Highly Cancellous Titanium Alloy (TiAl6V4) Surfaces on Three-Dimensionally Printed, Custom-Made Intercalary Tibia Prostheses: Promising Short- to Intermediate-Term Results

被引:20
作者
Guder, Wiebke K. [1 ]
Hardes, Jendrik [1 ]
Nottrott, Markus [1 ]
Podleska, Lars E. [1 ]
Streitbuerger, Arne [1 ]
机构
[1] Univ Hosp Essen, Dept Orthoped Oncol, Hufelandstr 55, D-45147 Essen, Germany
关键词
highly cancellous; implant surface; tibia; titanium alloy; 3D printing; megaendoprosthesis; orthopedic oncology; DISTAL TIBIA; LIMB SALVAGE; ANKLE JOINT; BONE; RECONSTRUCTION; REPLACEMENT; INFECTION; RESECTION; MEGAPROSTHESES; DEFECT;
D O I
10.3390/jpm11050351
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Custom-made, three-dimensionally-printed (3D) bone prostheses gain increasing importance in the reconstruction of bone defects after musculoskeletal tumor resections. They may allow preservation of little remaining bone stock and ensure joint or limb salvage. However, we believe that by constructing anatomy-imitating implants with highly cancellous titanium alloy (TiAl6V4) surfaces using 3D printing technology, further benefits such as functional enhancement and reduction of complications may be achieved. We present a case series of four patients reconstructed using custom-made, 3D-printed intercalary monobloc tibia prostheses treated between 2016 and 2020. The mean patient age at operation was 30 years. Tumor resections were performed for Ewing sarcoma (n = 2), high-grade undifferentiated pleomorphic bone sarcoma (n = 1) and adamantinoma (n = 1). Mean resection length was 17.5 cm and mean operation time 147 min. All patients achieved full weight-bearing and limb salvage at a mean follow-up of 21.25 months. One patient developed a non-union at the proximal bone-implant interface. Alteration of implant design prevented non-union in later patients. Mean MSTS and TESS scores were 23.5 and 88. 3D-printed, custom-made intercalary tibia prostheses achieved joint and limb salvage in this case series despite high, published complication rates for biological and endoprosthetic reconstructions of the diaphyseal and distal tibia. Ingrowth of soft tissues into the highly cancellous implant surface structure reduces dead space, enhances function, and appears promising in reducing complication rates.
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页数:10
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