An innovative strategy to treat large metaphyseal segmental femoral bone defect using customized design and 3D printed m
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CLINICAL APPLICATIONS OF BIOMATERIALS Original Research
An innovative strategy to treat large metaphyseal segmental femoral bone defect using customized design and 3D printed microporous prosthesis: a prospective clinical study Guojin Hou1,2 Bingchuan Liu1,2 Yun Tian 1,2 Zhongjun Liu1,2 Fang Zhou1,2 Hongquan Ji1,2 Zhishan Zhang1,2 Yan Guo1,2 Yang Lv1,2 Zhongwei Yang1,2 Peng Wen3 Yufeng Zheng4 Yan Cheng4 ●
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Received: 18 March 2020 / Accepted: 12 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Five patients with segmental irregular-shaped bone defect of the femur were recruited in this study from 2017.12 to 2018.11. All patients were treated by customized design and 3D printed micro-porous prosthesis. And the procedure was divided into stages: radical debridement and temporary fixation (the first stage); the membrane formation and virtual surgery (intervening period for 6–8 weeks); definite reconstruction the defects (the second stage). Routine clinical follow-up and radiographic evaluation were done to assess bone incorporation and complications of internal fixation. The weight-bearing time and the joint function of the patients were recorded. The patients were followed up for an average of 16.4 months. The average length of bone defect and the distal residual bone was 12 cm and 6.5 cm. The average time of partial weight-bearing and full weight-bearing was 12.7 days and 2.6 months. X-ray demonstrated good osseous integration of the implant/bone interface. No complications occurred such as implant loosening, subsidence, loss of correction and infection. At the last follow-up, Harris score of hip joint was excellent in 2 cases, good in 2 cases, fair in 1 case; HSS score of knee joint was good in 4 cases, middle in 1 case. From our study, we concluded that meticulous customized design 3D printed micro-porous prosthesis combined with intramedullary nail may be a promising and an alternative strategy to treat metaphyseal segmental irregularshaped femoral bone defect, especially for cases with massive juxta-articular bone loss. Graphical Abstract Larg segmental infectious one defect at the dista femur.
Radical d bridement and Virtual surgery and esign of the implant.
tempo ary fixation.
X-ray demonstrated good os eous integration of
Defin te reconstruction with
the rosthesis- one interfa e (yellow arrow).
3 printed prosthesis.
* Yun Tian [email protected] 1
2
Department of Orthopaedic Surgery, Peking University Third Hospital, No 49, North Garden Rd, HaiDian District 100191 Beijing, China Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third
Hospital, No 49, North Garden Rd, HaiDian District 100191 Beijing, China 3
Tsinghua University, 100084 Beijing, China
4
Peking University, 100871 Beijing, China
66 Page 2 of 9
Journal of Materials Science: Materials in Medicine (2020)31:66
Abbreviations PMMA Polymethyl Methacrylate CT computed tomography EM
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