Department of Orthopedics, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, 283 Tongzipo Road, Changsha, Hunan, 410013, People's Republic of China.
J Orthop Surg Res. 2021 May 28;16(1):343. doi: 10.1186/s13018-021-02374-w.
Surgical resection and reconstruction for low-grade bone sarcoma in the metaphysis of the distal femur remain challenging. We hypothesized that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function.
From January 2017 to August 2019, five patients diagnosed with low-grade bone sarcoma in the metaphysis of the distal femur were treated with hemicortical resection using 3D printing guide plate. Autologous bone graft was inactivated in a high-temperature water bath and re-implanted in situ fixed with plate and screw. Patients were followed up from 17 to 33 months. The Musculoskeletal Tumor Society Score was used to evaluate the joint function. X-ray was used to evaluate the bone union.
One patient was paracorticular osteosarcoma, and four cases had highly differentiated chondrosarcoma. All cases were involved in the metaphysis of the distal femur. Patients were followed up from 13 to 33 months, with an average of 23.6 months. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society Score averaged at 28.1, while the International Society of Limb Salvage imaging score examination averaged 89.8%.
Here, we demonstrate that the 3D printing osteotomy guide plate-assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of the distal femur and retained satisfied joint function.
股骨远端干骺端低度恶性骨肿瘤的外科切除和重建仍然具有挑战性。我们假设 3D 打印截骨导板可以辅助准确切除肿瘤病变并保留关节功能。
2017 年 1 月至 2019 年 8 月，采用 3D 打印导板行半骺骨切除治疗 5 例股骨远端干骺端低度恶性骨肿瘤患者。将自体骨在高温水浴中灭活，原位再植，用钢板和螺钉固定。患者随访 17 至 33 个月。采用肌肉骨骼肿瘤学会评分评估关节功能，X 线评估骨愈合情况。
1 例为皮质旁骨肉瘤，4 例为高级别软骨肉瘤，均累及股骨远端干骺端。患者随访 13 至 33 个月，平均 23.6 个月。所有患者均无术后感染、内固定松动或骨折。肌肉骨骼肿瘤学会评分为 28.1 分，国际保肢协会影像学评分检查平均为 89.8%。
我们证明 3D 打印截骨导板辅助半骺骨切除是一种有效的策略，可以有效切除股骨远端干骺端原发性低度恶性骨肿瘤，并保留满意的关节功能。
