Acetabular reconstruction with custom prosthesis after tumor en-bloc resection using computer assisted navigation

Abstract

Objective To investigate the efficacy of 3D image fusion used in acetabular reconstruction with custom prosthesis after tumor en-bloc resection using computer assisted navigation.Methods The preoperative CT and MR images of a 55-year-old male patient with tumor recurrence after resection of chondrosarcoma at the left pelvis were collected for 3D image fusion.The range of tumor invasion,safe boundaries for resection and planning osteotomy plane were marked on the 3D model.A custom acetabular prosthesis was designed and manufactured using CAD/CAM techniques according to the parameters.The CT data,osteotomy boundaries marked and prosthesis fitting parameters were imported into the Computer Assisted Navigation System preoperatively for surgical planning.The tumor was accurately resected and the custom prosthesis precisely fixed with the help of navigation system according to the preoperative planning.The excision boundaries and the acetabular center position were checked.Results 3D image fusion technique made it easy and effective to define safe boundaries of tumor resection in a complicated acetabular region.Pathological examination showed absence of tumor at the margins of resection.The navigation system and X-ray evaluation indicated that the prosthesis was fixed precisely,with well-fitted interface with the bone,fine acetabular locations and angles.Conclusion Multiple digital techniques can help a great deal in precise acetabular reconstruction with a custom prosthesis after tumor en-bloc resection to achieve good pelvic stability and fine functional recovery of the hip. Key words: Computer-aided design; Acetabulum; Tumor; Prosthesis design; Computer assisted navigation