Abstract
BackgroundPubic defects resulting from type III hemipelvectomy are commonly not reconstructed due to the need to preserve the weight-bearing axis. However, the opening of the anterior pelvic ring will inevitably lead to increased pelvic instability. To improve long-term pelvic stability, three-dimensional (3D)-printed customized prostheses were designed to reconstruct pubic defects. This study presents and evaluates the short-term clinical outcomes and complications from the use of this construct.MethodsFive patients who underwent type III hemipelvectomy and 3D-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analysed. Operation time and blood loss during the operation were recorded. Local and functional recovery was assessed. Prosthetic position and osseointegration were evaluated. Oncology results and complications were recorded.Results The prostheses consisted of three with stems and two without. The mean follow-up time was 23.6 months. At the last follow-up, all five patients were alive with no evidence of disease. No deep infections or local recurrence had occurred. The mean blood loss and mean intraoperative time were 1680 ml and 294 min, respectively. The mean functional MSTS score at the final follow-up was 29.8. Fretting wear around the prosthetic stem was found in 3 patients, while bone wear on the normal-side pubis was found in 2 patients. Osseointegration was observed in all patients.Conclusions3D-printed customized prostheses for reconstructing pubic bone defects after type III hemipelvectomy showed acceptable early outcomes. The good outcomes were inseparable from the precision prosthesis design, strict surgical procedures, and sensible postoperative management.
Highlights
Surgical reconstruction of pelvic bone tumour defects is a complicated procedure due to the complexity and irregularity of the pelvis
This study introduces our experience in using Three dimensional (3D)-printed customized prostheses for reconstruction after type III hemipelvectomy and
At the time of the last follow-up, all five patients were alive with no evidence of disease (NED)
Summary
Surgical reconstruction of pelvic bone tumour defects is a complicated procedure due to the complexity and irregularity of the pelvis. According to the Enneking and Dunham classification [1], type III hemipelvectomy involves resection of either part of or the entire pubis from the symphysis to the lateral margin of the obturator foramen. This type of hemipelvectomy is uncommon, accounting for only approximately 11 % of procedures [2,3,4]. Most defects following type III hemipelvectomy are commonly not reconstructed because of the need to preserve the weight-bearing axis [4,5,6]. Pubic defects resulting from type III hemipelvectomy are commonly not reconstructed due to the need to preserve the weight-bearing axis. This study presents and evaluates the short-term clinical outcomes and complications from the use of this construct
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