Хирургическое лечение пациентов с опухолями длинных трубчатых костей верхних конечностей с использованием индивидуальных имплантатов из костнозамещающего материала, созданных по технологиям 3D-печати

Abstract

Purpose To evaluate outcomes of surgical treatment of patients with tumors of long bones of upper limbs using a single-stage repair of bone defects with tailored bone substitute implants manufactured with 3D printing technique. Materials and methods Clinical and radiological assessment of 22 patients with tumors of long bones of upper limbs was produced after surgical treatment that included removal of neoplasm and one-stage bone plasty using a tailored implant manufactured with three-dimensional printing (Patent RU 2598769). Bone cement and Recost bone substitute (Patent RU 2518753) were used to produce an implant. All patients were evaluated preoperatively and at 12-month follow-up using the 36-item Short Form Health Survey (SF-36), Musculoskeletal Tumor Society (MSTS) Rating Scale and visual analogue scale (VAS). Results Postoperatively, all patients showed pain reduction and improved function of the upper limb. No radiographic evidence of implant migration was observed throughout the followup. Evaluation of benign patients at one year after surgical intervention showed average 71.4 ± 6.6 of SF-36, 2.5 ± 1.5 of VAS, and 65.1 ± 8.3 % of MSTS scoring system; malignant cases demonstrated average figures of SF-36 39.2 ± 4.3, VAS 4.8 ± 1.4, and 41.8 ± 5.2 % at MSTS rating scale. Conclusion Surgical treatment of patients with tumors of the humerus, ulna and radius using one-stage plasty of bone defects with tailored 3D-printed bone substitute implants has shown to be an efficient method in improving an affected upper limb function and patient’s quality of life. The use of 3D printing to manufacture implants allows for precise and single-stage repair of bone defects of any shape, size and complexity with the technique making surgery easier to perform.