Bone tumor resection guide using three-dimensional printing for limb salvage surgery

2018 ◽  
Vol 118 (6) ◽  
pp. 898-905 ◽  
Author(s):  
Jong Woong Park ◽  
Hyun Guy Kang ◽  
Kwun Mook Lim ◽  
Dae Woo Park ◽  
June Hyuk Kim ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Bone Tumor ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Limb Salvage Surgery ◽  
Three Dimensional Printing ◽  
Bone Tumor Resection ◽  
Dimensional Printing

scholarly journals Three-Dimensional Printing and Navigation in Bone Tumor Resection

3D Printing ◽  
2018 ◽  
Author(s):  
Lucas E. Ritacco ◽  
Candelaria Mosquera ◽  
Ignacio Albergo ◽  
Domingo L. Muscolo ◽  
German L. Farfalli ◽  
...  
Keyword(s):  
Bone Tumor ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Three Dimensional Printing ◽  
Bone Tumor Resection ◽  
Dimensional Printing

scholarly journals Epiphyseal Sparing and Reconstruction by Frozen Bone Autograft after Malignant Bone Tumor Resection in Children

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ahmed Hamed Kassem Abdelaal ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
Shinji Miwa ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Limb Salvage ◽  
Bone Tumor ◽  
Treatment Options ◽  
Tumor Resection ◽  
Limb Salvage Surgery ◽  
Leg Length ◽  
Primary Bone Tumors ◽  
Bone Tumor Resection ◽  
Bone Autograft

Limb salvage surgery has become the standard treatment for malignant primary bone tumors in the extremities. Limb salvage represents a challenge in skeletally immature patients. Several treatment options are available for limb reconstruction after tumor resection in children. We report our results using the technique of epiphyseal sparing and reconstruction with frozen autograft bone in 18 children. The mean follow-up period for the all patients included in this study is 72 ± 26 m. Eight patients remained disease-free, seven patients lived with no evidence of disease, two were alive but with disease, and one patient died of the disease. Five- and ten-year rates of survival were 94.4%. Graft survival at 5 and 10 years was 94.4%. Functional outcome using the Enneking scale was excellent in 17 patients (94.4%) and poor in one patient (5.5%). Complications include 2 nonunions, 2 fractures, 2 deep infections, 1 soft tissue recurrence, and leg length discrepancy in 7 cases. This technique is a good reconstructive choice in a child with a nonosteolytic primary or secondary bone tumor, responsive to chemotherapy, without involvement of the articular cartilage. It is a straight forward, effective, and biological technique, which affords immediate mobilization of joints and possible cryoimmune effects, with excellent long term functional outcome and less complication.

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.

scholarly journals The Accuracy of Three-Dimensional Planned Bone Tumor Resection Using Patient-Specific Instrument

2020 ◽  
Vol Volume 12 ◽  
pp. 6533-6540
Author(s):  
Daniel A Müller ◽  
Yannik Stutz ◽  
Lazaros Vlachopoulos ◽  
Mazda Farshad ◽  
Philipp Fürnstahl
Keyword(s):  
Bone Tumor ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Patient Specific ◽  
Specific Instrument ◽  
Bone Tumor Resection

Improving Cutting Path on Custom 3D-Printed Surgical Guides for Bone-Tumor Resection

2019 ◽  
Author(s):  
Carlos G. Helguero ◽  
Juan Castro ◽  
César Ochoa ◽  
Fausto Maldonado ◽  
Emilio A. Ramírez ◽  
...  
Keyword(s):  
Bone Tumor ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Element Analysis ◽  
Surgical Guides ◽  
Orthopedic Oncology ◽  
3D Printed ◽  
Bone Tumor Resection ◽  
High Level ◽  
Cutting Path

Abstract Custom three-dimensional (3D) printed guides are being used in the operative room as an aid to surgeons for increasing the accuracy of their cutting and resection techniques. In terms of bone-tumor resection, the cutting path printed in the custom jig is significantly important for two main purposes: first, the required fit for the implant that will replace the resected bone section and, second, the interaction between the remaining, healthy bone and the new implant in terms of forces, stresses and deformation. Bone tumor resection has posed a challenge in orthopedic oncology, specifically due to a high level of difficulty in performing a limb-sparing surgery with negative margins on the remaining bone. A straight cutting path is usually used in clinical procedures due to the type of tooling available inside the operative room. 3D printed cutting path guides offer the possibility to evolve from a straight to a different path, e.g. a tapered path, and overcome fitting problems during surgery. This work investigates the current straight cutting path used for typical bone tumor resection and compares it to a proposed tapered cutting path in terms of both implant fitting and stress analysis. Finite element analysis software is used to simulate a compression force exerted over the femur bone. Different taper cut angles are studied and results are reported to obtain an ideal angle for resection. Results are presented to evidence the need to evolve from the current resection technique in order to minimize the number of revision surgeries and for a better quality of life of patients under this type of surgical procedure.

scholarly journals Surgical Technique and Outcome of Joint Sparing Limb Salvage Surgery by Three-Dimensional-Printed Prothesis for Children with Osteosarcoma in Distal Femur

2020 ◽  
Author(s):  
Tao Cai ◽  
Chunlin Zhang ◽  
Lei Zhang ◽  
Kunpeng Zhu ◽  
Jianping Hu ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Limb Salvage ◽  
Distal Femur ◽  
Salvage Surgery ◽  
Three Dimensional ◽  
Limb Length Discrepancy ◽  
Limb Salvage Surgery ◽  
3D Printed ◽  
The Mean

Abstract Purpose The purpose of this study was to introduce the surgical technique and functional outcome of joint-sparing limb salvage surgery with metaphyseal osteotomy by dependent design of three-dimensional printed prothesis for children with osteosarcoma in distal femur.Methods Between 2012 to 2019, we performed twelve joint sparing limb salvage surgeries (JSLSS) with metaphyseal osteotomy for the children of osteosarcoma in the distal femur with our dependent design of 3D-printed guided plate and prothesis. The clinical assessment including resection margin, limb-length discrepancy, orthopaedic complications and functional outcome would be analyzed.Results The mean operation time for JSLSS was 107.6 minutes and the average blood loss was 194.5ml with the dependent design of 3D-printed prosthesis. With the assistance of guide plate, the mean margin of the osteosarcoma from the epiphyseal plate was 1.6 cm and the mean limb-length discrepancy was 2.2 cm with maximum follow-up period of seven years (mean 45.3 months, range 12-84 months). All the patients could bend their knee through >90° flexion, achieved similar results for ROMs in 6DOF during gait compared with normal data of Chinese knees, and the mean MSTS score was 94.7 for the patients with JSLSS. One patient had a superficial infection and there was one patient of local recurrence happened during the follow-up with the necrosis rate less than 90% by preoperative chemotherapy. None aseptic loosening happened in distal femur for the patients in this group with dependent design of 3D-printed prosthesis.Conclusion Joint-sparing limb salvage surgery by metaphyseal osteotomy with the dependent design of 3D-printed prosthesis and guide plate would be a good choice for the children with osteosarcoma in distal femur.

scholarly journals Treatment-Related Prognostic Factors in Managing Osteosarcoma around the Knee with Limb Salvage Surgery: A Lesson from a Long-Term Follow-Up Study

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Jianping Hu ◽  
Chunlin Zhang ◽  
Kunpeng Zhu ◽  
Lei Zhang ◽  
Tao Cai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Local Recurrence ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Survival Rates ◽  
Tumor Resection ◽  
Limb Salvage Surgery ◽  
Related Factors

Purpose. The aim of this study was to assess the treatment-related factors associated with local recurrence and overall survival of patients with osteosarcoma treated with limb-salvage surgery. Patients and Methods. Treatment-related factors were analyzed to evaluate their effects on local recurrence-free survival (LRFS) and overall survival (OS) in 182 patients from 2004 to 2013. Results. The mean length of follow-up was 73.4 ± 34.7 months (median, 68 months; range, 12-173 months), and 63 patients died by the end of the follow-up. The 5-year and 10-year overall survival rates were 68.6 ± 6.6% and 59.4 ± 10.6%, respectively. Univariate analysis showed that treatment-related prognostic factors for overall survival were prolonged symptom intervals >=60 days, biopsy/tumor resection performed by different centers, previous medical history, incomplete preoperative chemotherapy (<8 weeks), and prolonged postoperative interval >21 days. In the multivariate analysis, biopsy/tumor resection performed by different centers, incomplete implementation of planned new adjuvant chemotherapy, and delayed resumption of postoperative chemotherapy (>21 days) were risk factors for poor prognosis; biopsy/tumor resection performed by different centers and tumor necrosis <90% were independent predictors of local recurrence. Conclusion. For localized osteosarcoma treated with limb-salvage surgery, it is necessary to optimize timely standard chemotherapy and to resume postoperative chemotherapy to improve survival rates. Biopsies should be performed at experienced institutions in cases of developing local recurrence.

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