title: Customized Knee Prosthesis in Treatment of Giant Cell Tumors of the Proximal Tibia: Application of 3-Dimensional Printing Technology in Surgical Design.
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 AND 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.
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Wenbin
authors.initials: W
authors.lastname: Luo
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Lanfeng
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: He
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Wenrui
authors.initials: W
authors.lastname: Qu
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Chenyu
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Qing
authors.initials: Q
authors.lastname: Han
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Jincheng
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland).
authors.forename: Yanguo
authors.initials: Y
authors.lastname: Qin
mesh_terms: D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D018212:Giant Cell Tumor of Bone / Q000601:surgery*; D005870:Giant Cell Tumors / Q000473:pathology / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D066330:Printing, Three-Dimensional; D011474:Prosthesis Design / Q000295:instrumentation / Q000379:methods*; D013977:Tibia / Q000473:pathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome