3D打印定制半骨盆假体置换治疗原发性髋臼周围恶性肿瘤的疗效评估

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Abstract Objective To describe the preoperative personalized planning and surgical operation of 3D-printed customized hemipelvic prosthesis，and to evaluate and discuss the short-term efficacy of prosthesis reconstruction after resection of periacetabular primary malignant tumors.Methods From February 2018 to February 2019，a total of 22 patients with periacetabular primary malignant tumors who underwent 3D-printed custom-made hemipelvic prosthesis reconstruction in our center were collected.There were 10 males and 12 females.The age ranged from 31 to 76 years，with an average of (53.64±10.55)years.According to Enneking pelvic tumor division，there were 5 patients with pelvic area Ⅰ and Ⅱ involvement，10 patients with pelvic area Ⅱ and Ⅲ involvement and 7 patients with pelvic area Ⅰ，Ⅱ and Ⅲ involvement.There were included 12 conventional osteosarcoma，3 telangiectatic osteosarcoma，6 chondr osarcoma，and 1 ewing’s sarcoma.All patients had no distant tumor metastasis.Preoperative 3D modeling by thin-section CT data was used to determine the tumor-free resection margin，design the osteotomy guide，and customize prosthesis.Harris and musculoskeletal tumor society(MSTS) functional scoring were used for evaluation，oncology prognosis and complications were recorded.X-ray was used to evaluate the length of lower limb，acetabular abduction angle，anteversion angle，acetabular eccentricity，et al.Results R0 resection and precise reconstruction were performed in all patients.9 patients had preservation of the anterior inferior iliac spine without rectus reconstruction，and 13 patients had rectus reconstruction.Gluteus maximus，iliopsoas，sartorius and rectus femoris were all well reconstructed.The mean operative time was (414.22±89.13)min，and the mean intraoperative blood loss was (2 682.22±1 909.93)mL.The followup time ranged from 20 to 27 months，with an average of (23.78±2.54) months.At the final follow-up，all patients achieved good osseointegration.There was no significant difference in postoperative lower limb length，acetabular height，and bodyweight moment arm compared with the healthy side(P＞0.05).There was no significant difference in postoperative acetabular eccentricity，abduction angle，and anteversion angle compared with the preoperative(P＞0.05).Harris and MSTS scores were significantly improved after operation (P＜0.05).4 patients had incision infection and 5 had delayed wound healing due to fat necrosis，which were cured after treatment.The average follow-up time was 23.78 months.No tumor recurrence，deep infection，prosthesis dislocation，screw break，or other complications happened. Conclusion Preoperative personalized design of 3D-printed customized hemipelvic prosthesis is effective in the treatment of primary malignant tumors around the acetabulum and is a reliable method for reconstruction after resection of malignant tumors.

Key words： 3D-printed prosthesis implantation pelvis acetabulu malignant tumor

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	Articles by authors
	Zhang Qiang
	Du Junwei
	Dai Zhibing
	Wu Junshen
	Jiang Renbing *

Cite this article:

Zhang Qiang,Du Junwei,Dai Zhibing, et al. The Outcomes of Three Dimensional-printed Custom-made Hemipelvic Prosthesis Replacement for Primary Malignancies Involving the Acetabulum[J]. sygkzz, 2022, 28(3): 203-208.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I3/203

［1］Sys G，Uyttendaele D，Poffyn B，et al.Extracorporeally irradiated autografts in pelvic reconstruction after malignant tumour resection［J］.Int Orthop，2002，26(3)：174-178.
［2］Delloye C，Banse X，Brichard B，et al.Pelvic reconstruction with a structural pelvic allograft after resection of a malignant bone tumor［J］.J Bone Joint Surg(Am)，2007，89(3)：579-587.
［3］Fuchs B，O'Connor MI，Kaufman KR，et al.Iliofemoral arthrodesis and pseudarthrosis：a long-term functional outcome evaluation［J］.Clin Orthop Relat Res，2002(397)：29-35.
［4］Aljassir F，Beadel GP，Turcotte RE，et al.Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis［J］.Clin Orthop Relat Res，2005(438)：36-41.
［5］Jansen JA，van de Sande MA，Dijkstra PD，et al.Poor long-term clinical results of saddle prosthesis after resection of periacetabular tumors［J］.Clin Orthop Relat Res，2013(471)：324-331.
［6］Bus MP，Szafranski A，Sellevold S，et al.LUMiC(R) endoprosthetic reconstruction after periacetabular tumor resection：Short-term results［J］.Clin Orthop Relat Res，2017(475)：686-695.
［7］Issa SP，Biau D，Babinet A，et al.Pelvic reconstructions following peri-acetabular bone tumour resections using a cementless ice-cream cone prosthesis with dual mobility cup［J］.Int Orthop，2018，42(8)：1987-1997.
［8］Ogura K，Susa M，Morioka H，et al.Reconstruction using a constrained-type hip tumor prosthesis after resection of malignant periacetabular tumors：A study by the Japanese Musculoskeletal Oncology Group (JMOG)［J］.J Surg Oncol，2018，117(7)：1455-1463.
［9］Wang B，Xie X，Yin J，et al.Reconstruction with modular hemipelvic endoprosthesis after pelvic tumor resection：a report of 50 consecutive cases［J］.PLoS One，2015，10(5)：127-263.
［10］Ozaki T，Hoffmann C，Hillmann A，et al.Implantation of hemipelvic prosthesis after resection of sarcoma［J］.Clin Orthop Relat Res，2002(396)：197-205.
［11］Holzapfel BM，Pilge H，Prodinger PM，et al.Customised osteotomy guides and endoprosthetic reconstruction for periacetabular tumours［J］.Int Orthop，2014，38(7)：1435-1442.
［12］Wang B，Hao Y，Pu F，et al.Computer-aided designed，three dimensional-printed hemipelvic prosthesis for peri-acetabular malignant bone tumour［J］.Int Orthop，2018，42(3)：687-694.
［13］Wong KC，Kumta SM，Geel NV，et al.One-step reconstruction with a 3D-printed，biomechanically evaluated custom implant after complex pelvic tumor resection［J］.Comput Aided Surg，2015，20(1)：14-23.
［14］Liu X，Liu Y，Lu W，et al.Combined application of modified three-dimensional printed anatomic templates and customized cutting blocks in pelvic reconstruction after pelvic tumor resection［J］.J Arthroplasty，2019，34(2)：338-345.
［15］张兰，王翔，刘军，等.3D打印钛合金骨小梁多孔结构的拉伸性能［J］.中国组织工程研究，2020，24(22)：3498-3503.
［16］Shah FA，Omar O，Suska F，et al.Long-term osseointegration of 3D printed CoCr constructs with an interconnected open-pore architecture prepared by electron beam melting［J］.Acta Biomater，2016(36)：296-309.
［17］Wang C，Liu D，Xie Q，et al.A 3D printed porous titanium alloy rod with diamond crystal lattice for treatment of the early-stage femoral head osteonecrosis in sheep［J］.Int J Med Sci，2016，16 (3)：486-493.
［18］Hara D，Nakashima Y，Sato T，et al.Bone bonding strength of diamond-structured porous titanium-alloy implants manufactured using the electron beam-melting technique［J］.Mater Sci Eng C Mater Biol Appl，2016(59)：1047-1052.
［19］Dai K.R，Yan MN，Zhu ZA，et al.Computer-aided custom-made hemipelvic prosthesis used in extensive pelvic lesions［J］.J Arthroplasty，2007，22(7)：981-986.
［20］Sun W，Li J，Li Q，et al.Clinical effectiveness of hemipelvic reconstruction using computer-aided custom-made prostheses after resection of malignant pelvic tumors［J］.J Arthroplasty，2011，26 (8)：1508-1513.
［21］Witte D，Bernd L，Bruns J，et al.Limb-salvage reconstruction with MUTARS hemipelvic endoprosthesis：a prospective multicenter study［J］.Eur J Surg Oncol，2009，35(12)：1318-1325.
［22］Fritzsche H，Goronzy J，Schaser K.D，et al.Complication profile and revision concepts for megaprosthetic reconstruction following tumour resection at the hip［J］.Orthopade，2020，49 (2)：123-132.
［23］Rudert M，Holzapfel BM，Pilge H，et al.Partial pelvic resection (internal hemipelvectomy) and endoprosthetic replacement in periacetabular tumors［J］.Oper Orthop Traumatol，2012，24(3)：196-214.
［24］郭宇，冯德宏，王凌，等.3D打印技术在髋关节置换中的应用及价值［J］.中国组织工程研究，2020，24(12)：1962-1968.