Reconstruction of the proximal radius with 3D-printed personalized prosthesis after tumor resection: case series

Abstract

Giant cell tumor of bone (GCTB) (Campanacci III) or malignant tumors extend to the epiphyseal region, and intra-articular resection of the proximal radius is often needed. In the present study, we present the patients who underwent reconstruction of the proximal radius with 3D-printed personalized prosthesis after tumor resection, aiming to describe the prosthesis design and surgical technique and evaluate the clinical outcomes of this method. Between November 2018 and January 2021, nine patients received radial hemiarthroplasty with 3D-printed personalized prostheses after tumor resection. The pathological diagnosis was GCTB (Campanacci III) in seven patients, osteosarcoma (IIB) in one patient, and synovial sarcoma (IIB) in one patient. The range of motion (ROM) and strength in terms of elbow flexion/extension and forearm supination/pronation were evaluated. Pain was assessed by the visual analog scale (VAS) preoperatively and at each follow-up visit. To evaluate the functional outcome, the Mayo Elbow Performance Score (MEPS) system and the Musculoskeletal Tumor Society (MSTS) scoring system were administered at each follow-up visit. Complications and oncological outcomes were recorded. The patients were followed from 24 to 51 months, with a median follow-up of 35 months. No patients were lost to follow-up. During the follow-up, local recurrence and metastasis were not observed. The VAS score improved from a median of 5 points (range 4 to 7) preoperatively to 1 point (range 0 to 2) at the last follow-up visit. The mean MEPS score was 88.5% (83 to 93), and the mean MSTS score was 25.3 (24 to 27) at the last follow-up visit. No complications such as infection and aseptic loosening were detected. The implantation of a 3D-printed personalized prosthesis after proximal radial resection showed excellent oncologic outcomes and postoperative function at short-term follow-up and is a viable alternative method for reconstruction of the proximal radius bone defect after tumor resection.