3D-printed modular prostheses for reconstruction of intercalary bone defects after joint-sparing limb salvage surgery for femoral diaphyseal tumours

Xiaojun Zhu; Jinxin Hu; Jiaming Lin; Guohui Song; Huaiyuan Xu; Jinchang Lu; Qinglian Tang; Jin Wang

doi:10.1302/2633-1462.54.BJO-2023-0170.R1

3D-printed modular prostheses for reconstruction of intercalary bone defects after joint-sparing limb salvage surgery for femoral diaphyseal tumours

Bone Jt Open. 2024 Apr 18;5(4):317-323. doi: 10.1302/2633-1462.54.BJO-2023-0170.R1.

Authors

Xiaojun Zhu^{1

2}, Jinxin Hu^{1

2}, Jiaming Lin^{1

2}, Guohui Song^{1

2}, Huaiyuan Xu^{1

2}, Jinchang Lu^{1

2}, Qinglian Tang^{1

2}, Jin Wang^{1

2}

Affiliations

¹ Department of Musculoskeletal Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
² State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.

PMID: 38631693
PMCID: PMC11023719
DOI: 10.1302/2633-1462.54.BJO-2023-0170.R1

Abstract

Aims: The aim of this study was to investigate the safety and efficacy of 3D-printed modular prostheses in patients who underwent joint-sparing limb salvage surgery (JSLSS) for malignant femoral diaphyseal bone tumours.

Methods: We retrospectively reviewed 17 patients (13 males and four females) with femoral diaphyseal tumours who underwent JSLSS in our hospital.

Results: In all, 17 patients with locally aggressive bone tumours (Enneking stage IIB) located in the femoral shaft underwent JSLSS and reconstruction with 3D-printed modular prostheses between January 2020 and June 2022. The median surgical time was 153 minutes (interquartile range (IQR) 117 to 248), and the median estimated blood loss was 200ml (IQR 125 to 400). Osteosarcoma was the most common pathological type (n = 12; 70.6%). The mean osteotomy length was 197.53 mm (SD 12.34), and the median follow-up was 25 months (IQR 19 to 38). Two patients experienced local recurrence and three developed distant metastases. Postoperative complications included wound infection in one patient and screw loosening in another, both of which were treated successfully with revision surgery. The median Musculoskeletal Tumor Society score at the final follow-up was 28 (IQR 27 to 28).

Conclusion: The 3D-printed modular prosthesis is a reliable and feasible reconstruction option for patients with malignant femoral diaphyseal tumours. It helps to improve the limb salvage rate, restore limb function, and achieve better short-term effectiveness.