3D-Printed Modular Hemipelvic Endoprosthetic Reconstruction Following Periacetabular Tumor Resection
Autor: | Haijie Liang, Taiqiang Yan, Xiaodong Tang, Yi Yang, Tao Ji, Rongli Yang, Wei Guo |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Bone Neoplasms Prosthesis Design Single Center Prosthesis Prosthesis Implantation Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Child Pelvic Bones Aged Retrospective Studies Wound dehiscence business.industry Acetabulum Prostheses and Implants General Medicine Middle Aged medicine.disease Surgery Hemipelvectomy Treatment Outcome 030104 developmental biology 030220 oncology & carcinogenesis Printing Three-Dimensional Pelvic tumor Female Implant Chondrosarcoma business Follow-Up Studies |
Zdroj: | Journal of Bone and Joint Surgery. 102:1530-1541 |
ISSN: | 1535-1386 0021-9355 |
Popis: | Background Reconstruction with an endoprosthesis following pelvic tumor resection has increased over the years. However, the long-term results reflect a disappointing frequency of mechanical complications and failures. In an attempt to enhance implant fixation, an electron beam melting (EBM)-based modular hemipelvic endoprosthesis was introduced. Our aim was to explore the preliminary clinical outcomes for patients who have been managed with this prosthesis. Methods We reviewed the records of 80 consecutive patients who had been managed at a single center between June 2015 and September 2017. Chondrosarcoma was the predominant diagnosis (31.3%). Osseous metastases were diagnosed in 16 patients (20.0%). The position of the reconstructed metallic acetabulum was measured on an anteroposterior pelvic radiograph. Bone ingrowth was evaluated in 2 samples harvested from patients with tumor recurrence. Results After a median duration of follow-up of 32.5 months (range, 9 to 52 months), no acetabular component instability was detected on radiographs. Histological sectioning of specimens harvested from 2 patients with tumor recurrence showed bone trabeculae extending toward the implant and bone ingrowth within the porous network. At the time of the latest follow-up, 59 patients (73.8%) were alive with no evidence of disease, 5 patients (6.3%) were alive with disease, and 16 patients (20.0%) had died of disease. Local recurrence occurred in 9 patients (11.3%). The mean Musculoskeletal Tumor Society score at the time of the latest follow-up was 83.9% (range, 43% to 100%). Complications occurred in 16 patients (20%), with wound dehiscence being the most common complication (8 patients; 10%). No aseptic loosening was found. Five patients (6.3%) had deep infection, and 2 patients (2.5%) had dislocation. Conclusions The use of a 3-dimensional (3D)-printed modular hemipelvic endoprosthesis with a highly porous metal interface represents a potential choice as a pelvic endoprosthesis after internal hemipelvectomy for the treatment of a primary or metastatic tumor. These preliminary results demonstrate stable fixation with acceptable early functional and radiographic outcomes. Level of evidence Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. |
Databáze: | OpenAIRE |
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