP might provide a promising strategy for intercalary reconstruction in limb salvage surgery with more precise reconstruction, higher surgical efficiency, and comparable satisfactory clinical outcomes.

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Funding

This work was supported by National Natural Science Foundation of China (No. 31971272); National Key R&D Program of China (No. 2016YFB1101104); Shaanxi Provincial Key R&D Program (No. 2018ZDXM-SF-075).

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Author notes

  1. Zhao Zhang, Yubo Shi and Jun Fu contributed equally to this work.

Authors and Affiliations

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

    Zhao Zhang, Yubo Shi, Jun Fu, Dong Liu, Dongze Zhu, Xincheng Liu, Jingyi Dang & Hongbin Fan

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  1. Zhao Zhang
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  2. Yubo Shi
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  3. Jun Fu
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Hongbin Fan, Zhao Zhang, Yubo Shi, and Jun Fu. The first draft of the manuscript was written by Zhao Zhang, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Hongbin Fan.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the institutional review board of Xi-Jing Hospital, the Fourth Military Medical University (no. 2018–122(H)).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1–4 and Supplementary file.

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The authors declare no competing interests.

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Level of evidence: Therapeutic Level IV.

The original version of this article was revised. The correct statement should be: Zhao Zhang, Yubo Shi and Jun Fu contributed equally to this work.

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Zhang, Z., Shi, Y., Fu, J. et al. Customized three dimensional printed prosthesis as a novel intercalary reconstruction for resection of extremity bone tumours: a retrospective cohort study. International Orthopaedics (SICOT) 46, 2971–2981 (2022). https://doi.org/10.1007/s00264-022-05559-y

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