下肢骨肉瘤切除后大段骨缺损患者的3D打印假体复合β-TCP生物陶瓷重建

来源 :中国骨与关节杂志 | 被引量 : 0次 | 上传用户:JK0803yangye
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目的探讨3D打印假体复合β-TCP生物陶瓷重建下肢骨肉瘤切除后大段骨缺损的可行性,评估其短期临床疗效.方法选取2017年1月至2018年11月在我院就诊,符合纳入标准的下肢骨肉瘤者6例.结合术前薄层CT数据设计手术方式及3D打印假体.于肿瘤切除后,将β-TCP生物陶瓷颗粒复合于3D打印假体进行安装固定.术后定期对患者进行临床随访及影像学评估.以国际骨骼肌肉肿瘤保肢功能评分系统(MSTS)对肢体的功能状态进行评估并详细记录肿瘤学结果以及假体并发症.结果6例均手术成功,术后平均随访9.5个月.术后影像学结果显示所有安装假体均稳定,未发生假体周围感染、无菌性松动、假体断裂等并发症.至末次随访,患者均存活且无肿瘤复发及转移.至术后9个月,可见假体断端与骨整合良好.患者术后末次随访平均MSTS评分85.33%(60.00%~96.67%).结论3D打印假体复合β-TCP生物陶瓷重建下肢骨肉瘤切除后大段骨缺损,其短期随访临床疗效满意.为下肢恶性肿瘤切除后大段骨缺损的重建提供了一种新的选择.“,”Objective To explore the feasibility of the reconstruction of segmental defect after resection of osteosarcoma in lower extremities with 3D-printed prosthesis combined withβ-TCP porous bioceramics and evaluate its short-term clinical efficacy.Methods From January 2017 to November 2018, 6 patients with lower limb osteosarcoma who met the inclusion criteria were recruited.The surgical strategy and the 3D-printed prosthesis were designed based on the preoperative CT data.After tumor resection, the 3D-printed prosthesis combined withβ-TCP porous bioceramic granules were installed and fixed.All patients were followed up and evaluated regularly after operation.The functional status was assessed by the Musculoskeletal Tumor Society (MSTS) score.Oncology results and complications were recorded in detail.Results All operations were successfully performed.The mean follow-up period was 9.5 months.Postoperative imaging results showed that all the implants were stable without complications such as peripheral infection, aseptic loosening or fracture.At the last follow-up, all patients survived without tumour recurrence or metastasis.The 3D-printed prosthesis composite achieved substantial bone integration at follow-up more than 9 months after the operation.The average MSTS score was 85.33% (60.00%-96.67%).Conclusions The3D printed prosthesis combined withβ-TCP porous bioceramics can be used to reconstruct the bone defect after the resection of osteosarcoma in the lower extremities, and the clinical efficacy was satisfactory in the short-term followup.It provides a new option for the reconstruction of large bone defect after tumor resection.
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