Applying 3D-Printed Porous Ti6Al4V Prostheses to Repair Osteomyelitis-Induced Partial Bone Defects of Lower Limbs: Finite Element Analysis and Clinical Outcomes

被引:0
作者
Liu, Bingchuan [1 ,2 ]
Tan, Qizhao [1 ,2 ]
Wang, Zhengguang [1 ,2 ]
Hou, Guojin [1 ,2 ]
Wang, Caimei [3 ]
Tian, Yun [1 ,2 ]
机构
[1] Peking Univ Third Hosp, Dept Orthopaed, Beijing, Peoples R China
[2] Minist Educ, Engn Res Ctr Bone & Joint Precis Med, Beijing, Peoples R China
[3] Beijing AKEC Med Co Ltd, Beijing, Peoples R China
基金
中国国家自然科学基金;
关键词
3D printing technology; clinical study; finite element analysis; osseointegration; partial bone defect;
D O I
10.1111/os.14268
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective: The clinical management of partial bone defects in lower limbs, particularly those resulting from osteomyelitis, remains a significant challenge. This study aimed to systematically evaluate the effectiveness of 3D-printed porous Ti6Al4V prostheses in addressing osteomyelitis-induced partial bone defects. Methods: We established a comprehensive protocol for utilizing 3D-printed prostheses for bone defect repair, encompassing 3D simulation of prosthesis implantation and internal fixation, finite element analysis (FEA), and clinical implementation. Mimics software facilitated simulation of fixation patterns and screw lengths. FEA modeled bone defects in the distal metaphyseal femur and distal diaphyseal tibia to assess changes in stress conduction pre- and post-prosthesis implantation. The clinical study involved eight patients (average age: 56.3 years) with an average defect length of 14.9 cm. Postoperative outcomes were evaluated using X-rays and the Lower Extremity Functional Scale (LEFS). Results: FEA demonstrated that the implanted prostheses effectively shared stress and reduced the load on residual bone in both models, thus lowering the risk of fractures under external forces. The average follow-up period was 24.5 months, with patients initiating weight-bearing activities on average 7.8 days post-surgery. Serial postoperative X-rays demonstrated long-term stability of the prostheses, with progressive bone regeneration around and integration with the prostheses. While two patients experienced infection recurrence requiring prosthesis removal and debridement, the remaining six showed significant improvement in LEFS scores, increasing from 31.5 preoperatively to 61.0 at the last follow-up. Conclusions: 3D-printed porous Ti6Al4V prostheses effectively restore anatomical integrity and optimize stress conduction in lower limbs, resulting in substantial functional recovery. This innovative approach shows promise for wider clinical adoption and warrants further investigation in medical practice.
引用
收藏
页码:115 / 124
页数:10
相关论文
共 25 条
  • [1] Outcomes of Surgical Reconstruction Using Custom 3D-Printed Porous Titanium Implants for Critical-Sized Bone Defects of the Foot and Ankle
    Abar, Bijan
    Kwon, Nicholas
    Allen, Nicholas B.
    Lau, Trent
    Johnson, Lindsey G.
    Gall, Ken
    Adams, Samuel B.
    [J]. FOOT & ANKLE INTERNATIONAL, 2022, 43 (06) : 750 - 761
  • [2] Biographical Sketch Julius Wolff, 1836-1902
    Brand, Richard A.
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (04) : 1047 - 1049
  • [3] Mechanisms of bone response to injury
    Dittmer, Keren E.
    Firth, Elwyn C.
    [J]. JOURNAL OF VETERINARY DIAGNOSTIC INVESTIGATION, 2017, 29 (04) : 385 - 395
  • [4] A 3D-Printed Scaffold for Repairing Bone Defects
    Dong, Jianghui
    Ding, Hangxing
    Wang, Qin
    Wang, Liping
    [J]. POLYMERS, 2024, 16 (05)
  • [5] 3D printed scaffold design for bone defects with improved mechanical and biological properties
    Fallah, Ali
    Altunbek, Mine
    Bartolo, Paulo
    Cooper, Glen
    Weightman, Andrew
    Blunn, Gordon
    Koc, Bahattin
    [J]. JOURNAL OF THE MECHANICAL BEHAVIOR OF BIOMEDICAL MATERIALS, 2022, 134
  • [6] Combining non-vascularized fibula and cancellous graft in the masquelet technique: A promising approach to distal femur compound fracture management with large defects
    Gannamani, Subramaniam
    Rachakonda, Kamalakar Rao
    Tellakula, Yeseswi
    Takkalapally, Harsha
    Maryada, Venkateshwar Reddy
    Reddy, A. V. Gurava
    [J]. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2024, 55 (02):
  • [7] 3D-printed porous Ti6Al4V scaffolds for long bone repair in animal models: a systematic review
    Gu, Yifei
    Sun, Yi
    Shujaat, Sohaib
    Braem, Annabel
    Politis, Constantinus
    Jacobs, Reinhilde
    [J]. JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2022, 17 (01)
  • [8] Knee Reconstruction Using 3D-Printed Porous Tantalum Augment in the Treatment of Charcot Joint
    Hua, Long
    Lei, Pengfei
    Hu, Yihe
    [J]. ORTHOPAEDIC SURGERY, 2022, 14 (11) : 3125 - 3128
  • [9] Outcomes of rotating versus pure hinge knee arthroplasty in the setting of one-stage exchange for periprosthetic joint infection
    Liechti, Emanuel F.
    Linke, Philip
    Gehrke, Thorsten
    Citak, Mustafa
    Lausmann, Christian
    [J]. INTERNATIONAL ORTHOPAEDICS, 2024, 48 (07) : 1689 - 1690
  • [10] Repair of critical diaphyseal defects of lower limbs by 3D printed porous Ti6Al4V scaffolds without additional bone grafting: a prospective clinical study
    Liu, Bingchuan
    Hou, Guojin
    Yang, Zhongwei
    Li, Xingcai
    Zheng, Yufeng
    Wen, Peng
    Liu, Zhongjun
    Zhou, Fang
    Tian, Yun
    [J]. JOURNAL OF MATERIALS SCIENCE-MATERIALS IN MEDICINE, 2022, 33 (09)