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Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses

BACKGROUND: Reconstruction of pelvis girdle stability after tumor-induced hemipelvectomy remains challenging. We surgically treated 13 patients with custom-made, three-dimensional printed hemipelvic prostheses. We aim to identify the preliminary outcomes for patients who have been managed with more...

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Autores principales: Xu, Shenglin, Guo, Zehao, Shen, Qiling, Peng, Yongjun, Li, Jian, Li, Sheng, He, Peng, Jiang, Zheng, Que, Yukang, Cao, Kun, Hu, Bo, Hu, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282862/
https://www.ncbi.nlm.nih.gov/pubmed/35847863
http://dx.doi.org/10.3389/fonc.2022.935059
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author Xu, Shenglin
Guo, Zehao
Shen, Qiling
Peng, Yongjun
Li, Jian
Li, Sheng
He, Peng
Jiang, Zheng
Que, Yukang
Cao, Kun
Hu, Bo
Hu, Yong
author_facet Xu, Shenglin
Guo, Zehao
Shen, Qiling
Peng, Yongjun
Li, Jian
Li, Sheng
He, Peng
Jiang, Zheng
Que, Yukang
Cao, Kun
Hu, Bo
Hu, Yong
author_sort Xu, Shenglin
collection PubMed
description BACKGROUND: Reconstruction of pelvis girdle stability after tumor-induced hemipelvectomy remains challenging. We surgically treated 13 patients with custom-made, three-dimensional printed hemipelvic prostheses. We aim to identify the preliminary outcomes for patients who have been managed with more mixed regions of prosthetic pelvic reconstruction and the feasibility of two reconstructive systems. METHODS: Seven male patients and 6 female patients treated at our center between January 2019 and May 2021 were included. There were 11 primary sarcomas and 2 solitary bone metastases. After en bloc tumor resection, two types of personalized, three-dimensional printed prostheses were fixed to restore the stability and rebuild the load transfer. The position of the reconstructed hemipelvis was evaluated on an anteroposterior plain radiograph. The complications and outcomes were traced. One amputation specimen was discovered through histological analysis of the porous structure. RESULTS: The operative duration was 467 ± 144 min, and the blood loss was 3,119 ± 662 ml. During a follow-up of 22.4 ± 8.5 months, two patients had delayed wound healing and one had a second-stage flap transfer. One patient with osteosarcoma died of pulmonary metastasis 27 months after surgery. Two patients with marginal resection suffered from local recurrence and had extra surgeries. One patient had traumatic hip dislocation 2 months after surgery and manipulative reduction was performed. The acetabular inclination of the affected side was 42.2 ± 4.3°, compared with 42.1 ± 3.9° on the contralateral side. The horizontal distance between the center of the femoral head and the middle vertical line was 10.4 ± 0.6 cm, while the reconstructed side was 9.8 ± 0.8 cm. No significant difference in acetabular position after surgery was found (p > 0.05). The amputation specimen harvested from one patient with local recurrence demonstrated bone and soft tissue ingrowth within the three-dimensional printed trabecular structure. Walking ability was preserved in all patients who are still alive and no prosthesis-related complications occurred. The MSTS score was 22.0 ± 3.7. CONCLUSIONS: Both types of custom-made, three-dimensional printed prostheses manifested excellent precision, mechanical stability, and promising functional rehabilitation. The porous structure exhibited favorable histocompatibility to facilitate the ingrowth of bone and soft tissue.
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spelling pubmed-92828622022-07-15 Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses Xu, Shenglin Guo, Zehao Shen, Qiling Peng, Yongjun Li, Jian Li, Sheng He, Peng Jiang, Zheng Que, Yukang Cao, Kun Hu, Bo Hu, Yong Front Oncol Oncology BACKGROUND: Reconstruction of pelvis girdle stability after tumor-induced hemipelvectomy remains challenging. We surgically treated 13 patients with custom-made, three-dimensional printed hemipelvic prostheses. We aim to identify the preliminary outcomes for patients who have been managed with more mixed regions of prosthetic pelvic reconstruction and the feasibility of two reconstructive systems. METHODS: Seven male patients and 6 female patients treated at our center between January 2019 and May 2021 were included. There were 11 primary sarcomas and 2 solitary bone metastases. After en bloc tumor resection, two types of personalized, three-dimensional printed prostheses were fixed to restore the stability and rebuild the load transfer. The position of the reconstructed hemipelvis was evaluated on an anteroposterior plain radiograph. The complications and outcomes were traced. One amputation specimen was discovered through histological analysis of the porous structure. RESULTS: The operative duration was 467 ± 144 min, and the blood loss was 3,119 ± 662 ml. During a follow-up of 22.4 ± 8.5 months, two patients had delayed wound healing and one had a second-stage flap transfer. One patient with osteosarcoma died of pulmonary metastasis 27 months after surgery. Two patients with marginal resection suffered from local recurrence and had extra surgeries. One patient had traumatic hip dislocation 2 months after surgery and manipulative reduction was performed. The acetabular inclination of the affected side was 42.2 ± 4.3°, compared with 42.1 ± 3.9° on the contralateral side. The horizontal distance between the center of the femoral head and the middle vertical line was 10.4 ± 0.6 cm, while the reconstructed side was 9.8 ± 0.8 cm. No significant difference in acetabular position after surgery was found (p > 0.05). The amputation specimen harvested from one patient with local recurrence demonstrated bone and soft tissue ingrowth within the three-dimensional printed trabecular structure. Walking ability was preserved in all patients who are still alive and no prosthesis-related complications occurred. The MSTS score was 22.0 ± 3.7. CONCLUSIONS: Both types of custom-made, three-dimensional printed prostheses manifested excellent precision, mechanical stability, and promising functional rehabilitation. The porous structure exhibited favorable histocompatibility to facilitate the ingrowth of bone and soft tissue. Frontiers Media S.A. 2022-06-30 /pmc/articles/PMC9282862/ /pubmed/35847863 http://dx.doi.org/10.3389/fonc.2022.935059 Text en Copyright © 2022 Xu, Guo, Shen, Peng, Li, Li, He, Jiang, Que, Cao, Hu and Hu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Xu, Shenglin
Guo, Zehao
Shen, Qiling
Peng, Yongjun
Li, Jian
Li, Sheng
He, Peng
Jiang, Zheng
Que, Yukang
Cao, Kun
Hu, Bo
Hu, Yong
Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses
title Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses
title_full Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses
title_fullStr Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses
title_full_unstemmed Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses
title_short Reconstruction of Tumor-Induced Pelvic Defects With Customized, Three-Dimensional Printed Prostheses
title_sort reconstruction of tumor-induced pelvic defects with customized, three-dimensional printed prostheses
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282862/
https://www.ncbi.nlm.nih.gov/pubmed/35847863
http://dx.doi.org/10.3389/fonc.2022.935059
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