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Sunday, May 06, 2018 12:43:58 PM
Chinese Researchers Validate Effectiveness of Teenager’s 3D Printed Custom Knee Joint Replacement Prosthesis
Chinese Researchers Validate Effectiveness of Teenager’s 3D Printed Custom Knee Joint Replacement Prosthesis - May 04, 2018
Recently, a team of medical experts from West China Hospital at Sichuan University published a study, titled “Uncemented three-dimensional-printed prosthetic reconstruction for massive bone defects of the proximal tibia,” in the World Journal of Surgical Oncology about their use of 3D printing to develop a custom knee joint replacement prosthesis for a teenager with metaphyseal osteosarcoma of the tibia.
According to the paper, “Currently, it is challenging to treat massive bone defects of proximal tibia. Although numerous methods are available for reconstruction with epiphysis preservation, limitations in knee function and complications are noted with these methods. Our paper describes our attempt to reconstruct a marked defect in the proximal tibia with an uncemented three-dimensional (3D)-printed prosthesis and to evaluate the prosthesis design and short-term outcomes.
“A 15-year-old boy with metaphyseal osteosarcoma of the tibia underwent intercalary allograft reconstruction following wide tumour resection with epiphysis preservation. However, chronic allograft rejection and/or infection occurred after the surgery and a sinus tract was formed.”
Things turned around for the patient once the initial graft was removed and an antibiotic-loaded cement spacer was implanted, but his limb function still wasn’t up to par.
Due to the odd shape of the defect, and how short the residual proximal tibia was, the team turned to 3D printing to fabricate a custom prosthesis in order to reconstruct the defect and preserve the knee joint. The team learned that a porous structure, with 600µm pore size and 65% porosity, would be able to simulate the real properties of trabecular structures in humans.
Titanium alloys, which offer good mechanical strength, were used at the core of the uncemented prosthesis, in order to improve the matching between the bone defect region and the implant device. To achieve improved bone-impact integration, the stem of the distal part of the 3D printed prosthesis was coated with sophisticated porous bioceramics.
The proximal part was 3D printed on an Arcam Q10 using Electron Beam Melting (EBM) technology, which has seen rising adoption in China and worldwide for prosthetics.
Post-op, the teenager seems to be tolerating the 3D printed prosthetic implant just fine, showing “satisfactory limb function” at his 26-month follow-up appointment and being able to walk, run, and jump with no pain. The prosthesis is fitting well with the real tibia, and there have been so signs of complication – the knee joint is exhibiting motion of 0-130° and an Enneking function score of 93%, which are “comparable” results when compared to normal knee joint motion.
Final product of 3D printed prosthesis.
Chinese Researchers Validate Effectiveness of Teenager’s 3D Printed Custom Knee Joint Replacement Prosthesis - May 04, 2018
Recently, a team of medical experts from West China Hospital at Sichuan University published a study, titled “Uncemented three-dimensional-printed prosthetic reconstruction for massive bone defects of the proximal tibia,” in the World Journal of Surgical Oncology about their use of 3D printing to develop a custom knee joint replacement prosthesis for a teenager with metaphyseal osteosarcoma of the tibia.
According to the paper, “Currently, it is challenging to treat massive bone defects of proximal tibia. Although numerous methods are available for reconstruction with epiphysis preservation, limitations in knee function and complications are noted with these methods. Our paper describes our attempt to reconstruct a marked defect in the proximal tibia with an uncemented three-dimensional (3D)-printed prosthesis and to evaluate the prosthesis design and short-term outcomes.
“A 15-year-old boy with metaphyseal osteosarcoma of the tibia underwent intercalary allograft reconstruction following wide tumour resection with epiphysis preservation. However, chronic allograft rejection and/or infection occurred after the surgery and a sinus tract was formed.”
Things turned around for the patient once the initial graft was removed and an antibiotic-loaded cement spacer was implanted, but his limb function still wasn’t up to par.
Due to the odd shape of the defect, and how short the residual proximal tibia was, the team turned to 3D printing to fabricate a custom prosthesis in order to reconstruct the defect and preserve the knee joint. The team learned that a porous structure, with 600µm pore size and 65% porosity, would be able to simulate the real properties of trabecular structures in humans.
Titanium alloys, which offer good mechanical strength, were used at the core of the uncemented prosthesis, in order to improve the matching between the bone defect region and the implant device. To achieve improved bone-impact integration, the stem of the distal part of the 3D printed prosthesis was coated with sophisticated porous bioceramics.
The proximal part was 3D printed on an Arcam Q10 using Electron Beam Melting (EBM) technology, which has seen rising adoption in China and worldwide for prosthetics.
Post-op, the teenager seems to be tolerating the 3D printed prosthetic implant just fine, showing “satisfactory limb function” at his 26-month follow-up appointment and being able to walk, run, and jump with no pain. The prosthesis is fitting well with the real tibia, and there have been so signs of complication – the knee joint is exhibiting motion of 0-130° and an Enneking function score of 93%, which are “comparable” results when compared to normal knee joint motion.
Final product of 3D printed prosthesis.
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