title: Computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee: outcomes of 12 cases.
abstract: BACKGROUND
  To report the outcomes of computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee.
  
  
  METHODS
  Computed tomography (CT) and magnetic resonance imaging (MRI) data were input into computer software to produce three-dimensional (3D) models of the tumor extent. Imaging data was then used to create a template for surgical resection, and development of an individualized combined allogeneic bone/endoprosthesis. Surgical simulations were performed prior to the actual surgery.
  
  
  RESULTS
  This study included 9 males and 3 females with a mean age of 25.3 years (range, 13 to 40 years). There were 9 tumors in the distal femur and 3 in the proximal tibia. There were no surgical complications. In all cases pathologically confirmed clear surgical margins were obtained. Postoperative radiographs showed the range of tumor resection was in accordance with the preoperative design, and the morphological reconstruction of the bone defect was satisfactory with complete bilateral symmetry. The mean follow-up time was 26.5 months. Two patients died of their disease and the remaining are alive and well without evidence of recurrence. All patients are able to ambulate freely without restrictions. At the last follow-up, the average International Society of Limb Salvage score was 25.8 (range, 18 to 27), and was excellent in 8 cases and good in 4 cases.
  
  
  CONCLUSIONS
  Computer-aided design and modeling for the surgical management of bone tumors and subsequent limb reconstruction provides accurate tumor removal with the salvage of a maximal amount of unaffected bone and precise endoprosthesis reconstruction.
authors.affiliation: School of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong 510010, China. dhuanwen123@aliyun.com.
authors.forename: Huan-wen
authors.initials: HW
authors.lastname: Ding
authors.forename: Guang-wen
authors.initials: GW
authors.lastname: Yu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Tu
authors.forename: Bao
authors.initials: B
authors.lastname: Liu
authors.forename: Jian-jian
authors.initials: JJ
authors.lastname: Shen
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.forename: Ying-jun
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D019468:Disease Management; D005260:Female; D005269:Femur / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007720:Knee Prosthesis; D008297:Male; D011474:Prosthesis Design / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013977:Tibia / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult