Elgamal Mohamed, Elnewishy Ahmed, Shah Sohaib, Hassanin Tarek, Noureldin Mahmoud, Hamada Ahmed, Fadlelmola Mohamed Muawia Yousif, Hussein Hatem, Chahal Kayden
Trauma and Orthopaedics, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.
Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, GBR.
Cureus. 2025 Jul 27;17(7):e88838. doi: 10.7759/cureus.88838. eCollection 2025 Jul.
Orthopedic sarcomas present unique surgical challenges due to their anatomical complexity and the need to balance oncologic control with functional preservation. Three-dimensional (3D) printing has emerged as a promising technology to improve surgical precision through patient-specific planning and reconstruction. This systematic review aimed to evaluate the effectiveness, safety, and clinical applications of 3D printing in the management of orthopedic sarcomas. Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Scopus, Google Scholar, and institutional databases for studies published between 2016 and 2025. Twenty studies involving 296 patients with primary bone sarcomas treated using 3D-printed implants, resection guides, or hybrid constructs were included. The most common anatomical sites were the pelvis, sacrum, and long bones. The majority of studies reported high rates of negative surgical margins, with at least 14 of 18 studies achieving R0 resections in over 90% of cases. Functional outcomes were favorable, with pooled Musculoskeletal Tumor Society (MSTS) scores averaging 78-80% of normal limb function, particularly in reconstructions of the ankle, femur, and tibia. The overall complication rate was 22%, with wound morbidity and infection being the most frequent adverse events. Comparative cohorts demonstrated improved surgical accuracy and lower complication rates in the 3D-assisted groups. While early outcomes are promising and support the utility of 3D printing in enhancing personalized oncologic surgery, further prospective studies with standardized outcome measures are needed to validate long-term benefits and inform wider clinical adoption.
由于解剖结构复杂，且需要在肿瘤控制与功能保留之间取得平衡，骨科肉瘤带来了独特的手术挑战。三维（3D）打印已成为一项有前景的技术，可通过针对患者的规划和重建来提高手术精度。本系统评价旨在评估3D打印在骨科肉瘤治疗中的有效性、安全性及临床应用。按照PRISMA指南，在PubMed、Scopus、谷歌学术和机构数据库中进行了全面的文献检索，以查找2016年至2025年发表的研究。纳入了20项研究，共296例使用3D打印植入物、切除导板或混合结构治疗的原发性骨肉瘤患者。最常见的解剖部位是骨盆、骶骨和长骨。大多数研究报告手术切缘阴性率较高，18项研究中至少有14项在超过90%的病例中实现了R0切除。功能结果良好，肌肉骨骼肿瘤学会（MSTS）综合评分平均为正常肢体功能的78 - 80%，尤其是在踝关节、股骨和胫骨的重建中。总体并发症发生率为22%，伤口并发症和感染是最常见的不良事件。比较队列显示，3D辅助组的手术准确性提高，并发症发生率降低。虽然早期结果很有前景，支持3D打印在增强个性化肿瘤手术中的作用，但需要进一步开展具有标准化结局指标的前瞻性研究，以验证长期益处并为更广泛的临床应用提供依据。
