Li Ye, Li Longqing, He Xuanhong, Gong Taojun, Li Zhuangzhuang, Liu Xiaoyan, Luo Yi, Zhou Yong, Min Li, Tu Chongqi
Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
Bone and Joint 3D-Printing and Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2025 Aug 18;15:1562205. doi: 10.3389/fonc.2025.1562205. eCollection 2025.
To investigate the short- and mid-term clinical efficacy of denosumab combined with 3D-printed prosthesis in the treatment of patients with giant cell tumor of the distal radius.
From January 2016 to January 2022, 20 patients with giant cell tumor of the distal radius underwent denosumab treatment combined with 3D-printed prosthetic reconstruction at our hospital. This study evaluates the short- and mid-term efficacy by analyzing clinical cases where denosumab was used preoperatively, followed by 3D-printed biological prosthesis reconstruction of the distal radius tumor segment defect. We analyzed complications, function, survival rate, and recurrence rate after denosumab treatment and surgery.
A total of 20 patients underwent 3D-printed biological prosthesis replacement of the distal radius, with an average of 5.5 doses (range, 4-7) of 120 mg denosumab administered preoperatively. The average age of the patients was 37.2 years (range, 17-52 years), with an average follow-up of 47.3 months (range, 24-72 months). At the last follow-up, no local recurrence or pulmonary metastasis was observed in any of the patients. The pre-treatment wrist range of motion (ROM) was: extension 17.0° (range, 5°-25°), flexion 17.3° (range, 10°-30°), pronation 19.3° (range, 10°-30°), and supination 18.8° (range, 10°-30°). After denosumab treatment and before prosthesis replacement, wrist ROM improved to: extension 33.0° (range, 15°-70°), flexion 39.0° (range, 15°-60°), pronation 37.5° (range, 20°-55°), and supination 40.5° (range, 20°-60°). After prosthesis replacement, wrist ROM further improved to: extension 46.4° (range, 20°-80°), flexion 55.8° (range, 20°-85°), pronation 57.0° (range, 30°-80°), and supination 61.8° (range, 25°-80°). The average Mayo wrist score was 71.8 points, and the average Disabilities of the Arm, Shoulder and Hand (DASH) score was 16.2 points. Regarding complications, one patient experienced wrist subluxation postoperatively, and two patients experienced distal radioulnar joint separation.
Denosumab treatment during the prosthesis production period improved wrist function and inhibited tumor progression. Patients undergoing 3D-printed biological prosthesis replacement of the distal radius showed good short- and mid-term functional outcomes, with good integration of the prosthesis with the host bone and low prosthesis-related complications. The overall clinical outcomes were satisfactory, though long-term effects of the prosthesis require further observation.
探讨地诺单抗联合3D打印假体治疗桡骨远端骨巨细胞瘤患者的短期和中期临床疗效。
2016年1月至2022年1月，我院20例桡骨远端骨巨细胞瘤患者接受了地诺单抗治疗并联合3D打印假体重建。本研究通过分析术前使用地诺单抗，随后对桡骨远端肿瘤节段缺损进行3D打印生物假体重建的临床病例，评估短期和中期疗效。我们分析了地诺单抗治疗及手术后的并发症、功能、生存率和复发率。
共有20例患者接受了桡骨远端3D打印生物假体置换，术前平均给予120mg地诺单抗5.5剂（范围4 - 7剂）。患者平均年龄37.2岁（范围17 - 52岁），平均随访47.3个月（范围24 - 72个月）。末次随访时，所有患者均未观察到局部复发或肺转移。治疗前腕关节活动范围（ROM）为：伸展17.0°（范围5° - 25°），屈曲17.3°（范围10° - 30°），旋前19.3°（范围10° - 30°），旋后18.8°（范围10° - 30°）。地诺单抗治疗后及假体置换前，腕关节ROM改善为：伸展33.0°（范围15° - 70°），屈曲39.0°（范围15° - 60°），旋前37.5°（范围20° - 55°），旋后40.5°（范围20° - 60°）。假体置换后，腕关节ROM进一步改善为：伸展46.4°（范围20° - 80°），屈曲55.8°（范围20° - 85°），旋前57.0°（范围30° - 80°），旋后61.8°（范围25° - 80°）。平均Mayo腕关节评分为71.8分，平均上肢、肩部和手部功能障碍（DASH）评分为16.2分。关于并发症，1例患者术后出现腕关节半脱位，2例患者出现下尺桡关节分离。
在假体制作期间使用地诺单抗治疗可改善腕关节功能并抑制肿瘤进展。接受桡骨远端3D打印生物假体置换患者的短期和中期功能结果良好，假体与宿主骨整合良好，假体相关并发症低。总体临床结果令人满意，不过假体的长期效果需要进一步观察。
