scholarly journals Additively manufactured patient-specific prosthesis for tumor reconstruction: Design, process, and properties

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253786
Author(s):  
Maryam Tilton ◽  
Gregory S. Lewis ◽  
Michael W. Hast ◽  
Edward Fox ◽  
Guha Manogharan
Keyword(s):  
Proximal Humerus ◽  
Permanent Deformation ◽  
Tumor Resection ◽  
Bone Defects ◽  
Patient Specific ◽  
Loading Conditions ◽  
Micro Computed Tomography ◽  
Biomechanical Behavior ◽  
Large Bone ◽  
Large Bone Defects

Design and processing capabilities of additive manufacturing (AM) to fabricate complex geometries continues to drive the adoption of AM for biomedical applications. In this study, a validated design methodology is presented to evaluate AM as an effective fabrication technique for reconstruction of large bone defects after tumor resection in pediatric oncology patients. Implanting off-the-shelf components in pediatric patients is especially challenging because most standard components are sized and shaped for more common adult cases. While currently reported efforts on AM implants are focused on maxillofacial, hip and knee reconstructions, there have been no reported studies on reconstruction of proximal humerus tumors. A case study of a 9-year-old diagnosed with proximal humerus osteosarcoma was used to develop a patient-specific AM prosthesis for the humerus following tumor resection. Commonly used body-centered cubic (BCC) structures were incorporated at the surgical neck and distal interface in order to increase the effective surface area, promote osseointegration, and reduce the implant weight. A patient-specific prosthesis was fabricated using electron beam melting method from biocompatible Ti-6Al-4V. Both computational and biomechanical tests were performed on the prosthesis to evaluate its biomechanical behavior under varying loading conditions. Morphological analysis of the construct using micro-computed tomography was used to compare the as-designed and as-built prosthesis. It was found that the patient-specific prosthesis could withstand physiologically-relevant loading conditions with minimal permanent deformation (82 μm after 105 cycles) at the medial aspect of the porous surgical neck. These outcomes support potential translation of the patient-specific AM prostheses to reconstruct large bone defects following tumor resection.

Bone Transport Osteogenesis for Limb Salvage

2000 ◽  
Vol 13 (01) ◽  
pp. 18-22 ◽  
Author(s):  
M. Degna ◽  
A. Feretti ◽  
P. Buracco ◽  
Nicole Ehrhart
Keyword(s):  
Surgical Technique ◽  
Limb Salvage ◽  
Tumor Resection ◽  
Bone Defects ◽  
Bone Transport ◽  
Successful Outcome ◽  
Strict Adherence ◽  
Initial Learning ◽  
Large Bone ◽  
Large Bone Defects

Six dogs with osteosarcoma of the radius were treated by local resection and limb salvage using bone transport osteogenesis. One case is described in detail. Although the initial learning curve is steep for this technique, strict adherence to oncologic surgical technique and the principles of Ilizarov can lead to a successful outcome. Bone transport shows promise as an alternative to cortical allografts for reconstruction of large bone defects after tumor resection in the canine radius.

scholarly journals Bone transport for reconstruction of large bone defects after tibial tumor resection: a report of five cases

2018 ◽  
Vol 46 (8) ◽  
pp. 3219-3225 ◽  
Author(s):  
Zhengming Yang ◽  
Huimin Tao ◽  
Zhaoming Ye ◽  
Libin Jin ◽  
Nong Lin ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Tumor Resection ◽  
Bone Defects ◽  
Bone Transport ◽  
Malignant Schwannoma ◽  
Transport Time ◽  
Musculoskeletal Tumor Society ◽  
Large Bone ◽  
Average Bone ◽  
Large Bone Defects

This study was performed to explore the clinical efficacy of bone transport using external fixation for treatment of large bone defects after tibial tumor resection in five patients. Bone transport started 14 days postoperatively at 1 mm/day and was adjusted according to the callus-to-diameter ratio. The bone transport time, bone graft fusion, relapse, and metastasis were recorded. Clinical efficacy was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system. The tumors included osteosarcoma (n=2), Ewing sarcoma (n=1), malignant schwannoma (n=1), and hemangioma (n=1). The average bone defect length after resection was 11.6 cm. The five patients were followed up for an average of 50.8 months, and the average bone transport time was 15.5 months. Three patients who underwent postoperative chemotherapy were followed for 22.7 months, and two who did not undergo chemotherapy were followed for 4.75 months. Four patients underwent iliac bone grafting, and one underwent vascular pedicle fibular transplantation. The average MSTS score was 21.2 (19.3 for patients who underwent chemotherapy and 24.0 for patients who did not). No relapse or metastasis was observed. Bone transport is effective for reconstruction of large bone defects after tibial tumor resection as well as tibial malignancies with high doses of chemotherapy.

scholarly journals An Osteoconductive, Osteoinductive, and Osteogenic Tissue-Engineered Product for Trauma and Orthopaedic Surgery: How Far Are We?

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Wasim S. Khan ◽  
Faizal Rayan ◽  
Baljinder S. Dhinsa ◽  
David Marsh
Keyword(s):  
Donor Site ◽  
Tumor Resection ◽  
Bone Defects ◽  
Donor Site Morbidity ◽  
Complex Issue ◽  
Congenital Deformities ◽  
Autologous Bone Grafts ◽  
Reconstruction Of Bone Defects ◽  
Large Bone ◽  
Large Bone Defects

The management of large bone defects due to trauma, degenerative disease, congenital deformities, and tumor resection remains a complex issue for the orthopaedic reconstructive surgeons. The requirement is for an ideal bone replacement which is osteoconductive, osteoinductive, and osteogenic. Autologous bone grafts are still considered the gold standard for reconstruction of bone defects, but donor site morbidity and size limitations are major concern. The use of bioartificial bone tissues may help to overcome these problems. The reconstruction of large volume defects remains a challenge despite the success of reconstruction of small-to-moderate-sized bone defects using engineered bone tissues. The aim of this paper is to understand the principles of tissue engineering of bone and its clinical applications in reconstructive surgery.

3D-printed magnetic Fe3O4/MBG/PCL composite scaffolds with multifunctionality of bone regeneration, local anticancer drug delivery and hyperthermia

2014 ◽  
Vol 2 (43) ◽  
pp. 7583-7595 ◽  
Author(s):  
Jianhua Zhang ◽  
Shichang Zhao ◽  
Min Zhu ◽  
Yufang Zhu ◽  
Yadong Zhang ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Bone Regeneration ◽  
Tumor Resection ◽  
Bone Defects ◽  
Composite Scaffolds ◽  
Anticancer Drug Delivery ◽  
3D Printed ◽  
Large Bone ◽  
Large Bone Defects ◽  
Magnetic Fe3o4

The 3D-printed Fe3O4/MBG/PCL scaffolds with potential multifunctionality would be promising for use in the treatment and regeneration of large bone defects after tumor resection.

scholarly journals Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Noboru Matsumura ◽  
Kazuya Kaneda ◽  
Satoshi Oki ◽  
Hiroo Kimura ◽  
Taku Suzuki ◽  
...  
Keyword(s):  
Humeral Head ◽  
Glenohumeral Joint ◽  
Three Dimensional ◽  
Clinical Results ◽  
Bone Defects ◽  
Symptom Duration ◽  
Glenohumeral Instability ◽  
Explanatory Variables ◽  
Large Bone ◽  
Large Bone Defects

Abstract Background Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. Methods A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. Results Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). Conclusions Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations.

scholarly journals Vascularization of Nanohydroxyapatite/Collagen/Poly(L-lactic acid) Composites by Implanting Intramuscularly In Vivo

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hai Wang ◽  
Xiao Chang ◽  
Guixing Qiu ◽  
Fuzhai Cui ◽  
Xisheng Weng ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Orthopaedic Surgery ◽  
Bone Substitutes ◽  
Bone Defects ◽  
Large Defect ◽  
Natural Bone ◽  
Composition And Structure ◽  
Large Bone ◽  
Large Bone Defects

It still remains a major challenge to repair large bone defects in the orthopaedic surgery. In previous studies, a nanohydroxyapatite/collagen/poly(L-lactic acid) (nHAC/PLA) composite, similar to natural bone in both composition and structure, has been prepared. It could repair small sized bone defects, but they were restricted to repair a large defect due to the lack of oxygen and nutrition supply for cell survival without vascularization. The aim of the present study was to investigate whether nHAC/PLA composites could be vascularized in vivo. Composites were implanted intramuscularly in the groins of rabbits for 2, 6, or 10 weeks (n=5×3). After removing, the macroscopic results showed that there were lots of rich blood supply tissues embracing the composites, and the volumes of tissue were increasing as time goes on. In microscopic views, blood vessels and vascular sprouts could be observed, and microvessel density (MVD) of the composites trended to increase over time. It suggested that nHAC/PLA composites could be well vascularized by implanting in vivo. In the future, it would be possible to generate vascular pedicle bone substitutes with nHAC/PLA composites for grafting.

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