Reconstruction with 3D-printed modular pelvic endoprostheses after pelvic tumor resection / 中华骨科杂志

ABSTRACT

Objective To investigate the ideal reconstruction methods after pelvic tumor resection and to assess the feasibility of three-dimensional (3D) printing technology for pelvic reconstruction,we performed a retrospective study of patients with pelvic tumors who received tumor resection and reconstruction using 3D-printed pelvic endoprostheses.Methods Thirty-five patients received tumor resection and functional reconstruction with 3D-printed pelvic endoprostheses in our center from Sep.2013 to Dec.2015.According to Enneking' s classification,there were 3 cases of Type Ⅰ,12 cases of Type Ⅱ+Ⅲ,5 cases of Type Ⅰ+Ⅱ,2 case of Type Ⅰ+Ⅱ+Ⅲ,10 cases of type Ⅰ+Ⅱ+Ⅳ and 3 cases of type Ⅰ+Ⅱ+Ⅲ+Ⅳ resection.Methods of reconstruction included 3 patients with 3D-printed iliac endoprosthesis,12 patients with 3D-printed standard hemipelvic endoprosthesis and 20 patients with 3D-printed screw-rod connected hemipelvic endoprosthesis.Results All 35 patients underwent en bloc resection.Margins were wide in 15 cases,marginal in 14 cases and intralesional in 6 cases.After a mean followed-up of 20.5 months (6 to 30),25 patients survived without evidence of disease,5 patients were alive with diseases and 5 patients died of distant metastasis.Complications included 7 cases of delayed wound healing,2 cases of hip dislocation and no cases of deep infection.The average MSTS 93 score was 19.1 (9-26) for all of the 30 alive patients,22.7 (20 to 25) for 3 patients with iliac endoprosthesis reconstruction,19.8 (15 to 26) for 12 patients with standard hemipelvic endoprosthesis reconstruction,and 17.7 (9 to 25) for 15 patients with screw-rod connected hemipelvic endoprosthesis at the last follow up.Conclusion The application of 3D-printing technology could facilitate precise matching and osseointegration between the implants and host bone.Our clinical results proved that application of 3D-printed pelvic endoprostheses for reconstruction of bony defect was safe without additional complications,and that good functional results could be expected during short-term follow-up.