scholarly journals 3D printing guide plate for accurate hemicortical bone tumor resection in metaphysis of distal femoral: a technical note

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hongwei Wu ◽  
Shuo Yang ◽  
Jianfan Liu ◽  
Linqin Li ◽  
Yi Luo ◽  
...  
Keyword(s):  
3D Printing ◽  
Distal Femur ◽  
Tumor Resection ◽  
Bone Sarcoma ◽  
Technical Note ◽  
Low Grade ◽  
Joint Function ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Guide Plate

Abstract Background Surgical resection and reconstruction for low-grade bone sarcoma in the metaphysis of the distal femur remain challenging. We hypothesized that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function. Methods From January 2017 to August 2019, five patients diagnosed with low-grade bone sarcoma in the metaphysis of the distal femur were treated with hemicortical resection using 3D printing guide plate. Autologous bone graft was inactivated in a high-temperature water bath and re-implanted in situ fixed with plate and screw. Patients were followed up from 17 to 33 months. The Musculoskeletal Tumor Society Score was used to evaluate the joint function. X-ray was used to evaluate the bone union. Results One patient was paracorticular osteosarcoma, and four cases had highly differentiated chondrosarcoma. All cases were involved in the metaphysis of the distal femur. Patients were followed up from 13 to 33 months, with an average of 23.6 months. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society Score averaged at 28.1, while the International Society of Limb Salvage imaging score examination averaged 89.8%. Conclusions Here, we demonstrate that the 3D printing osteotomy guide plate-assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of the distal femur and retained satisfied joint function.

3D Printing Guide Plate for Accurate Hemicortical Bone Resection in Low-Grade Bone Sarcoma

2020 ◽  
Author(s):  
Hongwei Wu ◽  
Xian'an Li ◽  
Shuo Yang ◽  
Jie Bu ◽  
Xuezheng Xu ◽  
...  
Keyword(s):  
3D Printing ◽  
Bone Sarcoma ◽  
Long Bone ◽  
Low Grade ◽  
Joint Function ◽  
Bone Resection ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Guide Plate ◽  
Post Operation

Abstract Background: Surgical resection and reconstruction for low grade bone sarcoma in the metaphysis of the long bone remains challenging. We hypothesize that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function without higher recurrence rate. Methods: From January 2017 to August 2019, ten patients with low-grade malignant bone tumor in metaphysis of the limbs were treated with hemicortical resection using 3D printing guide plate and biological reconstruction. Results: Four patients were paracorticular osteosarcoma, five cases had highly differentiated chondrosarcoma, and one case was a chondromyxoid fibroma. Two of the cases involved the proximal humerus, while eight cases involved the distal femur. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society score averaged at 27.1, while the International Society of Limb Salvage imaging score examination averaged 87.8%. Conclusions: Here, we demonstrate that the 3D printing osteotomy guide plate assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of long bone and restore excellent joint function.

Reconstruction with Custom Unicondylar Hemiarthroplasty following Tumor Resection: A Case Series and Review of the Literature

2019 ◽  
Vol 33 (08) ◽  
pp. 818-824
Author(s):  
Joseph A. Ippolito ◽  
Megan L. Campbell ◽  
Brianna L. Siracuse ◽  
Joseph Benevenia
Keyword(s):  
Distal Femur ◽  
Weight Bearing ◽  
Tumor Resection ◽  
Case Series ◽  
Full Weight Bearing ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Optimal Function ◽  
Tumor Involvement

AbstractFor patients with tumors of the distal femur, options for limb salvage include tumor resection followed by reconstruction. While reconstruction commonly involves a distal femoral replacement, careful selection of patients with tumor involvement limited to a single condyle may be candidates for reconstruction with distal femur hemiarthroplasty. In these procedures, resection spares considerably more native anatomy. Three consecutive patients who underwent resection and reconstruction at the distal femur with custom unicondylar hemiarthroplasty are presented in this case series at a mean follow-up of 45 months (range, 26–78). In two cases, prostheses were utilized as a secondary procedure after failure of initial reconstruction. In one case, the custom prosthesis was utilized as the primary method of reconstruction. Mean Musculoskeletal Tumor Society disease-specific scores were 26.7 (range, 25–28). All patients achieved a return to full weight bearing, activities of daily living, and functional range of motion. In appropriately selected patients with tumors of the distal femur, reconstruction with custom unicondylar hemiarthroplasty provides benefits including optimal function postoperatively via preservation of tumor-free bone and ligamentous structures. Additionally, maintenance of greater bone stock may confer benefits to patients with pathology at a high likelihood for recurrence and need for subsequent procedures.

scholarly journals Plastic lengthening amputation with vascularized bone grafts in children with bone sarcoma: a preliminary report

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Zhiqiang Zhao ◽  
Qinglin Jin ◽  
Xianbiao Xie ◽  
Yongqian Wang ◽  
Tiao Lin ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Young Patients ◽  
Bone Sarcoma ◽  
Postoperative Management ◽  
Functional Score ◽  
Leg Length ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Functional Scores ◽  
Distal Joint

Abstract Background At present, amputation was widely adopted for young patients when limb salvage was deemed risky with several surgical strategy such as rotationplasty. However, leg length discrepancies and unfavorable cosmetic results were indispensable complication of this strategy. The purpose of this study was to propose a novel reconstruction strategy and evaluate the early clinical and functional outcomes of the strategy. Methods Plastic lengthening amputation (PLA) has been developed by lengthening the stump to preserve one additional distal joint for fixing the artificial limb well. The surgical technique and postoperative management were documented, and the functional outcomes were compared with those of traditional amputation (TA). Six pairs of patients matched for age, sex, location, pathological type, and final prosthesis underwent individually designed plastic lengthening amputation with vascularized autografts or traditional amputation between January 2005 and December 2007. All patients were followed, and the locomotor index and the musculoskeletal tumor society score (MSTS) were used to describe and quantitatively grade limb functional outcomes after amputation. The complications and functional outcomes of the patients taken two kinds of procedures were compared. Results Twelve patients with osteosarcoma or Ewing’s sarcoma of either the femur or tibia were included in the study. Six patients underwent plastic lengthening amputations, three of whom also underwent vascular anastomosis. Patients were followed for an average of 48.17 months; bone healing required an average of 3.3 months. No local recurrence was found. The average postoperative locomotor index functional score of the affected limb was 32.67 ± 5.89 in the plastic lengthening amputation group while was 19.50 ± 7.87 in the traditional amputation group. The MSTS functional scores were 22.67 ± 1.33 and 24.17 ± 1.45 at 6 and 12 months for patients in PLA group while 17.00 ± 1.549 and 17.83 ± 1.64 at 6 and 12 months for patients in TA group. Conclusions Plastic lengthening amputations with vascularized autografts could preserve the knee joint to improve the function of the amputated limb in selected bone sarcoma patients.

scholarly journals Clinical Outcomes of Osteoarticular Extracorporeal Irradiated Autograft for Malignant Bone Tumor

Sarcoma ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Satoshi Takenaka ◽  
Nobuhito Araki ◽  
Takafumi Ueda ◽  
Shigeki Kakunaga ◽  
Yoshinori Imura ◽  
...  
Keyword(s):  
Bone Tumor ◽  
Functional Outcomes ◽  
Tumor Resection ◽  
Radiographic Evaluation ◽  
Functional Score ◽  
Operation Technique ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Radiographic Score ◽  
Radiographic Changes

Background and Objectives. Osteoarticular extracorporeal irradiated autograft is an alternative operation technique to prosthetic devices or allografts for reconstruction after resection of bone malignancies. The aim of this study is to assess the complications, radiographic changes, and functional outcomes of osteoarticular ECIA. Methods. We retrospectively reviewed 33 patients who underwent osteoarticular ECIA after bone tumor resection from 1988 to 2014. We investigated complications, radiographic changes by the International Society of Limb Salvage graft evaluation criteria, and functional outcomes according to the Musculoskeletal Tumor Society scoring system. Results. Fifteen patients were reoperated upon due to infection (n = 9), protruding fixation implant (n = 4), or fracture of the grafted bone (n = 2). The average radiographic evaluation score was 66.4%, and the median functional score was 23 (77%). The radiographic score for the proximal humerus or proximal tibia was lower than that for the other locations. The functional score was not different among the autograft sites but was related to the radiographic score. Conclusion. Although osteoarticular ECIA is one of the reasonable surgical options for patients with tumors for which reliable prostheses are not available, we do not recommend osteoarticular ECIA as a routine procedure because of high complication rate.

scholarly journals A CASE REPORT OF FEMUR OSTEOCHONDROMA IN 22 YEARS OLD FEMALE PATIENT

2020 ◽  
Vol 8 (10) ◽  
pp. 1263-1267
Author(s):  
Abdulrahman M. Bin Mohi ◽  
◽  
Ahmed A. Alzahrani ◽  
Bashar R. Reda
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Proximal Femur ◽  
Conflict Of Interest ◽  
Distal Femur ◽  
Tumor Resection ◽  
Surgical Excision ◽  
Low Grade ◽  
The Right ◽  
Hands And Feet

Chondromais considered a nonmalignant tumor that composed of mature hyaline cartilage and commonly occur in hands and feet. Overall incidents show that females are predominant comparing to males with evenly distributed range of ages. Multiple chondromas have to be differentiated from osteochondroma and chondrosarcoma. This paper reports three different types of lesions in one patient.Osteochondroma or exostosis is the most common benign tumor of the skeleton. It is a developmental osseous anomaly, which arises from exophytic outgrowth on bone surfaces characteristically. Osteochondroma account for about 12% of bone tumors. Here, we have described a 22 years old female patient with left knee joint pain and swelling of the left distal femur with limited movements. The incisional biopsy of the left distal femur identified low-grade chondrosarcoma and chondroma after histopathology. This underwent one-stage surgical excision of the tumor with a posterior approach and tumor resection from the femur. After surgery, an unusual pain appears in the right hip joint during the post-operative period.Machine resonance imaging (MRI), and X-ray of pelvis help to diagnose thewell-differentiated chondrosarcoma and chondroma. This was a case of osteochondroma in the right proximal femur, chondroma like lesion in the left proximal femur and chondrosarcoma in the left distal femur. Ethical consideration: Written informed consent was obtained from the patient for publication of this case report and accompanying images. Conflict of interest: There is no conflict of interest.

scholarly journals Clinical outcomes of frozen autograft reconstruction for the treatment of primary bone sarcoma in adolescents and young adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshihiro Araki ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
Shinji Miwa ◽  
...  
Keyword(s):  
Young Adults ◽  
Clinical Outcomes ◽  
Bone Sarcoma ◽  
Adolescents And Young Adults ◽  
Appendicular Skeleton ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Primary Bone Sarcoma ◽  
Primary Bone

AbstractAge affects the clinical outcomes of cancer treatment, including those for bone sarcoma. Successful reconstruction using frozen autograft after excision of bone sarcoma has been reported; however, little is known about the clinical outcomes of frozen autograft reconstruction according to age. The purpose was to evaluate the clinical outcomes of the frozen autograft reconstruction focusing on skeletally mature adolescents and young adults (AYAs) that was 15 to 39 years of age. A total of 37 AYA patients with primary bone sarcoma on the appendicular skeleton were enrolled in this study. The mean follow-up period was 89 months. The graft survival (GS), overall survival (OS), recurrence-free survival (RFS), complications and the function were retrospectively evaluated using medical records. The 10-year GS, OS, and RFS rates were 76%, 84%, and 79%, respectively. Bone union was achieved with a rate of 94% within 1 year after surgery, and nonunion (n = 1) and fracture (n = 2) were infrequently observed. Graft removal was performed in 7 cases, and the most common reason for the removal was infection (n = 5). The Musculoskeletal Tumor Society score was excellent in 23 cases of the available 29 cases. Frozen autograft reconstruction for AYAs showed excellent clinical outcomes, although the long-term follow-up is required.

scholarly journals New Directions in 3D Medical Modeling: 3D-Printing Anatomy and Functions in Neurosurgical Planning

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Paolo Gargiulo ◽  
Íris Árnadóttir ◽  
Magnús Gíslason ◽  
Kyle Edmunds ◽  
Ingvar Ólafsson
Keyword(s):  
3D Printing ◽  
3D Model ◽  
Surgical Navigation ◽  
Tumor Resection ◽  
University Hospital ◽  
Low Grade ◽  
Skull Base Tumor ◽  
Fiber Tract ◽  
Neurosurgical Planning

This paper illustrates the feasibility and utility of combining cranial anatomy and brain function on the same 3D-printed model, as evidenced by a neurosurgical planning case study of a 29-year-old female patient with a low-grade frontal-lobe glioma. We herein report the rapid prototyping methodology utilized in conjunction with surgical navigation to prepare and plan a complex neurosurgery. The method introduced here combines CT and MRI images with DTI tractography, while using various image segmentation protocols to 3D model the skull base, tumor, and five eloquent fiber tracts. This 3D model is rapid-prototyped and coregistered with patient images and a reported surgical navigation system, establishing a clear link between the printed model and surgical navigation. This methodology highlights the potential for advanced neurosurgical preparation, which can begin before the patient enters the operation theatre. Moreover, the work presented here demonstrates the workflow developed at the National University Hospital of Iceland, Landspitali, focusing on the processes of anatomy segmentation, fiber tract extrapolation, MRI/CT registration, and 3D printing. Furthermore, we present a qualitative and quantitative assessment for fiber tract generation in a case study where these processes are applied in the preparation of brain tumor resection surgery.

scholarly journals Long-Term Follow-Up in Tumoral Arthroplasty

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 54
Author(s):  
G. Iacobescu ◽  
R. Ene ◽  
A. Cursaru ◽  
D. Anghelescu ◽  
C. Cîrstoiu
Keyword(s):  
Functional Recovery ◽  
Selection Criteria ◽  
Distal Femur ◽  
Functional Results ◽  
Close Correlation ◽  
Late Complications ◽  
Tumor Formation ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society

Abstract Introduction. Efficient management of a segmental resection or major osteolysis in the distal femur secondary to a tumor formation remains a controversial problem. Available options include the use of a modular or customized megaprosthetic implant. Modularity allows versatility for reconstruction and avoids the delay required to make a customized implant. Hypothesis and type of study. Performing a clinical and radiological retrospective study that aims to evaluate long-term efficiency in the use of megaprostheses in segmental distal femur resections. Elaboration of patient selection criteria for modular prosthesis. Materials and methods. We followed retrospectively 33 patients for 5 years from the time of the first surgery. We evaluated the implant stability, the late complications rate, and the long-term functional recovery of patients with distal femoral tumors who underwent segmental resections and subsequently reconstructive arthroplasty. Results. Thirty of the 33 patients maintained a mobile knee joint. An intermediate staging was performed at 30 months, which determined tumor recurrence in 2 patients, aseptic degradation of the components in 3 of them, and septic degradation in two of the evaluated cases. Because a tumoral recurrence occurred on the 45th month, the need for amputation of the prosthetic limb was imposed. The degradation of the polyethylene component (in 5 cases) was observed in the 5-year assessment. The functional results were excellent with the Musculoskeletal Tumor Society Score of 88% and a Toronto Extremity Severity Scale Score of 94%. Conclusions. Patients with distal femoral bone tumors undergoing modular reconstruction prosthetic arthroplasty have excellent functional results with retaining the affected limb and knee mobility. There was a close correlation between correctly applying the selection criteria for patients undergoing prosthesis intervention and functional recovery results.

scholarly journals Surveillance Strategies for Sarcoma: Results of a Survey of Members of the Musculoskeletal Tumor Society

Sarcoma ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
David D. Greenberg ◽  
Brooke Crawford
Keyword(s):  
Soft Tissue ◽  
Radiation Exposure ◽  
Tumor Size ◽  
Surgical Margin ◽  
Bone Sarcoma ◽  
Histologic Grade ◽  
Public Health Issue ◽  
Evidence Based ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society

Background. Surveillance is crucial to oncology, yet there is scant evidence to guide strategies.Purpose. This survey identified sarcoma surveillance strategies for Musculoskeletal Tumor Society (MSTS) members and rationales behind them. Understanding current practice should facilitate studies to generate evidence-based surveillance protocols.Methods. Permission was granted by the Research and Executive Committee of the MSTS to survey members on surveillance strategies. First, the questionnaire requested demographic and clinical practice information. Second, the survey focused on clinicians’ specific surveillance soft tissue and bone sarcoma protocols.Results. 20 percent of MSTS members completed the survey. The primary rationale for protocols was training continuation, followed by published guidelines, and finally personal interpretation of the literature. 95% of the respondents believe that additional studies regarding appropriate surveillance protocols are needed. 87% reported patient concerns regarding radiation exposure from surveillance imaging. For soft tissue and bone sarcoma local recurrence, responders identified surgical margin, histologic grade, and tumor size as the most important factors. For metastases, important risk factors identified included histologic grade, tumor size, and histologic type. Protocols demonstrated wide variation.Conclusion. This survey demonstrates that surveillance strategies utilized by MSTS members are not evidence-based, providing rationale for multi-institutional studies. It also confirms the public health issue of excessive radiation exposure.

scholarly journals Application of a three-dimensional printed segmental scapula prosthesis in the treatment of scapula tumors

2019 ◽  
Vol 47 (11) ◽  
pp. 5873-5882
Author(s):  
Linglong Deng ◽  
Xing Zhao ◽  
Chi Wei ◽  
Wenqiang Qu ◽  
Li Yu ◽  
...  
Keyword(s):  
3D Printing ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Limb Salvage Surgery ◽  
Bony Defect ◽  
Low Grade ◽  
Printing Technique ◽  
3D Printing Technique

Chondrosarcoma is characterized by the presence of histologically aggressive behavior, and commonly involves the scapula. Currently, limb salvage surgery is the recommended surgical treatment. Owing to the irregularity of the tumor, the suitability of an implant after tumor resection is a challenge for surgeons. Three-dimensional (3D) printing technology has the potential to make personalized limb salvage surgery a reality. We report the case of a 53-year-old man who was diagnosed with chondrosarcoma of the scapula. Considering the low-grade malignancy and lack of invasion of the glenoid, we agreed upon segmental scapula replacement as the treatment protocol. Nevertheless, reconstruction of the irregular bony defect remaining after tumor resection can be complicated. Therefore, a personalized prosthesis and navigation template corresponding to tumor was designed with 3D printing technique, and tumor resection, prosthesis implantation, and rotator cuff reconstruction were completed. The affected shoulder achieved satisfactory function during a 32-month follow-up with no tumor recurrence. 3D printing technique can help implement the individualized design of the implant and accurate reconstruction after tumor resection, simplify complicated operations, improve operational efficiency, and allow early functional recovery.

Sign in / Sign up

Export Citation Format

Share Document