{"title":"带骨小梁的三维打印钛假体可以实现骨肿瘤切除后的机械生物重建。","authors":"Feifei Pu, Wei Wu, Doudou Jing, Yihan Yu, Yizhong Peng, Jianxiang Liu, Qiang Wu, Baichuan Wang, Zhicai Zhang, Zengwu Shao, Zz, Zs, Yp, Jl, Qw, Bw, Fp, Ww, Dj, Yy","doi":"10.12336/biomatertransl.2022.02.005","DOIUrl":null,"url":null,"abstract":"<p><p>Reconstruction after resection has always been an urgent problem in the treatment of bone tumours. There are many methods that can be used to reconstruct bone defects; however, there are also many complications, and it is difficult to develop a safe and effective reconstruction plan for the treatment of bone tumours. With the rapid development of digital orthopaedics, three-dimensional printing technology can solve this problem. The three-dimensional printing of personalised prostheses has many advantages. It can be used to print complex structures that are difficult to fabricate using traditional processes and overcome the problems of stress shielding and low biological activity of conventional prostheses. In this study, 12 patients with bone tumours were selected as research subjects, and based on individualised reverse-engineering design technology, a three-dimensional model of each prosthesis was designed and installed using medical image data. Ti6Al4V was used as the raw material to prepare the prostheses, which were used to repair bone defects after surgical resection. The operation time was 266.43 ± 21.08 minutes (range 180-390 minutes), and intraoperative blood loss was 857.26 ± 84.28 mL (range 800-2500 mL). One patient had delayed wound healing after surgery, but all patients survived without local tumour recurrence, and no tumour metastasis was found. No aseptic loosening or structural fracture of the prosthesis, and no non-mechanical prosthesis failure caused by infection, tumour recurrence, or progression was observed. The Musculo-Skeletal Tumour Society (MSTS) score of limb function was 22.53 ± 2.09 (range 16-26), and ten of the 12 patients scored ≥ 20 and were able to function normally. The results showed that three-dimensional printed prostheses with an individualised design can achieve satisfactory short-term clinical efficacy in the reconstruction of large bone defects after bone tumour resection.</p>","PeriodicalId":58820,"journal":{"name":"Biomaterials Translational","volume":"3 2","pages":"134-141"},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/fe/bt-03-02-134.PMC9465991.pdf","citationCount":"3","resultStr":"{\"title\":\"Three-dimensional-printed titanium prostheses with bone trabeculae enable mechanical-biological reconstruction after resection of bone tumours.\",\"authors\":\"Feifei Pu, Wei Wu, Doudou Jing, Yihan Yu, Yizhong Peng, Jianxiang Liu, Qiang Wu, Baichuan Wang, Zhicai Zhang, Zengwu Shao, Zz, Zs, Yp, Jl, Qw, Bw, Fp, Ww, Dj, Yy\",\"doi\":\"10.12336/biomatertransl.2022.02.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Reconstruction after resection has always been an urgent problem in the treatment of bone tumours. There are many methods that can be used to reconstruct bone defects; however, there are also many complications, and it is difficult to develop a safe and effective reconstruction plan for the treatment of bone tumours. With the rapid development of digital orthopaedics, three-dimensional printing technology can solve this problem. The three-dimensional printing of personalised prostheses has many advantages. It can be used to print complex structures that are difficult to fabricate using traditional processes and overcome the problems of stress shielding and low biological activity of conventional prostheses. In this study, 12 patients with bone tumours were selected as research subjects, and based on individualised reverse-engineering design technology, a three-dimensional model of each prosthesis was designed and installed using medical image data. Ti6Al4V was used as the raw material to prepare the prostheses, which were used to repair bone defects after surgical resection. The operation time was 266.43 ± 21.08 minutes (range 180-390 minutes), and intraoperative blood loss was 857.26 ± 84.28 mL (range 800-2500 mL). One patient had delayed wound healing after surgery, but all patients survived without local tumour recurrence, and no tumour metastasis was found. No aseptic loosening or structural fracture of the prosthesis, and no non-mechanical prosthesis failure caused by infection, tumour recurrence, or progression was observed. The Musculo-Skeletal Tumour Society (MSTS) score of limb function was 22.53 ± 2.09 (range 16-26), and ten of the 12 patients scored ≥ 20 and were able to function normally. The results showed that three-dimensional printed prostheses with an individualised design can achieve satisfactory short-term clinical efficacy in the reconstruction of large bone defects after bone tumour resection.</p>\",\"PeriodicalId\":58820,\"journal\":{\"name\":\"Biomaterials Translational\",\"volume\":\"3 2\",\"pages\":\"134-141\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/fe/bt-03-02-134.PMC9465991.pdf\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biomaterials Translational\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.12336/biomatertransl.2022.02.005\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomaterials Translational","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12336/biomatertransl.2022.02.005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3
摘要
骨肿瘤切除后重建一直是骨肿瘤治疗中亟待解决的问题。有许多方法可用于重建骨缺损;然而,骨肿瘤的治疗也存在许多并发症,难以制定安全有效的骨肿瘤重建方案。随着数字骨科的快速发展,三维打印技术可以解决这一问题。个性化义肢的三维打印有很多优点。它可以用于打印传统工艺难以制造的复杂结构,克服了传统假体的应力屏蔽和低生物活性的问题。本研究选取12例骨肿瘤患者作为研究对象,基于个性化逆向工程设计技术,利用医学影像数据设计并安装每个假体的三维模型。以Ti6Al4V为原料制备假体,用于修复手术切除后的骨缺损。手术时间266.43±21.08 min (180 ~ 390 min),术中出血量857.26±84.28 mL (800 ~ 2500 mL)。1例患者术后伤口愈合延迟,但所有患者均存活,无局部肿瘤复发,未发现肿瘤转移。无无菌性假体松动或结构性骨折,无感染、肿瘤复发或进展引起的非机械性假体失效。肌肉骨骼肿瘤学会(MSTS)肢体功能评分为22.53±2.09(范围16-26),12例患者中有10例评分≥20,功能正常。结果表明,个性化设计的三维打印假体在骨肿瘤切除后大面积骨缺损重建中可获得满意的短期临床效果。
Three-dimensional-printed titanium prostheses with bone trabeculae enable mechanical-biological reconstruction after resection of bone tumours.
Reconstruction after resection has always been an urgent problem in the treatment of bone tumours. There are many methods that can be used to reconstruct bone defects; however, there are also many complications, and it is difficult to develop a safe and effective reconstruction plan for the treatment of bone tumours. With the rapid development of digital orthopaedics, three-dimensional printing technology can solve this problem. The three-dimensional printing of personalised prostheses has many advantages. It can be used to print complex structures that are difficult to fabricate using traditional processes and overcome the problems of stress shielding and low biological activity of conventional prostheses. In this study, 12 patients with bone tumours were selected as research subjects, and based on individualised reverse-engineering design technology, a three-dimensional model of each prosthesis was designed and installed using medical image data. Ti6Al4V was used as the raw material to prepare the prostheses, which were used to repair bone defects after surgical resection. The operation time was 266.43 ± 21.08 minutes (range 180-390 minutes), and intraoperative blood loss was 857.26 ± 84.28 mL (range 800-2500 mL). One patient had delayed wound healing after surgery, but all patients survived without local tumour recurrence, and no tumour metastasis was found. No aseptic loosening or structural fracture of the prosthesis, and no non-mechanical prosthesis failure caused by infection, tumour recurrence, or progression was observed. The Musculo-Skeletal Tumour Society (MSTS) score of limb function was 22.53 ± 2.09 (range 16-26), and ten of the 12 patients scored ≥ 20 and were able to function normally. The results showed that three-dimensional printed prostheses with an individualised design can achieve satisfactory short-term clinical efficacy in the reconstruction of large bone defects after bone tumour resection.