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The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft

CATEGORY: Trauma, Emerging Technology INTRODUCTION/PURPOSE: Modern day management of segmental defects of the tibia shaft (SDTS) involve autologous nonvascularized grafts, autologous vascularized contralateral fibula grafts, as well as bone transport distraction osteogenesis, however single stage ti...

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Autores principales: Tracey, Joseph, Parekh, Selene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697268/
http://dx.doi.org/10.1177/2473011419S00420
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author Tracey, Joseph
Parekh, Selene
author_facet Tracey, Joseph
Parekh, Selene
author_sort Tracey, Joseph
collection PubMed
description CATEGORY: Trauma, Emerging Technology INTRODUCTION/PURPOSE: Modern day management of segmental defects of the tibia shaft (SDTS) involve autologous nonvascularized grafts, autologous vascularized contralateral fibula grafts, as well as bone transport distraction osteogenesis, however single stage titanium cages with adjuvant biologics continue to demonstrate advantages. With the development of advanced additive manufacturing further modalities such as complex variable lattice structure and submicron texture may be incorporated into custom fit implants. We aim to further investigate the potential of this technology on osteoinduction, and hypothesize early bone in-growth. METHODS: A retrospective analysis was performed on 3 patients undergoing custom cage implantation for SDTS. All three patients were male with an average age of 60, 2 patients were diabetic, and one was a smoker. All three cases were performed in the setting of post-infection salvage. Pertinent demographic and clinical history was retrieved through the medical record. RESULTS: All three cases were uncomplicated in the post-surgical period, and early bone in-growth was demonstrated in successive follow-ups. One case was single-staged and built into a prior total ankle arthroplasty, the next was a deformity correcting intramedullary rod that became infected requiring two-stage salvage with an antibiotic spacer and subsequent custom cage with Intramedullary rod supplementation, and the third case was a two-stage trauma salvage initially using an antibiotic spacer with subsequent custom cage implantation. CONCLUSION: 3D printed custom cages were found to be a safe and efficacious option for management of SDTS, with demonstrated early bone in-growth. Considering the incorporation of advanced additive manufacturing techniques, strong implementations may be present for salvage cases.
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spelling pubmed-86972682022-01-28 The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft Tracey, Joseph Parekh, Selene Foot Ankle Orthop Article CATEGORY: Trauma, Emerging Technology INTRODUCTION/PURPOSE: Modern day management of segmental defects of the tibia shaft (SDTS) involve autologous nonvascularized grafts, autologous vascularized contralateral fibula grafts, as well as bone transport distraction osteogenesis, however single stage titanium cages with adjuvant biologics continue to demonstrate advantages. With the development of advanced additive manufacturing further modalities such as complex variable lattice structure and submicron texture may be incorporated into custom fit implants. We aim to further investigate the potential of this technology on osteoinduction, and hypothesize early bone in-growth. METHODS: A retrospective analysis was performed on 3 patients undergoing custom cage implantation for SDTS. All three patients were male with an average age of 60, 2 patients were diabetic, and one was a smoker. All three cases were performed in the setting of post-infection salvage. Pertinent demographic and clinical history was retrieved through the medical record. RESULTS: All three cases were uncomplicated in the post-surgical period, and early bone in-growth was demonstrated in successive follow-ups. One case was single-staged and built into a prior total ankle arthroplasty, the next was a deformity correcting intramedullary rod that became infected requiring two-stage salvage with an antibiotic spacer and subsequent custom cage with Intramedullary rod supplementation, and the third case was a two-stage trauma salvage initially using an antibiotic spacer with subsequent custom cage implantation. CONCLUSION: 3D printed custom cages were found to be a safe and efficacious option for management of SDTS, with demonstrated early bone in-growth. Considering the incorporation of advanced additive manufacturing techniques, strong implementations may be present for salvage cases. SAGE Publications 2019-10-28 /pmc/articles/PMC8697268/ http://dx.doi.org/10.1177/2473011419S00420 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Tracey, Joseph
Parekh, Selene
The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft
title The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft
title_full The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft
title_fullStr The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft
title_full_unstemmed The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft
title_short The Use of Structurally Augmented 3D Printed Cages in Segmental Defects of the Tibial Shaft
title_sort use of structurally augmented 3d printed cages in segmental defects of the tibial shaft
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697268/
http://dx.doi.org/10.1177/2473011419S00420
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