Preliminary application of three dimensional printing personalized navigation template in assisting total elbow replacement for patients with elbow tumor_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MIAO Qiuju ^1,2 ,  DING Huanwen ¹ , HUANG Minqiang ^1,2 , SHEN Jianjian ¹ , TU Qiang ¹ , HUANG Miaojun ³

1. Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010, P.R.China;
2. Graduate College, Traditional Chinese Medicine University of Guangzhou, Guangzhou Guangdong, 510010, P.R.China;
3. Guangdong University of Technology, Guangzhou Guangdong, 510006, P.R.China;

Corresponding author：

DING Huanwen, Email: dhuanwen123@aliyun.com

Keywords：

Total elbow replacement; elbow prosthesis; three-dimensional printing technology; computer aided design; bone tumor

DOI：

10.7507/1002-1892.201611091

Video：

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Objective To explore the clinical methods of resection of elbow tumor and total elbow replacement with custom personalized prosthesis based on three dimensional (3-D) printing navigation template. Methods In August 2016, a 63-year-old male patient with left elbow joint tumor was treated, with the discovery of the left distal humerus huge mass over 3 months, with elbow pain, activity limitation of admission. Computer-assisted reduction technique combined with 3-D printing was used to simulate preoperative tumor resection, a customized personal prosthesis was developed; tumor was accurately excised during operation, and the clinical result was evaluated after operation. Results The time was 46 minutes for tumor resection, and was 95 minutes for personalized implant and allograft bone without fluoroscopy. X-ray and CT examination at 1 week after operation showed good position of artificial elbow joint; the anteversion of ulna prosthesis was 30° and the elbow carrying angle was 15°, which were consistent with the simulated results before surgery. The finger flexion was normal at 1 month after operation; the range of motion was 0-130° for elbow flexion and extension, 80° for forearm pronation, and 80° for forearm supination. The elbow function was able to meet the needs of daily life at 7 months after operation, and no recurrence and metastasis of tumor were observed. Conclusion For limb salvage of elbow joint, computer aided design can make preoperative surgical simulation; the navigation template can improve surgical precision; and the function of elbow joint can be reconstructed with customized and personlized prosthesis for total elbow replacement.

Citation： MIAO Qiuju, DING Huanwen, HUANG Minqiang, SHEN Jianjian, TU Qiang, HUANG Miaojun. Preliminary application of three dimensional printing personalized navigation template in assisting total elbow replacement for patients with elbow tumor. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(4): 385-391. doi: 10.7507/1002-1892.201611091 Copy

1.	王克平, 李智明, 盛晓赟, 等. 全肘关节置换治疗老年陈旧性肘关节骨折脱位.临床骨科杂志, 2015, 18(4): 425-428.
2.	Fadero PE, Shah M. Three dimensional (3D) modelling and surgical planning in trauma and orthopaedics. Surgeon, 2014, 12(6): 328-333.
3.	Tang X, Guo W, Yang R, et al. Custom-made prosthesis replacement for reconstruction of elbow after tumor resection. J Shoulder Elbow Surg, 2009, 18(5): 796-803.
4.	Lenoir H, Chammas M, Micallef JP, et al. The effect of the anatomy of the distal humerus and proximal ulna on the positioning of the components in total elbow arthroplasty. Bone Joint J, 2015, 97-B(11): 1539-1545.
5.	Chia HN, Wu BM. Recent advances in 3D printing of biomaterials. J Biol Eng, 2015, 9(4): 1-14.
6.	Zerr J, Chatzinoff Y, Chopra R, et al. Three-dimensional printing for preoperative planning of total hip arthroplasty revision: case report. Skeletal Radiol, 2016, 45(10): 1431-1435.
7.	付军, 郭征, 王臻, 等. 多种 3-D 打印手术导板在骨肿瘤切除重建手术中的应用. 中国修复重建外科杂志, 2014, 28(3): 304-308.
8.	韩娟, 杨明, 欧丽影, 等. 3D 打印技术辅助儿童胫骨远端骨软骨瘤的应用. 中国数字医学, 2015, 10(7): 30-32.
9.	丁焕文, 易灿, 涂强, 等. 计算机辅助骨盆肿瘤精确切除和功能重建. 中国修复重建外科杂志, 2011, 25(10): 1218-1223.
10.	Figgie MP, Wright TM, Drinkwater D, et al. What design and material factors impact the wear and corrosion performance in total elbow arthroplasties. Clin Orthop Relat Res, 2014, 472(12): 3770-3776.
11.	Cesar M, Roussanne Y, Bonnel F, et al. GSB III total elbow replacement in rheumatoid arthritis. J Bone Joint Surg (Br), 2007, 89(3): 330-334.
12.	Ogino H, Ito H, Furu M, et al. Outcome of shortened extra-small ulnar component in linked total elbow arthroplasty for patients with rheumatoid arthritis. Mod Rheumatol, 2015, 25(6): 849-853.
13.	Qiao F, Li D, Jin Z, et al. Application of 3D printed customized external fixator in fracture reduction. Injury, 2015, 46(6): 1150-1155.
14.	刘宏伟, 翁益平, 张云坤, 等. 计算机辅助设计及电子束熔融快速成型金属 3D 打印技术制备个性化股骨假体. 中国修复重建外科杂志, 2015, 29(9): 1088-1091.
15.	Kiene J, Wendlandt R, Heinritz M, et al. A physiological dynamic testing machine for the elbow joint. Open Orthop J, 2013, 7(1): 78-85.
16.	Ding HW, Yu GW, Tu Q, et al. Computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee: outcomes of 12 cases. BMC Musculoskeletal Disorders, 2013, 14(1): 331.
17.	潘露. 自体骨结合同种异体骨治疗四肢恶性骨肿瘤的疗效观察. 实用癌症杂志, 2015, 30(6): 824-827.
18.	Ma L, Zhou Y, Zhu Y, et al. 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep, 2016, 6: 1-9.

1. 王克平, 李智明, 盛晓赟, 等. 全肘关节置换治疗老年陈旧性肘关节骨折脱位.临床骨科杂志, 2015, 18(4): 425-428.
2. Fadero PE, Shah M. Three dimensional (3D) modelling and surgical planning in trauma and orthopaedics. Surgeon, 2014, 12(6): 328-333.
3. Tang X, Guo W, Yang R, et al. Custom-made prosthesis replacement for reconstruction of elbow after tumor resection. J Shoulder Elbow Surg, 2009, 18(5): 796-803.
4. Lenoir H, Chammas M, Micallef JP, et al. The effect of the anatomy of the distal humerus and proximal ulna on the positioning of the components in total elbow arthroplasty. Bone Joint J, 2015, 97-B(11): 1539-1545.
5. Chia HN, Wu BM. Recent advances in 3D printing of biomaterials. J Biol Eng, 2015, 9(4): 1-14.
6. Zerr J, Chatzinoff Y, Chopra R, et al. Three-dimensional printing for preoperative planning of total hip arthroplasty revision: case report. Skeletal Radiol, 2016, 45(10): 1431-1435.
7. 付军, 郭征, 王臻, 等. 多种 3-D 打印手术导板在骨肿瘤切除重建手术中的应用. 中国修复重建外科杂志, 2014, 28(3): 304-308.
8. 韩娟, 杨明, 欧丽影, 等. 3D 打印技术辅助儿童胫骨远端骨软骨瘤的应用. 中国数字医学, 2015, 10(7): 30-32.
9. 丁焕文, 易灿, 涂强, 等. 计算机辅助骨盆肿瘤精确切除和功能重建. 中国修复重建外科杂志, 2011, 25(10): 1218-1223.
10. Figgie MP, Wright TM, Drinkwater D, et al. What design and material factors impact the wear and corrosion performance in total elbow arthroplasties. Clin Orthop Relat Res, 2014, 472(12): 3770-3776.
11. Cesar M, Roussanne Y, Bonnel F, et al. GSB III total elbow replacement in rheumatoid arthritis. J Bone Joint Surg (Br), 2007, 89(3): 330-334.
12. Ogino H, Ito H, Furu M, et al. Outcome of shortened extra-small ulnar component in linked total elbow arthroplasty for patients with rheumatoid arthritis. Mod Rheumatol, 2015, 25(6): 849-853.
13. Qiao F, Li D, Jin Z, et al. Application of 3D printed customized external fixator in fracture reduction. Injury, 2015, 46(6): 1150-1155.
14. 刘宏伟, 翁益平, 张云坤, 等. 计算机辅助设计及电子束熔融快速成型金属 3D 打印技术制备个性化股骨假体. 中国修复重建外科杂志, 2015, 29(9): 1088-1091.
15. Kiene J, Wendlandt R, Heinritz M, et al. A physiological dynamic testing machine for the elbow joint. Open Orthop J, 2013, 7(1): 78-85.
16. Ding HW, Yu GW, Tu Q, et al. Computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee: outcomes of 12 cases. BMC Musculoskeletal Disorders, 2013, 14(1): 331.
17. 潘露. 自体骨结合同种异体骨治疗四肢恶性骨肿瘤的疗效观察. 实用癌症杂志, 2015, 30(6): 824-827.
18. Ma L, Zhou Y, Zhu Y, et al. 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep, 2016, 6: 1-9.

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