Application of three-dimensional printing technology in treatment of limb bone tumors_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 NIU Xiaohui , JIN Tao , XU Hairong

Department of Orthopaedic Oncology Surgery, Beijing Jishuitan Hospital, Beijing, 102208, P. R. China;

Corresponding author：

NIU Xiaohui, Email: Niuxiaohui@263.net

Keywords：

Three-dimensional printing technology; bone tumor; bone defect; repair and reconstruction

DOI：

10.7507/1002-1892.202203006

Video：

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With the developing of three-dimensional (3D) printing technology, it is widely used in the treatment of bone tumors in the clinical orthopedics. Because of the great individual differences in the location of bone tumor, resection and reconstruction are difficult. Based on 3D printing technology, the 3D models can be prepared to show the anatomical part of the disease, so that the surgeons can create a patient-specific operational plans based on better understand the local conditions. At the same time, preoperative simulation can also be carried out for complex operations and patient-specific prostheses can be further designed and prepared according to the location and size of tumor, which may have more advantages in adaptability. In this paper, the domestic and international research progress of 3D printing technology in the treatment of limb bone tumors in recent years were reviewed and summarized.

Citation： NIU Xiaohui, JIN Tao, XU Hairong. Application of three-dimensional printing technology in treatment of limb bone tumors. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(7): 790-795. doi: 10.7507/1002-1892.202203006 Copy

1.	Diment LE, Thompson MS, Bergmann JHM. Clinical efficacy and effectiveness of 3D printing: a systematic review. BMJ Open, 2017, 7(12): e016891. doi: 10.1136/bmjopen-2017-016891.
2.	Duncan JM, Nahas S, Akhtar K, et al. The use of a 3D printer in pre-operative planning for a patient requiring acetabular reconstructive surgery. J Orthop Case Rep, 2015, 5(1): 23-25.
3.	Haleem A, Javaid M. Role of CT and MRI in the design and development of orthopaedic model using additive manufacturing. J Clin Orthop Trauma, 2018, 9(3): 213-217.
4.	Duan X, Wang B, Yang L, et al. Applications of 3D printing technology in orthopedic treatment. Biomed Res Int, 2021, 2021: 9892456. doi: 10.1155/2021/9892456.
5.	Xiao JR, Huang WD, Yang XH, et al. En bloc resection of primary malignant bone tumor in the cervical spine based on 3-dimensional printing technology. Orthop Surg, 2016, 8(2): 171-178.
6.	张玉东, 吴仁愿, 谢丁丁, 等. 3D打印技术对骨盆骨折治疗效果影响的Meta分析. 中国骨伤, 2018, 31(5): 465-471.
7.	Van Genechten W, Van Tilborg W, Van den Bempt M, et al. Feasibility and 3D planning of a novel patient-specific instrumentation technique in medial opening-wedge high tibial osteotomy. J Knee Surg, 2021, 34(14): 1560-1569.
8.	McCulloch RA, Frisoni T, Kurunskal V, et al. Computer navigation and 3D printing in the surgical management of bone sarcoma. Cells, 2021, 10(2): 195-210.
9.	Xu L, Qin H, Tan J, et al. Clinical study of 3D printed personalized prosthesis in the treatment of bone defect after pelvic tumor resection. J Orthop Translat, 2021, 29: 163-169.
10.	Fujiwara T, Ogura K, Christ A, et al. Periacetabular reconstruction following limb-salvage surgery for pelvic sarcomas. J Bone Oncol, 2021, 31: 100396. doi: 10.1016/j.jbo.2021.100396.
11.	Wang J, Min L, Lu M, et al. Three-dimensional-printed custom-made hemipelvic endoprosthesis for primary malignancies involving acetabulum: the design solution and surgical techniques. J Orthop Surg Res, 2019, 14(1): 389-399.
12.	Angelini A, Trovarelli G, Berizzi A, et al. Three-dimension-printed custom-made prosthetic reconstructions: from revision surgery to oncologic reconstructions. Int Orthop, 2019, 43(1): 123-132.
13.	Liang H, Ji T, Zhang Y, et al. Reconstruction with 3D-printed pelvic endoprostheses after resection of a pelvic tumour. Bone Joint J, 2017, 99-B(2): 267-275.
14.	Xu H, Li Y, Zhang Q, et al. Does adding femoral lengthening at the time of rotation hip transposition after periacetabular tumor resection allow for restoration of limb length and function? Interim results of a modified hip transposition procedure. Clin Orthop Relat Res, 2021, 479(7): 1521-1530.
15.	Wong KC, Kumta SM, Geel NV, et al. One-step reconstruction with a 3D-printed, biomechanically evaluated custom implant after complex pelvic tumor resection. Comput Aided Surg, 2015, 20(1): 14-23.
16.	杨勇昆, 牛晓辉, 李远, 等. 计算机导航辅助髋臼骨巨细胞瘤精确切除和全髋关节置换的临床效果. 骨科临床与研究杂志, 2018, 3(5): 295-300.
17.	Ma L, Zhou Y, Zhu Y, et al. 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep, 2016, 6: 23335. doi: 10.1038/srep23335.
18.	纪玉清, 吴玉仙, 李建民, 等. 3D打印截骨导板在股骨远端骨肉瘤肿瘤切除、假体重建术中的应用. 中国骨与关节杂志, 2018, 7(7): 547-551.
19.	Wang J, An J, Lu M, et al. Is three-dimensional-printed custom-made ultra-short stem with a porous structure an acceptable reconstructive alternative in peri-knee metaphysis for the tumorous bone defect? World J Surg Oncol, 2021, 19(1): 235-246.
20.	张清, 牛晓辉, 王涛, 等. 计算机导航辅助下保留关节治疗肢体恶性骨肿瘤. 中华创伤骨科杂志, 2011, 13(12): 1148-1151.
21.	Yang QD, Mu MD, Tao X, et al. Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature. World J Clin Cases, 2021, 9(13): 3147-3156.
22.	Fang X, Liu H, Xiong Y, et al. Total talar replacement with a novel 3D printed modular prosthesis for tumors. Ther Clin Risk Manag, 2018, 14: 1897-1905.
23.	Zhang L, Lu C, Lv Y, et al. Three-dimensional printing-assisted Masquelet technique in the treatment of calcaneal defects. Orthop Surg, 2021, 13(3): 876-883.
24.	郝永强, 艾松涛, 沈陆, 等. 3D打印个性化重建假体在肩胛骨恶性肿瘤保肢重建中的应用//中国中西医结合学会骨伤科分会. 第二十四届中国中西医结合骨伤科学术年会论文汇编. 内蒙古: [出版者不详], 2017.
25.	Park JH, Jung HW, Jang WY. The usefulness of a three-dimensional printed segmental scapula prosthesis for recovering shoulder function in a patient with scapula chondrosarcoma: A case report. Medicine (Baltimore), 2021, 100(8): e24817. doi: 10.1097/MD.0000000000024817.
26.	Liu D, Fu J, Fan H, et al. Application of 3D-printed PEEK scapula prosthesis in the treatment of scapular benign fibrous histiocytoma: A case report. J Bone Oncol, 2018, 12: 78-82.
27.	雷青, 陈松, 陈立, 等. 3D打印导板结合3D打印个体化金属骨小梁假体治疗肱骨干骨肿瘤二例. 临床外科杂志, 2020, 28(4): 393-395.
28.	Lu M, Min L, Xiao C, et al. Uncemented three-dimensional-printed prosthetic replacement for giant cell tumor of distal radius: a new design of prosthesis and surgical techniques. Cancer Manag Res, 2018, 10: 265-277.
29.	苗秋菊, 丁焕文, 黄敏强, 等. 3-D打印导航模板辅助肘关节肿瘤切除及个性化肘关节置换术的初步应用. 中国修复重建外科杂志, 2017, 31(4): 385-391.
30.	西北大学附属医院. 西安市第三医院成功实施西北首例3D打印双尺桡骨重建术. 临床医学研究与实践, 2021, 6(11): 4.
31.	Liu PC, Yang YJ, Liu R, et al. A study on the mechanical characteristics of the EBM-printed Ti-6Al-4V LCP plates in vitro. J Orthop Surg Res, 2014, 9: 106. doi: 10.1186/s13018-014-0106-3.
32.	Parthasarathy J, Starly B, Raman S, et al. Mechanical evaluation of porous titanium (Ti6Al4V) structures with electron beam melting (EBM). J Mech Behav Biomed Mater, 2010, 3(3): 249-259.
33.	Niinomi M. Mechanical biocompatibilities of titanium alloys for biomedical applications. J Mech Behav Biomed Mater, 2008, 1(1): 30-42.
34.	Marin E, Pressacco M, Fusi S, et al. Characterization of grade 2 commercially pure Trabecular Titanium structures. Mater Sci Eng C Mater Biol Appl, 2013, 33(5): 2648-2656.
35.	Frosch KH, Barvencik F, Lohmann CH, et al. Migration, matrix production and lamellar bone formation of human osteoblast-like cells in porous titanium implants. Cells Tissues Organs, 2002, 170(4): 214-227.
36.	Wang H, Su K, Su L, et al. Comparison of 3D-printed porous tantalum and titanium scaffolds on osteointegration and osteogenesis. Mater Sci Eng C Mater Biol Appl, 2019, 104: 109908. doi: 10.1016/j.msec.2019.109908.
37.	Wang F, Chen H, Yang P, et al. Three-dimensional printed porous tantalum prosthesis for treating inflammation after total knee arthroplasty in one-stage surgery—a case report. J Int Med Res, 2020, 48(3): 300060519891280. doi: 10.1177/0300060519891280.
38.	段钢, 陈宏亮, 郭开今, 等. 3D打印β-磷酸三钙仿生骨支架修复兔股骨髁骨缺损. 骨科临床与研究杂志, 2020, 5(4): 243-250.
39.	Kersten RF, van Gaalen SM, de Gast A, et al. Polyetheretherketone (PEEK) cages in cervical applications: a systematic review. Spine J, 2015, 15(6): 1446-1460.

1. Diment LE, Thompson MS, Bergmann JHM. Clinical efficacy and effectiveness of 3D printing: a systematic review. BMJ Open, 2017, 7(12): e016891. doi: 10.1136/bmjopen-2017-016891.
2. Duncan JM, Nahas S, Akhtar K, et al. The use of a 3D printer in pre-operative planning for a patient requiring acetabular reconstructive surgery. J Orthop Case Rep, 2015, 5(1): 23-25.
3. Haleem A, Javaid M. Role of CT and MRI in the design and development of orthopaedic model using additive manufacturing. J Clin Orthop Trauma, 2018, 9(3): 213-217.
4. Duan X, Wang B, Yang L, et al. Applications of 3D printing technology in orthopedic treatment. Biomed Res Int, 2021, 2021: 9892456. doi: 10.1155/2021/9892456.
5. Xiao JR, Huang WD, Yang XH, et al. En bloc resection of primary malignant bone tumor in the cervical spine based on 3-dimensional printing technology. Orthop Surg, 2016, 8(2): 171-178.
6. 张玉东, 吴仁愿, 谢丁丁, 等. 3D打印技术对骨盆骨折治疗效果影响的Meta分析. 中国骨伤, 2018, 31(5): 465-471.
7. Van Genechten W, Van Tilborg W, Van den Bempt M, et al. Feasibility and 3D planning of a novel patient-specific instrumentation technique in medial opening-wedge high tibial osteotomy. J Knee Surg, 2021, 34(14): 1560-1569.
8. McCulloch RA, Frisoni T, Kurunskal V, et al. Computer navigation and 3D printing in the surgical management of bone sarcoma. Cells, 2021, 10(2): 195-210.
9. Xu L, Qin H, Tan J, et al. Clinical study of 3D printed personalized prosthesis in the treatment of bone defect after pelvic tumor resection. J Orthop Translat, 2021, 29: 163-169.
10. Fujiwara T, Ogura K, Christ A, et al. Periacetabular reconstruction following limb-salvage surgery for pelvic sarcomas. J Bone Oncol, 2021, 31: 100396. doi: 10.1016/j.jbo.2021.100396.
11. Wang J, Min L, Lu M, et al. Three-dimensional-printed custom-made hemipelvic endoprosthesis for primary malignancies involving acetabulum: the design solution and surgical techniques. J Orthop Surg Res, 2019, 14(1): 389-399.
12. Angelini A, Trovarelli G, Berizzi A, et al. Three-dimension-printed custom-made prosthetic reconstructions: from revision surgery to oncologic reconstructions. Int Orthop, 2019, 43(1): 123-132.
13. Liang H, Ji T, Zhang Y, et al. Reconstruction with 3D-printed pelvic endoprostheses after resection of a pelvic tumour. Bone Joint J, 2017, 99-B(2): 267-275.
14. Xu H, Li Y, Zhang Q, et al. Does adding femoral lengthening at the time of rotation hip transposition after periacetabular tumor resection allow for restoration of limb length and function? Interim results of a modified hip transposition procedure. Clin Orthop Relat Res, 2021, 479(7): 1521-1530.
15. Wong KC, Kumta SM, Geel NV, et al. One-step reconstruction with a 3D-printed, biomechanically evaluated custom implant after complex pelvic tumor resection. Comput Aided Surg, 2015, 20(1): 14-23.
16. 杨勇昆, 牛晓辉, 李远, 等. 计算机导航辅助髋臼骨巨细胞瘤精确切除和全髋关节置换的临床效果. 骨科临床与研究杂志, 2018, 3(5): 295-300.
17. Ma L, Zhou Y, Zhu Y, et al. 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep, 2016, 6: 23335. doi: 10.1038/srep23335.
18. 纪玉清, 吴玉仙, 李建民, 等. 3D打印截骨导板在股骨远端骨肉瘤肿瘤切除、假体重建术中的应用. 中国骨与关节杂志, 2018, 7(7): 547-551.
19. Wang J, An J, Lu M, et al. Is three-dimensional-printed custom-made ultra-short stem with a porous structure an acceptable reconstructive alternative in peri-knee metaphysis for the tumorous bone defect? World J Surg Oncol, 2021, 19(1): 235-246.
20. 张清, 牛晓辉, 王涛, 等. 计算机导航辅助下保留关节治疗肢体恶性骨肿瘤. 中华创伤骨科杂志, 2011, 13(12): 1148-1151.
21. Yang QD, Mu MD, Tao X, et al. Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature. World J Clin Cases, 2021, 9(13): 3147-3156.
22. Fang X, Liu H, Xiong Y, et al. Total talar replacement with a novel 3D printed modular prosthesis for tumors. Ther Clin Risk Manag, 2018, 14: 1897-1905.
23. Zhang L, Lu C, Lv Y, et al. Three-dimensional printing-assisted Masquelet technique in the treatment of calcaneal defects. Orthop Surg, 2021, 13(3): 876-883.
24. 郝永强, 艾松涛, 沈陆, 等. 3D打印个性化重建假体在肩胛骨恶性肿瘤保肢重建中的应用//中国中西医结合学会骨伤科分会. 第二十四届中国中西医结合骨伤科学术年会论文汇编. 内蒙古: [出版者不详], 2017.
25. Park JH, Jung HW, Jang WY. The usefulness of a three-dimensional printed segmental scapula prosthesis for recovering shoulder function in a patient with scapula chondrosarcoma: A case report. Medicine (Baltimore), 2021, 100(8): e24817. doi: 10.1097/MD.0000000000024817.
26. Liu D, Fu J, Fan H, et al. Application of 3D-printed PEEK scapula prosthesis in the treatment of scapular benign fibrous histiocytoma: A case report. J Bone Oncol, 2018, 12: 78-82.
27. 雷青, 陈松, 陈立, 等. 3D打印导板结合3D打印个体化金属骨小梁假体治疗肱骨干骨肿瘤二例. 临床外科杂志, 2020, 28(4): 393-395.
28. Lu M, Min L, Xiao C, et al. Uncemented three-dimensional-printed prosthetic replacement for giant cell tumor of distal radius: a new design of prosthesis and surgical techniques. Cancer Manag Res, 2018, 10: 265-277.
29. 苗秋菊, 丁焕文, 黄敏强, 等. 3-D打印导航模板辅助肘关节肿瘤切除及个性化肘关节置换术的初步应用. 中国修复重建外科杂志, 2017, 31(4): 385-391.
30. 西北大学附属医院. 西安市第三医院成功实施西北首例3D打印双尺桡骨重建术. 临床医学研究与实践, 2021, 6(11): 4.
31. Liu PC, Yang YJ, Liu R, et al. A study on the mechanical characteristics of the EBM-printed Ti-6Al-4V LCP plates in vitro. J Orthop Surg Res, 2014, 9: 106. doi: 10.1186/s13018-014-0106-3.
32. Parthasarathy J, Starly B, Raman S, et al. Mechanical evaluation of porous titanium (Ti6Al4V) structures with electron beam melting (EBM). J Mech Behav Biomed Mater, 2010, 3(3): 249-259.
33. Niinomi M. Mechanical biocompatibilities of titanium alloys for biomedical applications. J Mech Behav Biomed Mater, 2008, 1(1): 30-42.
34. Marin E, Pressacco M, Fusi S, et al. Characterization of grade 2 commercially pure Trabecular Titanium structures. Mater Sci Eng C Mater Biol Appl, 2013, 33(5): 2648-2656.
35. Frosch KH, Barvencik F, Lohmann CH, et al. Migration, matrix production and lamellar bone formation of human osteoblast-like cells in porous titanium implants. Cells Tissues Organs, 2002, 170(4): 214-227.
36. Wang H, Su K, Su L, et al. Comparison of 3D-printed porous tantalum and titanium scaffolds on osteointegration and osteogenesis. Mater Sci Eng C Mater Biol Appl, 2019, 104: 109908. doi: 10.1016/j.msec.2019.109908.
37. Wang F, Chen H, Yang P, et al. Three-dimensional printed porous tantalum prosthesis for treating inflammation after total knee arthroplasty in one-stage surgery—a case report. J Int Med Res, 2020, 48(3): 300060519891280. doi: 10.1177/0300060519891280.
38. 段钢, 陈宏亮, 郭开今, 等. 3D打印β-磷酸三钙仿生骨支架修复兔股骨髁骨缺损. 骨科临床与研究杂志, 2020, 5(4): 243-250.
39. Kersten RF, van Gaalen SM, de Gast A, et al. Polyetheretherketone (PEEK) cages in cervical applications: a systematic review. Spine J, 2015, 15(6): 1446-1460.

Chinese Journal of Reparative and Reconstructive Surgery

Application of three-dimensional printing technology in treatment of limb bone tumors

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