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Customized Knee Prosthesis in Treatment of Giant Cell Tumors of the Proximal Tibia: Application of 3-Dimensional Printing Technology in Surgical Design

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ABSTRACT

Background: We explored the application of 3-dimensional (3D) printing technology in treating giant cell tumors (GCT) of the proximal tibia. A tibia block was designed and produced through 3D printing technology. We expected that this 3D-printed block would fill the bone defect after en-bloc resection. Importantly, the block, combined with a standard knee joint prosthesis, provided attachments for collateral ligaments of the knee, which can maintain knee stability.

Material/methods: A computed tomography (CT) scan was taken of both knee joints in 4 patients with GCT of the proximal tibia. We developed a novel technique – the real-size 3D-printed proximal tibia model – to design preoperative treatment plans. Hence, with the application of 3D printing technology, a customized proximal tibia block could be designed for each patient individually, which fixed the bone defect, combined with standard knee prosthesis.

Results: In all 4 cases, the 3D-printed block fitted the bone defect precisely. The motion range of the affected knee was 90 degrees on average, and the soft tissue balance and stability of the knee were good. After an average 7-month follow-up, the MSTS score was 19 on average. No sign of prosthesis fracture, loosening, or other relevant complications were detected.

Conclusions: This technique can be used to treat GCT of the proximal tibia when it is hard to achieve soft tissue balance after tumor resection. 3D printing technology simplified the design and manufacturing progress of custom-made orthopedic medical instruments. This new surgical technique could be much more widely applied because of 3D printing technology.

No MeSH data available.


Surgical simulation using 3D-printed model. (A, B) Models of the knee prosthesis and the block. (C) Internal structure of the block.
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f5-medscimonit-23-1691: Surgical simulation using 3D-printed model. (A, B) Models of the knee prosthesis and the block. (C) Internal structure of the block.

Mentions: After the design was completed, the model was saved as an STL file and then imported into a 3D printing machine. The designed block model, include tibia tray prosthesis with extension stem, was 3D-printed at 1: 1 scale. All these models were made of photosensitive resin. Preoperatively, surgical simulation based on the 3D-printed model was produced to check the accuracy of the model (Figure 5).


Customized Knee Prosthesis in Treatment of Giant Cell Tumors of the Proximal Tibia: Application of 3-Dimensional Printing Technology in Surgical Design
Surgical simulation using 3D-printed model. (A, B) Models of the knee prosthesis and the block. (C) Internal structure of the block.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5391808&req=5

f5-medscimonit-23-1691: Surgical simulation using 3D-printed model. (A, B) Models of the knee prosthesis and the block. (C) Internal structure of the block.
Mentions: After the design was completed, the model was saved as an STL file and then imported into a 3D printing machine. The designed block model, include tibia tray prosthesis with extension stem, was 3D-printed at 1: 1 scale. All these models were made of photosensitive resin. Preoperatively, surgical simulation based on the 3D-printed model was produced to check the accuracy of the model (Figure 5).

View Article: PubMed Central - PubMed

ABSTRACT

Background: We explored the application of 3-dimensional (3D) printing technology in treating giant cell tumors (GCT) of the proximal tibia. A tibia block was designed and produced through 3D printing technology. We expected that this 3D-printed block would fill the bone defect after en-bloc resection. Importantly, the block, combined with a standard knee joint prosthesis, provided attachments for collateral ligaments of the knee, which can maintain knee stability.

Material/methods: A computed tomography (CT) scan was taken of both knee joints in 4 patients with GCT of the proximal tibia. We developed a novel technique – the real-size 3D-printed proximal tibia model – to design preoperative treatment plans. Hence, with the application of 3D printing technology, a customized proximal tibia block could be designed for each patient individually, which fixed the bone defect, combined with standard knee prosthesis.

Results: In all 4 cases, the 3D-printed block fitted the bone defect precisely. The motion range of the affected knee was 90 degrees on average, and the soft tissue balance and stability of the knee were good. After an average 7-month follow-up, the MSTS score was 19 on average. No sign of prosthesis fracture, loosening, or other relevant complications were detected.

Conclusions: This technique can be used to treat GCT of the proximal tibia when it is hard to achieve soft tissue balance after tumor resection. 3D printing technology simplified the design and manufacturing progress of custom-made orthopedic medical instruments. This new surgical technique could be much more widely applied because of 3D printing technology.

No MeSH data available.