Orthopedics & Traumatology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, 00168 Roma, Italy.
Orthopedics and Traumatology, Università Cattolica Del Sacro Cuore, 00168 Roma, Italy.
Curr Oncol. 2022 Jun 28;29(7):4566-4577. doi: 10.3390/curroncol29070361.
Bone can be affected by different neoplastic conditions. Limb salvage surgery has become the preferred treatment strategy for most malignant tumors of the extremities. Advanced 3D printing technology has transformed the conventional view of oncological surgery. These types of implants are produced by electron beam melting (EBM) technology by sintering titanium powder in a scaffold shape designed following a project designed from HRCT and MRI. The aim of our study was to evaluate the outcomes and the mid-term follow-up of a population treated with 3D-printed custom-made prosthesis implantation in major oncological bone resection or after failure of primary implants. The primary outcome was the general patient satisfaction one year after surgery. The secondary outcomes were: mortality rate, treatment related complication rate, functional and clinical outcomes (KPS, ADL and IADL). Eight patients were included, five females and two males, with a mean age of 50.3 (±23.72) years at the surgery. The enrolled patients reported a mean satisfaction rate after surgery of 7.38 (±2) where 10 was the maximum value. There were no changes between pre- and postoperative mean KPS (81.43 +/−10.69). Mean preoperative ADL and IADL score was in both cases 4.86 (±1.07), while postoperative was 5 (±0.82), with a delta of 0.13 (p > 0.05). Custom-made prosthesis permits reconstructing bone defects caused by large tumor resection, especially in anatomically complex areas, restoring articular function.
骨骼可能会受到不同的肿瘤性疾病的影响。保肢手术已成为大多数四肢恶性肿瘤的首选治疗策略。先进的 3D 打印技术改变了传统的肿瘤外科观念。这些类型的植入物是通过电子束熔化 (EBM) 技术制造的，该技术通过在按照 HRCT 和 MRI 设计的项目设计的支架形状中烧结钛粉来生产。我们的研究目的是评估采用 3D 打印定制假体植入术治疗主要骨肿瘤切除或初次植入失败后的患者的结果和中期随访。主要结局是术后一年的总体患者满意度。次要结局为：死亡率、治疗相关并发症发生率、功能和临床结局（KPS、ADL 和 IADL）。共纳入 8 例患者，其中女性 5 例，男性 2 例，平均年龄为 50.3（±23.72）岁。术后患者的平均满意度为 7.38（±2），最高值为 10。术前和术后 KPS 平均值没有变化（81.43±10.69）。术前 ADL 和 IADL 评分平均均为 4.86（±1.07），术后为 5（±0.82），差值为 0.13（p>0.05）。定制假体允许重建由大肿瘤切除引起的骨缺损，尤其是在解剖结构复杂的区域，恢复关节功能。
