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3D 打印假体置换保肢治疗胫骨造釉细胞瘤根治性切除术后 1 年随访:1 例报告。

3D-Printed Prosthesis Replacement for Limb Salvage after Radical Resection of an Ameloblastoma in the Tibia with 1 Year of Follow Up: A Case Report.

机构信息

Department of Joint Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.

出版信息

Yonsei Med J. 2019 Sep;60(9):882-886. doi: 10.3349/ymj.2019.60.9.882.

Abstract

Ameloblastoma in the tibia is rare. Limb reconstruction after tumor resection is challenging in terms of selection of the operative method. Here, we report a case of radical resection of an ameloblastoma in the mid-distal tibia combined with limb salvage using a three-dimensional (3D)-printed prosthesis replacement, with 1-year follow-up results. After receiving local institutional review board approval, a titanium alloy prosthesis was designed using a computer and manufactured with 3D-printing technology. During the operation, the stem of the prosthesis was inserted closely into the proximal tibial medullary cavity. Then, the metal ankle mortise and the talus were compacted closely. Radiographic results at 1-year follow up showed that the prosthesis was well placed, and no loosening was observed. The Musculoskeletal Tumor Society (MSTS) 93 functional score was 26 points, and the functional recovery percentage was 86.7%. Computer-assisted 3D-printing technology allowed for more volume and structural compatibility of the prosthesis, thereby ensuring a smooth operation and initial prosthetic stabilization. During the follow up, the presence of bone ingrowths on the porous surface of some segments of the prosthesis suggested good outcomes for long-term biological integration between the prosthesis and host bone.

摘要

胫骨造釉细胞瘤较为罕见。肿瘤切除后进行肢体重建,在手术方法的选择上具有挑战性。本文报告 1 例胫骨中远端造釉细胞瘤行根治性切除术,结合 3D 打印假体置换进行保肢治疗,随访 1 年。获得局部机构审查委员会批准后,使用计算机设计钛合金假体,并采用 3D 打印技术制造。手术中,将假体的柄紧密插入胫骨近端髓腔。然后,使金属踝穴和距骨紧密贴合。术后 1 年的影像学结果显示假体位置良好,未见松动。肌肉骨骼肿瘤学会(MSTS)93 功能评分 26 分,功能恢复百分比为 86.7%。计算机辅助 3D 打印技术使假体具有更大的容积和结构兼容性,从而确保手术的顺利进行和假体的初始稳定性。随访期间,部分假体多孔表面有骨长入,表明假体与宿主骨的长期生物学整合具有良好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fda/6704015/84a22f2914d5/ymj-60-882-g001.jpg

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