Liang H, Ji T, Zhang Y, Wang Y, Guo W
Peking University People's Hospital, and Key Laboratory for Musculoskeletal Tumor of Beijing, Xizhimen Nan 11, Xicheng District, Beijing 100044, China.
Bone Joint J. 2017 Feb;99-B(2):267-275. doi: 10.1302/0301-620X.99B2.BJJ-2016-0654.R1.
The aims of this retrospective study were to report the feasibility of using 3D-printing technology for patients with a pelvic tumour who underwent reconstruction.
A total of 35 patients underwent resection of a pelvic tumour and reconstruction using 3D-printed endoprostheses between September 2013 and December 2015. According to Enneking's classification of bone defects, there were three Type I lesions, 12 Type II+III lesions, five Type I+II lesions, two Type I+II+III lesions, ten type I+II+IV lesions and three type I+II+III+IV lesions. A total of three patients underwent reconstruction using an iliac prosthesis, 12 using a standard hemipelvic prosthesis and 20 using a screw-rod connected hemipelvic prosthesis.
All patients had an en bloc resection. Margins were wide in 15 patients, marginal in 14 and intralesional in six. After a mean follow-up of 20.5 months (6 to 30), 25 patients survived without evidence of disease, five were alive with disease and five had died from metastatic disease. Complications included seven patients with delayed wound healing and two with a dislocation of the hip. None had a deep infection. For the 30 surviving patients, the mean Musculoskeletal Society 93 score was 22.7 (20 to 25) for patients with an iliac prosthesis, 19.8 (15 to 26) for those with a standard prosthesis, and 17.7 (9 to 25) for those with a screw-rod connected prosthesis.
The application of 3D-printing technology can facilitate the precise matching and osseointegration between implants and the host bone. We found that the use of 3D-printed pelvic prostheses for reconstruction of the bony defect after resection of a pelvic tumour was safe, without additional complications, and gave good short-term functional results. Cite this article: Bone Joint J 2017;99-B:267-75.
本回顾性研究的目的是报告3D打印技术应用于接受骨盆肿瘤重建患者的可行性。
2013年9月至2015年12月期间，共有35例患者接受了骨盆肿瘤切除及使用3D打印假体进行重建。根据Enneking骨缺损分类，有3例I型病变、12例II + III型病变、5例I + II型病变、2例I + II + III型病变、10例I + II + IV型病变和3例I + II + III + IV型病变。共有3例患者使用髂骨假体进行重建，12例使用标准半骨盆假体，20例使用螺杆连接半骨盆假体。
所有患者均接受了整块切除。15例患者切缘为广泛切除，14例为边缘切除，6例为病内切除。平均随访20.5个月（6至30个月）后，25例患者存活且无疾病证据，5例带瘤生存，5例死于转移性疾病。并发症包括7例伤口愈合延迟和2例髋关节脱位。无一例发生深部感染。对于30例存活患者，使用髂骨假体的患者肌肉骨骼协会93评分平均为（20至25）22.7分，使用标准假体的患者为（15至26）19.8分，使用螺杆连接假体的患者为（9至25）17.7分。
3D打印技术的应用可促进植入物与宿主骨之间的精确匹配和骨整合。我们发现，使用3D打印骨盆假体重建骨盆肿瘤切除后的骨缺损是安全的，无额外并发症，且短期功能结果良好。引用本文：《骨关节杂志》2017；99 - B：267 - 75。
