Zhang Tianwen, Tan Xiaoning, Yuan Zhenchao, Liu Bin, Tan Jiachang
Guangxi Medical University Cancer Hospital, Nanning, 530021, People's Republic of China.
Department of Orthopaedic Soft Tissue Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021, People's Republic of China.
3D Print Med. 2025 Mar 27;11(1):15. doi: 10.1186/s41205-025-00261-2.
This study introduces a surgical technique involving the use of 3D-printed all-metal prostheses combined with mesh patches for the treatment of distal radial giant cell tumors, analyzing and evaluating the midterm outcomes for patients undergoing this treatment. The experience provides insights into the application of prosthesis replacement for reconstructing distal radial defects.
From January 2018 to January 2021, our center treated five cases of distal radial giant cell tumors using 3D-printed all-metal prostheses combined with mesh patches. Postoperative pain, range of motion, and grip strength were evaluated for all patients. Oncological outcomes, complications, and degenerative changes in the wrist joint were also assessed. Functional outcomes were evaluated based on the Mayo wrist score system.
The average follow-up period was 40.8 months (range: 32-66months). At the last follow-up, the mean range of motion (ROM) in the affected wrists was 20° extension, 21.6° flexion, 71.2° pronation, and 50° supination. The mean grip strength on the affected side was 64.2% compared to the unaffected side, with a Mayo score of 70. There were no incidences of aseptic loosening, wrist subluxation, or infections post-prosthesis replacement, although two cases presented with distal radioulnar joint dislocation. Of these, one case demonstrated ulnar impaction syndrome with positive ulnar variance and lunate bone degenerative changes on the 12-month postoperative radiographs. No recurrences or metastases were observed.
Utilizing 3D-printed metal prostheses and mesh grafts for the treatment of Campanacci Grade III or recurrent giant cell tumors of the distal radius is an effective approach. This strategy provides favorable functional outcomes during the early to mid stages of treatment, while also maintaining a low risk of complications. The concurrent use of mesh grafts facilitates early postoperative exercise, thereby accelerating functional recovery. Moreover, the intraoperative protection or reconstruction of joint ligaments, along with precise matching of the prostheses, contributes to a reduction in the risk of complications.
本研究介绍一种手术技术，即使用3D打印全金属假体联合网片修补术治疗桡骨远端巨细胞瘤，并分析和评估接受该治疗患者的中期疗效。该经验为假体置换在重建桡骨远端缺损中的应用提供了见解。
2018年1月至2021年1月，我们中心使用3D打印全金属假体联合网片修补术治疗了5例桡骨远端巨细胞瘤。对所有患者评估术后疼痛、活动范围和握力。还评估了肿瘤学结局、并发症和腕关节退变情况。基于梅奥腕关节评分系统评估功能结局。
平均随访期为40.8个月（范围：32 - 66个月）。在最后一次随访时，患侧腕关节的平均活动范围为伸展20°、屈曲21.6°、旋前71.2°和旋后50°。患侧平均握力为健侧的64.2%，梅奥评分为70分。假体置换后未发生无菌性松动、腕关节半脱位或感染，尽管有2例出现桡尺远侧关节脱位。其中1例在术后12个月的X线片上显示尺骨撞击综合征伴阳性尺骨变异和月骨退变。未观察到复发或转移。
利用3D打印金属假体和网片移植治疗Campanacci III级或复发性桡骨远端巨细胞瘤是一种有效的方法。该策略在治疗的早期至中期提供了良好的功能结局，同时并发症风险也较低。网片移植的同时使用便于术后早期锻炼，从而加速功能恢复。此外，术中对关节韧带的保护或重建以及假体的精确匹配有助于降低并发症风险。
