Orthopedics. 2022 Jan-Feb;45(1):e35-e41. doi: 10.3928/01477447-20211124-07. Epub 2021 Dec 2.
The use of 3-dimensional (3D)-printed cutting guides for resection of long bone sarcoma is a novel technique. These 3D-printed guides provide a potential benefit over navigational or freehand osteotomy. We evaluated whether the use of 3D-printed cutting guides in the resection of long bone sarcoma affects margin status and rates of union compared with historical controls. In this study, we performed a retrospective review of a prospectively maintained surgical database and reviewed 6 patients who underwent limb salvage for long bone sarcoma. We collected and analyzed clinicopathologic and surgical data. Six (100%) cases recorded negative margins, with mean postoperative follow-up of 108 weeks (range, 8-211 weeks). Time (mean±SD) to bony union was 20.5±10.5 weeks. Nine of 12 (75%) cumulative (proximal and distal) osteotomy sites went on to achieve union, with a nonunion rate of 25% per osteotomy. One (33%) nonunion occurred after adjuvant radiation therapy. Long-term complications were limited to 2 (33.3%) patients overall who had implant failure according to the Henderson classification system, and there were zero local recurrences at the conclusion of the study. Our institution has successfully performed limb salvage surgery with patient-specific 3D-printed technology. We show high rates of negative margin resection and junctional union that align with and improve on earlier findings. [. 2022;45(1):e35-e41.].
使用 3 维（3D）打印的截骨导板进行长骨肉瘤切除术是一种新的技术。这些 3D 打印导板比导航或徒手截骨术具有潜在的优势。我们评估了在长骨肉瘤切除术中使用 3D 打印截骨导板是否会影响切缘状态和愈合率，并与历史对照进行比较。在这项研究中，我们对一个前瞻性维护的手术数据库进行了回顾性研究，并回顾了 6 例接受保肢治疗的长骨肉瘤患者。我们收集并分析了临床病理和手术数据。6 例（100%）记录为阴性切缘，平均术后随访 108 周（范围 8-211 周）。骨性愈合时间（平均值±标准差）为 20.5±10.5 周。12 个（75%）累积（近端和远端）截骨部位中有 9 个达到了愈合，每个截骨部位的不愈合率为 25%。1 例（33%）不愈合发生在辅助放疗后。长期并发症仅限于 2 例（33.3%）患者，根据 Henderson 分类系统，这些患者存在植入物失败，在研究结束时无局部复发。我们机构已经成功地使用患者特异性 3D 打印技术进行了保肢手术。我们显示出高比例的阴性切缘切除和关节愈合，与早期发现一致，并有所改善。[。2022；45（1）：e35-e41。]。
