3D Printing Individualized Assisted Repair and Reconstruction of Irregular Bone Neoplastic Bone Defects: Exploration and Practice in Scapular Aneurysmal Cystic Bone Defects

Abstract Objective: To explore the clinical efficacy of using 3D printing individualized treatment plan in the auxiliary repair and reconstruction of irregular bone tumor bone defect.Methods：Seven patients with aneurysmal bone cyst of scapula were selected. Based on the CT data of the patient, the scapula (including defect) and pelvis were reconstructed by computer Mimics Medical software. Print out the reconstructed scapula model with a 3D printer. Before operation, the model was used to design the surgical approach and simulate the operation process, to determine the length and Radian of the plate and the number and direction of screws, and to determine the bone mass of the ilium and make reasonable segmentation and distribution. The operation time, the amount of bleeding, the length and Radian of the plate, and the direction and number of screws were recorded.Results : The average follow-up time was 25.6 months, and none of the 7 patients had recurrence during the follow-up period; The surgical approach, the length and Radian of the internal fixation, the number and direction of screws were consistent with the designed operation plan. The anatomical structure of scapula and the function of shoulder joint gradually recovered.Conclusions: Compared with traditional methods, the use of 3D printing technology in the treatment of irregular bone tumor bone defect has less trauma, shorter operation time and less bleeding, which can reduce the waste of bone graft and reconstruct the anatomical structure of bone defect more completely.

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Individualized 3D printing-assisted repair and reconstruction of neoplastic bone defects at irregular bone sites: exploration and practice in the treatment of scapular aneurysmal bone cysts

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04859-5 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Guochen Luo ◽

Yao Zhang ◽

Xiahua Wang ◽

Shuaishuai Chen ◽

Dongyi Li ◽

...

Keyword(s):

3D Printing ◽

Surgical Approach ◽

Bone Structure ◽

Operation Time ◽

Bone Defects ◽

Anatomical Structure ◽

Printing Technology ◽

3D Printing Technology ◽

Medical Software

Abstract Background The irregular anatomical shape and complex structures of irregular bones make it more difficult to repair and reconstruct bone defects in irregular bones than in the long bones of the extremities. Three-dimensional (3D) printing technology can help to overcome the technical limitations of irregular bone repair by generating simulations that enable structural integration of the lesion area and bone structure of the donor site in all directions and at multiple angles. Thus, personalized and accurate treatment plans for restoring anatomical structure, muscle attachment points, and maximal function can be made. The present study aimed to investigate the ability of 3D printing technology to assist in the repair and reconstruction of scapular aneurysmal ABC defects. Methods The study included seven patients with ABCs of the scapula. Based on computed tomography (CT) data for the patient, the scapula (including the defect) and pelvis were reconstructed using Mimics Medical software. The reconstructed scapula model was printed using a 3D printer. Before the operation, the model was used to design the surgical approach and simulate the operation process, to determine the length and radius of the plate and the number and direction of screws, and to determine the bone mass of the ilium and develop reasonable strategies for segmentation and distribution. The operation time, amount of bleeding, length and radius of the plate, and direction and number of screws were recorded. Results The average duration of follow-up was 25.6 months, and none of the seven patients experienced recurrence during the follow-up period. The surgical approach, the length and radius of internal fixation, and the number and direction of screws were consistent with the designed operation plan. Patients gradually recovered the anatomical structure of the scapula and function of the shoulder joint. Conclusions In the treatment of bone defects caused by irregular bone tumors, 3D printing technology combined with surgery has the advantages of less trauma, short operation time, less bleeding and reducing the difficulty of operation, which can reduce the waste of bone graft, and more complete reconstruction of the anatomical structure of the defective bone.

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Traditional versus mirror three-dimensional printing technology for isolated acetabular fractures: a retrospective study with a median follow-up of 25 months

Journal of International Medical Research ◽

10.1177/03000605211028554 ◽

2021 ◽

Vol 49 (6) ◽

pp. 030006052110285

Author(s):

Kai Xiao ◽

Bo Xu ◽

Lin Ding ◽

Weiguang Yu ◽

Lei Bao ◽

...

Keyword(s):

3D Printing ◽

Three Dimensional ◽

Operation Time ◽

Harris Hip Score ◽

Acetabular Fractures ◽

Printing Technology ◽

Three Dimensional Printing ◽

3D Printing Technology ◽

Significant Difference

Objective To assess the outcomes of traditional three-dimensional (3D) printing technology (TPT) versus mirror 3D printing technology (MTT) in treating isolated acetabular fractures (IAFs). Methods Consecutive patients with an IAF treated by either TPT or MTT at our tertiary medical centre from 2012 to 2018 were retrospectively reviewed. Follow-up was performed 1, 3, 6, and 12 months postoperatively and annually thereafter. The primary outcome was the Harris hip score (HHS), and the secondary outcomes were major intraoperative variables and key orthopaedic complications. Results One hundred fourteen eligible patients (114 hips) with an IAF (TPT, n = 56; MTT, n = 58) were evaluated. The median follow-up was 25 months (range, 21–28 months). At the last follow-up, the mean HHS was 82.46 ±14.70 for TPT and 86.30 ± 13.26 for MTT with a statistically significant difference. Significant differences were also detected in the major intraoperative variables (operation time, intraoperative blood loss, number of fluoroscopic screenings, and anatomical reduction number) and the major orthopaedic complications (loosening, implant failure, and heterotopic ossification). Conclusion Compared with TPT, MTT tends to produce accurate IAF reduction and may result in better intraoperative variables and a lower rate of major orthopaedic complications.

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3D printing-based Ganz approach for treatment of femoral head fractures: a prospective analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1383-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

Jinwu Wang ◽

Leyi Cai ◽

Linzhen Xie ◽

Hua Chen ◽

Xiaoshan Guo ◽

...

Keyword(s):

Femoral Head ◽

3D Printing ◽

Blood Loss ◽

Surgical Approach ◽

Type I ◽

Type Ii ◽

Femoral Head Fracture ◽

Hip Function ◽

The Mean

Abstract Background Femoral head fractures are uncommon injuries. Open reduction and internal fixation (ORIF) of femoral head fracture is the preferred treatment for most patients. There are several surgical approaches and treatments for this difficult fracture. However, the optimal surgical approach for the treatment of femoral head fracture remains controversial. Meanwhile, the operation is difficult and the complications are numerous. We prospectively reviewed patients with femoral head fractures managed surgically through the 3D printing-based Ganz approach to define a better approach with the least morbidity. Patients and methods Between 2012 and 2017, a total of 17 patients were included in this study. An exact 1:1 3D printing model of the injured hip side was fabricated for each patient and simulated surgery was finished preoperative. The surgical approach was performed as described by Ganz. Functional assessment was performed using the modified Merle d’Aubigne scores. The reduction of the fracture was evaluated according to Matta’s criteria. The incidence of complications, such as heterotopic ossification (HO) and avascular necrosis (AVN), and the need for additional surgery were also documented. Results Twelve of 17 patients (four females and eight males) were available for 2 years follow-up. The mean follow-up was 35 months (25–48 months). Average age for the 12 patients was 39.9 ± 12.2 years. According to the Pipkin classification, four patients were type I fracture, three patients were type II fracture, and five patients were type IV fracture. The mean operative time was 124.2 ± 22.1 min, and the estimated blood loss was 437.5 ± 113.1 ml. According to Merle d’ Aubigne scores, excellent results were achieved in six of the 12 patients; four good and two poor results occurred in the rest of the patients. On the radiograph evaluation, fracture reduction was defined as anatomical in eight patients, and imperfect in four. Most patients had good outcomes and satisfactory hip function at last follow-up. Almost all great trochanteric osteectomy healed uneventfully. One patient developed symptomatic AVN of the femoral head and underwent THA at 3 years. After THA, she regained a good hip function with the ability to return to work and almost no reduction in sports activities. Heterotopic ossification was found in four cases (type I-1, type II-2, and type III-1). Conclusions The 3D printing-based Ganz approach provides a safe and reliable approach and satisfactory results of treatment in femoral head fractures. Using 3D printed model for the fracture of the femoral head, the fracture can be viewed in every direction to provide an accurate description of fracture characteristics, which contributes to make a reasonable surgical plan for patients. In addition, the 3D printing-based Ganz approach can obtain excellent surgical exposure and protection of the femoral head blood supply, reduce the operation time and intraoperative blood loss, make the precise osteotomy, anatomically fix the intra-articular fragments, and effectively reduce postoperative complications. Trial registration We register our research at http://www.researchregistry.com. The Unique Identifying Number (UIN) from the Research Registry of the study is researchregistry4847.

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Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis

BioMed Research International ◽

10.1155/2017/6250635 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yicun Wang ◽

Hui Jiang ◽

Zhantao Deng ◽

Jiewen Jin ◽

Jia Meng ◽

...

Keyword(s):

Internal Fixation ◽

External Fixation ◽

Bone Defect ◽

Fasting Blood Glucose ◽

Bone Defects ◽

Significant Difference ◽

Systemic Antibiotics ◽

Time Since Injury ◽

Small Bone

Background. To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement. Methods. 125 patients with chronic infectious osteomyelitis of tibia fracture who underwent multiple irrigation, debridement procedure, and local/systemic antibiotics were enrolled. Bone defects, which were less than 4 cm, were treated with bone grafting using either internal fixation or monolateral external fixation. 12-month follow-up was conducted with an interval of 3 months to evaluate union of bone defect. Results. Patients who underwent monolateral external fixation had higher body mass index and fasting blood glucose, longer time since injury, and larger bone defect compared with internal fixation. No significant difference was observed in incidence of complications (23.5% versus 19.3%), surgery time (156±23 minutes versus 162±21 minutes), and time to union (11.1±3.0 months versus 10.9±3.1 months) between external fixation and internal fixation. Internal fixation had no significant influence on the occurrence of postoperation complications after multivariate adjustment when compared with external fixation. Furthermore, patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. Conclusions. It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.

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Outcomes of arthroscopic capsulolabral reconstruction for anterior instability with greater than 20% glenoid bone defects: are Latarjet procedures absolutely indicated for these patients?

Clinics in Shoulder and Elbow ◽

10.5397/cise.2019.00094 ◽

2020 ◽

Vol 23 (2) ◽

pp. 62-70 ◽

Cited By ~ 1

Author(s):

Sae Hoon Kim ◽

Whanik Jung ◽

Sung-Min Rhee ◽

Ji Un Kim ◽

Joo Han Oh

Keyword(s):

Bone Defect ◽

Shoulder Instability ◽

Bone Defects ◽

Defect Size ◽

Anterior Shoulder Instability ◽

Return To Sports ◽

Anterior Instability ◽

Recurrent Instability ◽

Capsulolabral Reconstruction

Background: Recent studies have reported high rates of recurrence of shoulder instability in patients with glenoid bone defects greater than 20% after capsulolabral reconstruction. The purpose of the present study was to evaluate the failure rate of arthroscopic capsulolabral reconstruction for the treatment of anterior instability in the presence of glenoid bone deficits >20%. Methods: Retrospective analyses were conducted among cases with anterior shoulder instability and glenoid bone defects of >20% that were treated by arthroscopic capsulolabral reconstruction with a minimum 2-year follow-up (30 cases). We included the following variables: age, bone defect size, instability severity index score (ISIS), on-/off-track assessment, incidence recurrent instability, and return to sports. Results: The mean glenoid bone defect size was 25.8% ± 4.2% (range, 20.4%–37.2%), and 18 cases (60%) had defects of >25%. Bony Bankart lesions were identified in 11 cases (36.7%). Eleven cases (36.7%) had ISIS scores >6 points and 21 cases (70%) had off-track lesions. No cases of recurrent instability were identified over a mean follow-up of 39.9 months (range, 24–86 months), but a sense of subluxation was reported by three patients. Return to sports at the preinjury level was possible in 24 cases (80%), and the average satisfaction rating was 92%. Conclusions: Arthroscopic soft tissue reconstruction was successful for treating anterior shoulder instability among patients with glenoid bone defects >20%, even enabling return to sports. Future studies should focus on determining the range of bone defect sizes that can be successfully managed by soft tissue repair.

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Fibrin Glue Implants Seeded with Dental Pulp and Periodontal Ligament Stem Cells for the Repair of Periodontal Bone Defects: A Preclinical Study

Bioengineering ◽

10.3390/bioengineering8060075 ◽

2021 ◽

Vol 8 (6) ◽

pp. 75

Author(s):

Natella I. Enukashvily ◽

Julia A. Dombrovskaya ◽

Anastasia V. Kotova ◽

Natalia Semenova ◽

Irina Karabak ◽

...

Keyword(s):

Stem Cells ◽

3D Printing ◽

Fibrin Glue ◽

Bone Defect ◽

Dental Pulp ◽

Alveolar Bone ◽

Bone Defects ◽

Osteogenic Potential ◽

Fibrin Gel ◽

A Cell

A technology to create a cell-seeded fibrin-based implant matching the size and shape of bone defect is required to create an anatomical implant. The aim of the study was to develop a technology of cell-seeded fibrin gel implant creation that has the same shape and size as the bone defect at the site of implantation. Using computed tomography (CT) images, molds representing bone defects were created by 3D printing. The form was filled with fibrin glue and human dental pulp stem cells (DPSC). The viability, set of surface markers and osteogenic differentiation of DPSC grown in fibrin gel along with the clot retraction time were evaluated. In mice, an alveolar bone defect was created. The defect was filled with fibrin gel seeded with mouse DPSC. After 28 days, the bone repair was analyzed with cone beam CT and by histological examination. The proliferation rate, set of surface antigens and osteogenic potential of cells grown inside the scaffold and in 2D conditions did not differ. In mice, both cell-free and mouse DPSC-seeded implants increased the bone tissue volume and vascularization. In mice with cell-seeded gel implants, the bone remodeling process was more prominent than in animals with a cell-free implant. The technology of 3D-printed forms for molding implants can be used to prepare implants using components that are not suitable for 3D printing.

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Can 3D-printing avoid discomfort-related implant removal in midshaft clavicle fractures? A four-year follow-up

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-020-03654-6 ◽

2020 ◽

Author(s):

Rob F. M. van Doremalen ◽

Rens A. van der Linde ◽

Jan J. Kootstra ◽

Sven H. van Helden ◽

Edsko E. G. Hekman

Keyword(s):

Surgical Approach ◽

Clavicle Fracture ◽

Intervention Group ◽

Operation Time ◽

Reoperation Rate ◽

Implant Removal ◽

Control Group ◽

Preoperative Preparation ◽

3D Printed

Abstract Introduction Due to the variation in shape and curvature of the clavicle, plates often have to be adjusted during surgery to acquire a good fit. Poorly fitted plates can cause discomfort, eventually requiring implant removal. 3D-printed replicas of the fractured clavicle can assist in planning of the surgical approach, plate selection and, if necessary, adjustment of the plate prior to surgery. We hypothesized this method of preoperative preparation would reduce implant-related discomfort resulting in a reduced reoperation rate Materials and methods In a prospective cohort study, perioperative plate handling and clavicle fixation were timed and follow-up data were collected from participants undergoing operative treatment for a midshaft clavicle fracture. The control group (n = 7) received conventional surgery with standard precontoured plates. For the intervention group (n = 7), 3D-printed replicas of the fractured clavicle and a mirrored version of the healthy contralateral clavicle were available prior to surgery for planning of the surgical approach, and for plate selection and contouring. Primary outcome was reoperation rate due to implant-related discomfort. Secondary outcomes were complications and time differences in the different surgical phases (reduction, fixation and overall operation time) Results More participants in the control group had the plate removed due to discomfort compared to the intervention group (5/7 vs. 0/6; P = 0.012). One participant was excluded from the intervention group due to a postoperative complication; an infection occurred at the implant site. No relevant time difference in surgical plate handling was found between both groups. Conclusions Preoperative preparation using 3D-printed replicas of the clavicle fracture may reduce implant removal caused by plated-related discomfort. No relevant effect on surgery time was found. Trial registration Registered with ‘toetsingonline.nl’, trial number NL51269.075/14, 17-02-2015

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Novel Piston Technique Versus Ilizarov Technique for The Repair of Bone Defect After Lower Limb Infection

10.21203/rs.3.rs-749905/v1 ◽

2021 ◽

Author(s):

Jiafei Du ◽

Zifei Yin ◽

Pengfei Cheng ◽

Pei Han ◽

Hao Shen

Keyword(s):

Bone Defect ◽

Bone Healing ◽

Lower Limb ◽

Functional Results ◽

Bone Defects ◽

Ilizarov Technique ◽

Group A ◽

The Mean ◽

Group B

Abstract Background We described the use of a novel Piston technique versus Ilizarov technique to compare the effectiveness and complications for the repair of bone defect after lower limb infection. Patients and methods: We retrospectively reviewed 41 patients who had been treated at our department for lower extremity bone defects following osteomyelitis. They were 38 males and 3 females with a mean age of 43.41 (range 12 to 69 years). The infected bone defects involved 36 tibias and 5 femurs. Piston technique (PT, group A) was used in 12 patients and Ilizarov technique (IT, group B) in 29 ones. The mean duration of follow-up was 28.50 months (PT) and 29.90 months (IT). The modified Application of Methods of Illizarov (ASAMI) criteria was used to evaluate the bone healing and functional recovery. Results Complete eradication of infection and union of docking sites were accomplished well in both groups. The mean external fixator index (EFI) was 42.32 days/cm in group A versus 58.85 days/cm in group B (p < 0.001). The bone outcomes were similar between group A and B (p = 0.558) [excellent (9 vs. 19), good (3 vs.10)]; group A showed better functional outcomes than group B (p < 0.05) [excellent (7 vs. 6), good (4 vs. 12), fair (0 vs. 10) and poor (1 vs. 1)]. Pain was complained most during follow-up and group A had fewer cases of pin tract infection (1 vs. 6), adjacent joint stiffness (3 vs. 8) and delayed healing of the joint (0 vs. 3). Conclusions Satisfactory bone healing can be obtained by using both PT and IT, while PT had better functional results, lower EFI and allowed early removal of the external fixation. We have found that this novel Piston technique can improve the comfort of patients, reduce the incidence of complications, and provide a rapid and convenient rehabilitation.

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3D Printing of a Mandibular Bone Deffect

Materiale Plastice ◽

10.37358/mp.17.1.4778 ◽

2017 ◽

Vol 54 (1) ◽

pp. 29-31

Author(s):

Alin Gabor ◽

Tiberiu Hosszu ◽

Cristian Zaharia ◽

Alexandru Kozma ◽

Andreea Codruta Cojocariu ◽

...

Keyword(s):

3D Printing ◽

Bone Defect ◽

Maxillofacial Surgery ◽

Bone Defects ◽

Scanning System ◽

Printing Technology ◽

Mandibular Bone ◽

Optical Scanning ◽

3D Printing Technology ◽

Polymeric Scaffold

The aim of this study was to achieve a polymeric scaffold, ex-vivo, using 3D printing technology and then subjecting it to various tests to check its optimal property. Initially there was selected a lower jaw with a bone defect that would have prevented any treatment based prosthetic implant. The mandible was first scanned using an optical scanner (MAESTRO DENTAL SCANNER MDS400). The scanning parameters using optical scanning system are: 10 micron accuracy, resolution 0.07 mm, 2 rooms with High-Resolution LED structured light, two axes. The scan time of the mandible was 4-5 min. Later the same mandible was scanned using CBCT�s CRANEX 3DX. The images obtained using CBCT�s were correlated with those obtained by optical scanning. Further on, there was achieved the digital design of the future scaffold with the conventional technique of wax addition directly on the mandibular bone defect. After that, this was again scanned using scanning system MAESTRO DENTAL SCANNER MDS400, and using CBCT�s CRANEX 3DX. The images obtained were correlated with all the scanned images of original mandible bone defects. There were made two polymeric scaffolds using 3D printing system an (D20 Digital Wax System 3D Printer). After printing, scaffold sites were introduced for 30 minutes in an oven curing. Later the pieces obtained were processed to remove small excesses of work. There were obtained 3 blocks of polymers that have a good adaptation to the bone profile. Often, in oral implantology and maxillofacial surgery appear bone defects. They prevent an optimal treatment of bio-functional and aesthetic restoration. Using 3D printing technology one can achieve scaffold sites of different biocompatible materials that have optimal properties to replace bone defect and restore the defective area. These scaffold sites have an intimate adaptation to the defect. 3D printing techniques used to restore bone defects can quickly and efficiently give the possibility to have a successful implantology prosthetics treatment.

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ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.14 ◽

2011 ◽

pp. 114-118

Author(s):

Nhu Hiep Pham ◽

Huu Thien Ho ◽

Anh Vu Pham ◽

Van Nghia Tran

Keyword(s):

Laparoscopic Appendectomy ◽

Single Port ◽

Operation Time ◽

Invasive Procedure ◽

Minimal Invasive ◽

Central Hospital ◽

Surgical Department ◽

A New Technique ◽

Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

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