Reconstruction with 3D-printed pelvic endoprostheses after resection of a pelvic tumour.
OBJECTIVE
The aims of this retrospective study were to report the feasibility of using 3D-printing technology for patients with a pelvic tumour who underwent reconstruction.


METHODS
A total of 35 patients underwent resection of a pelvic tumour and reconstruction using 3D-printed endoprostheses between September 2013 and December 2015. According to Enneking's classification of bone defects, there were three Type I lesions, 12 Type II+III lesions, five Type I+II lesions, two Type I+II+III lesions, ten type I+II+IV lesions and three type I+II+III+IV lesions. A total of three patients underwent reconstruction using an iliac prosthesis, 12 using a standard hemipelvic prosthesis and 20 using a screw-rod connected hemipelvic prosthesis.


RESULTS
All patients had an en bloc resection. Margins were wide in 15 patients, marginal in 14 and intralesional in six. After a mean follow-up of 20.5 months (6 to 30), 25 patients survived without evidence of disease, five were alive with disease and five had died from metastatic disease. Complications included seven patients with delayed wound healing and two with a dislocation of the hip. None had a deep infection. For the 30 surviving patients, the mean Musculoskeletal Society 93 score was 22.7 (20 to 25) for patients with an iliac prosthesis, 19.8 (15 to 26) for those with a standard prosthesis, and 17.7 (9 to 25) for those with a screw-rod connected prosthesis.


CONCLUSIONS
The application of 3D-printing technology can facilitate the precise matching and osseointegration between implants and the host bone. We found that the use of 3D-printed pelvic prostheses for reconstruction of the bony defect after resection of a pelvic tumour was safe, without additional complications, and gave good short-term functional results. Cite this article: Bone Joint J 2017;99-B:267-75.
Peking University People's Hospital, and Key Laboratory for Musculoskeletal Tumor of Beijing, Xizhimen Nan 11, Xicheng District, Beijing 100044, China.
H
H
Liang
Peking University People's Hospital, and Key Laboratory for Musculoskeletal Tumor of Beijing, Xizhimen Nan 11, Xicheng District, Beijing 100044, China.
T
T
Ji
Peking University People's Hospital, and Key Laboratory for Musculoskeletal Tumor of Beijing, Xizhimen Nan 11, Xicheng District, Beijing 100044, China.
Y
Y
Zhang
Peking University People's Hospital, and Key Laboratory for Musculoskeletal Tumor of Beijing, Xizhimen Nan 11, Xicheng District, Beijing 100044, China.
Y
Y
Wang
Peking University People's Hospital, and Key Laboratory for Musculoskeletal Tumor of Beijing, Xizhimen Nan 11, Xicheng District, Beijing 100044, China.
W
W
Guo
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D010384:Pelvic Bones / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D066330:Printing, Three-Dimensional; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
3D-printing; Endoprosthesis; Pelvis; Reconstruction; Tumour