Primary Cooperative Application of a LARS® Tube and 3D‐Printed Prosthesis for Reconstruction of the Distal Radius after en bloc Resection of Giant Cell Tumor of Bone: A Comparative Retrospective Study

Autor: Xianhao Shao, Hao Ding, Jianmin Li, Zhaorui Lv, Qiang Yang, Qing Chu, Ka Li, Zhenfeng Li
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Orthopaedic Surgery, Vol 15, Iss 6, Pp 1521-1533 (2023)
Druh dokumentu: article
ISSN: 1757-7861
1757-7853
DOI: 10.1111/os.13722
Popis: Objective Using a fibula autograft (FA) to reconstruct defects after en bloc resection of giant cell tumor of bone (GCTB) in the distal radius is classic but has high complication rates. We describe a novel reconstruction method employing the cooperative application of LARS® and a 3D‐printed prosthesis (L‐P) and investigate whether it improves postoperative outcomes. Methods From April 2015 to August 2022, 14 patients who underwent the cooperative L‐P reconstruction method after en bloc resection of distal radial GCTBs and 31 patients who received FA reconstruction were enrolled as two retrospective cohorts in this comparative study. The properties of the implants and critical surgical techniques were elaborated in the L‐P group. Preoperative function, intraoperative data, and postoperative clinical, functional, and radiographic outcomes of all patients were recorded and compared between the two groups. The grip strength and range of wrist motion, including extension, flexion, radial deviation, and ulnar deviation, were measured. The Mayo modified wrist and Musculoskeletal Tumor Society scores were chosen to assess wrist function and surgical functional outcomes, respectively. Kaplan–Meier curves were generated to analyze the significant differences in complication rates and implant survival between the two groups. Results In both groups, all 45 patients underwent the operation without complication with similar average osteotomy lengths and bleeding volumes, while a shorter operative duration was achieved in the L‐P group (201.43 ± 22.87 min vs. 230.16 ± 51.44 min, P = 0.015). At a mean follow‐up of 40.42 ± 18.43 months (range, 14–72 months), both reconstruction methods effectively ameliorated postoperative function. Patients who received L‐P showed higher postoperative modified Mayo wrist scores (81.43 ± 5.49 vs. 71.13 ± 16.10, P = 0.003), Musculoskeletal Tumor Society scores (27.64 ± 1.34 vs. 25.06 ± 2.95, P = 0.004), and grip strength on the normal side (68.71% ± 8.00% vs. 57.81% ± 12.31%, P = 0.005) than the FA group. Better wrist extension (63.21° ± 8.99° vs. 45.32° ± 14.53°, P
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