Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;49(7):3000605211025347.
doi: 10.1177/03000605211025347.

Use of three-dimensional-printed custom-made prosthesis to treat unicondylar femoral defect secondary to pathological fracture caused by giant cell tumor

Yuqing Ji  1 , Yuxian Wu  1 , Jianmin Li  1
Affiliations

Use of three-dimensional-printed custom-made prosthesis to treat unicondylar femoral defect secondary to pathological fracture caused by giant cell tumor

Yuqing Ji et al. J Int Med Res. 2021 Jul.

Abstract

Objective: To evaluate the short-term effectiveness of using a three-dimensional (3D)-printed custom-made prosthesis to repair unicondylar femoral defects.

Methods: We retrospectively reviewed 26 patients with a primary pathological fracture of the distal femur caused by a giant cell tumor. All patients had unicondylar defects involving the articular surface. Twelve patients were treated with a 3D-printed custom-made prosthesis to repair the unicondylar defect (3D-printed group). The other 14 patients were treated with total knee replacement (TKR group). The operation time, blood loss, Musculoskeletal Tumor Society score, range of motion, local recurrence, and complications were statistically compared.

Results: The operation time was significantly shorter and the blood loss was significantly less in the 3D-printed group than in the TKR group. The Musculoskeletal Tumor Society scores were significantly higher in the 3D-printed group than in the TKR group from 3 to 24 months postoperatively. The range of motion was significantly better in the 3D-printed group than in the TKR group at 6 and 9 months postoperatively.

Conclusions: 3D-printed custom-made prostheses provide better short-term functional results than does TKR.

Keywords: 3D-printed prosthesis; Giant cell tumor of bone; femoral defect; functional outcome; knee; pathological fracture.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Imaging examinations of a woman aged 29 years in the 3D-printed group. (a) and (b) The preoperative radiographs show a pathological fracture secondary to a giant cell tumor in the left distal femur. The (c) magnetic resonance imaging scans and (d) computed tomography scans show an articular surface defect caused by the pathological fracture.
Figure 2.
Figure 2.
Flow chart of the design of the 3D-printed custom-made prosthesis to repair the articular surface defect.
Figure 3.
Figure 3.
The 3D-printed prosthesis and surgical procedures. (a) 3D-printed models of the distal femur containing a defect of the articular surface caused by a pathological fracture secondary to a giant cell tumor. (b) The defect of the articular surface. (c) and (d) The 3D printed prosthesis. (e) Intraoperative pictures show that the tumor tissue has been scraped off. (f) The distal femur showing that the defect of the articular surface has been restored by the 3D-printed prosthesis and that the prosthesis has been installed and fixed. (g) and (h) Postoperative radiographs of the distal femur.
Figure 4.
Figure 4.
Preoperative and postoperative imaging examinations of a 54-year-old man in the TKR group. (a) and (b) The preoperative computed tomography images show a pathological fracture secondary to a giant cell tumor in the left distal femur. (c) and (d) Radiographs after TKR of the left knee.
Figure 5.
Figure 5.
Radiographs taken 26.2 months after 3D-printed prosthesis reconstruction. (a) and (b) No recurrent composite fracture or prosthesis loosening was found.
Figure 6.
Figure 6.
Postoperative recovery of limb function. Satisfactory limb function was present 26.2 months after 3D-printed prosthesis reconstruction. (a) Standing. (b) Crouching. (c) Flexion of the knee. (d) Extension of the knee.
See this image and copyright information in PMC

References

    1. Xu SF, Adams B, Yu XC, et al.. Denosumab and giant cell tumour of bone-a review and future management considerations. Curr Oncol 2013; 20: e442–e447. - PMC - PubMed
    1. Tsukamoto S, Mavrogenis AF, Tanzi P, et al.. Similar local recurrence but better function with curettage versus resection for bone giant cell tumor and pathological fracture at presentation. J Surg Oncol 2019; 119: 864–872. - PubMed
    1. Van Der Heijden L, Dijkstra PD, Van De Sande MA, et al.. The clinical approach toward giant cell tumor of bone. Oncologist 2014; 19: 550–561. - PMC - PubMed
    1. Rigollino AV, Fernando TS, Tanaka MH, et al.. Giant cell tumor locally advanced around the knee: treatment and literature review. Rev Bras Ortop 2017; 52: 473–478. - PMC - PubMed
    1. Barut N, Anract P, Babinet A, et al.. Peri-prosthetic fractures around tumor endoprostheses: a retrospective analysis of eighteen cases. Int Orthop 2015; 39: 1851–1856. - PubMed

LinkOut - more resources