Han Qing, Zhang Kesong, Zhang Yong, Wang Chenyu, Yang Kerong, Zou Yun, Chen Bingpeng, Wang Jincheng
Department of Orthopedics.
Clinical Laboratories, Second Hospital of Jilin University, Changchun, Jilin Province, China.
Medicine (Baltimore). 2019 Sep;98(36):e16658. doi: 10.1097/MD.0000000000016658.
Pelvic tumor had great impact on patients' quality of life. After tumor resection, how to accurately fill bone defect remained challenging for orthopedic surgeons. Due to lack of individual design, high incidence of prosthetic mismatching, and loosening were reported in pelvic reconstruction surgery with conventional modular prostheses. Nowadays, with rapid development of three-dimensional (3D) print technology, pelvic prostheses could be designed according to patients' own anatomy. The objective of this study was to describe the application of 3D printed customized hemi-pelvic prosthesis for patients with pelvic tumor.
A 62-year-old female had developed severe right joint pain without obvious inducement from 5 months before she sought medical advice. Pain, swelling, and limited range of motion of right joint were founded during physical examination.
The patients were diagnosed as "right acetabulum metastatic carcinoma" INTERVENTION:: 3D printed titanium alloy hemi-pelvic prosthesis was designed according the morphology of unaffected side hemi-pelvis and subsequently implanted in surgery to reconstruct the pelvis. 3D printed osteotomy guide and pelvic model were also manufactured and applied to improve accuracy of osteotomy and reduce operation time. X-Ray of pelvis, Harris score, musculoskeletal tumor society score (MSTS) and The MOS item short from health survey (SF-36) were recorded during the period of preoperation, 1, 3, 6, 12 months follow-up after operation.
3D printed hemi-pelvic prosthesis matched precisely with pelvis and implanted successfully. There was no sign of prosthetic loosening within 12 months' follow-up. No sign of peri-prosthetic infection from laboratory examination. Harris score, MSTS, and SF-36 were gradually increasing during follow-up period.
Satisfactory effect of pelvic reconstruction could be achieved by 3D printed hemi-pelvic prostheses. It also provided a promising way to the treatment of pelvic tumor in similar cases.
骨盆肿瘤对患者的生活质量有很大影响。肿瘤切除后，如何准确填充骨缺损对骨科医生来说仍然具有挑战性。由于缺乏个性化设计，传统模块化假体在骨盆重建手术中报告了较高的假体不匹配发生率和松动率。如今，随着三维（3D）打印技术的快速发展，可以根据患者自身的解剖结构设计骨盆假体。本研究的目的是描述3D打印定制半骨盆假体在骨盆肿瘤患者中的应用。
一名62岁女性在寻求医疗建议前5个月无明显诱因出现严重的右关节疼痛。体格检查发现右关节疼痛、肿胀和活动范围受限。
患者被诊断为“右髋臼转移癌”
根据未受影响侧半骨盆的形态设计3D打印钛合金半骨盆假体，随后在手术中植入以重建骨盆。还制作并应用了3D打印截骨导向器和骨盆模型，以提高截骨的准确性并减少手术时间。在术前、术后1、3、6、12个月随访期间记录骨盆X线、Harris评分、肌肉骨骼肿瘤学会评分（MSTS）和健康调查简表（SF-36）。
3D打印半骨盆假体与骨盆精确匹配并成功植入。在12个月的随访期内没有假体松动的迹象。实验室检查未发现假体周围感染迹象。随访期间Harris评分、MSTS和SF-36逐渐增加。
3D打印半骨盆假体可实现令人满意的骨盆重建效果。它也为类似病例的骨盆肿瘤治疗提供了一种有前景的方法。
