Dynamic 3D printed titanium copy prosthesis: a novel design for large chest wall resection and reconstruction

Abstract

Due to high rates of complications, chest wall resection and reconstruction is a high risk procedure when large size of resection is required. Many different prosthetic materials have been used with similar results. Recently, thanks to the new advances in technology, personalized reconstruction have been possible with specific custom-made prosthesis. Nevertheless, they all generate certain amount of stiffness in thoracic motion because of his rigidity. In this report, we present a forward step in prosthesis design based on tridimensional titanium-printed technology. An exact copy of the resected chest wall was made, even endowing simulated sternochondral articulations, to achieve the most exact adaptation and best functional results, with a view to minimize postoperative complications. This novel design, may constitute an important step towards the improvement of the functional postoperative outcomes compared to the other prosthesis, on the hope, to reduce postoperative complications.

Keywords: 3D titanium-printed technology; Chest wall tumors; chest wall prosthesis; chest wall reconstruction; chest wall resection; chondrosarcoma.

Figure 1

Computerized tomography: chest wall tumor affecting 5^th rib.

Figure 2

Digital model used to plan resection and 3D titanium-printed implant: exact copy of the thorax damaged included superior, inferior ribs and sternum, digitally designed and created 3D printed endowed a specific dynamic system to simulate natural chondrosternal articulations. (A) 3D titanium-printed implant; (B) digital model used to plan resection. Red circle (T): tumor; Black line: planned resection.

Figure 3

Fixation to the sternum and costal endpoints.

Figure 4

CT scan at 8^th week from operation.