The world's first 3D printing can bear the calf shin bone

The 19-year-old boy Li Cheng (pseudonym) underwent limb salvage surgery for osteosarcoma, but the implanted calf bone had a rejection reaction. In order to preserve the patient's knee function, Huaxi Hospital used advanced 3D printing technology. A patient-loaded calf tibia was successfully printed and successfully implanted into the body, and the shape and function of the body were satisfactory. It is understood that functional reconstruction after resection of large segmental bone tumors has been a difficult point for surgical treatment of bone tumors. Recently, Professor Tu Zhongqi and his team at the West China Hospital of Sichuan University successfully completed the world's first reconstruction of the trabecular bone trabecular prosthesis. This is the first application of 3D printing technology in the field of surgical treatment of lower limb weight-bearing bone tumors in the world, marking the new stage of individualized treatment of bone tumor surgery in Southwest China.

Mianyang boy suffering from osteosarcoma

3D printing calf bone implant

Li Cheng, 19, from Mianyang, was diagnosed as “osteoblastic osteosarcoma” in April 2011. After adjuvant chemotherapy, he was treated with limb salvage surgery in May 2011. Allogeneic bone graft was used to reconstruct bone defect. The patient's own knee joint was retained, and the tumor was well controlled after complete chemotherapy. However, after the postoperative chronic rejection of the graft, after 5 months, allogeneic bone had to be removed and the antibiotic bone cement temporary prosthesis was re-implanted. "We found that although the patient has undergone multiple operations, the knee function has remained very good, but if the next step is to follow the usual treatments at home and abroad, it will not be able to protect its inherent knee function." Professor Tu Zhongqi told reporters There are few alternative surgical procedures. If allogeneic bone replacement is performed again, it may lead to rejection. Ordinary metal dry prosthesis replacement is easy to loose due to poor matching; if knee prosthesis is implanted, Will sacrifice his knee joint, the 10-year prosthesis failure rate is about 20%, the long-term effect is poor.

In order to preserve Xiaoli's original good knee function as much as possible, Professor Tu Zhongqi's team developed a 3D printed plan to preserve the knee humeral trabecular metal prosthesis. "Prosthesis production has the following steps: making a patient's tumor bone defect model based on the three-dimensional CT data of the affected limb, in vitro simulated surgery and optimizing the structure design of the prosthesis, and finally a 3D printed trabecular humeral dry metal prosthesis." The professor said that after more than three months of preliminary preparation, on October 21, the hospital performed an implant operation for Xiaoli. "The whole operation lasted for two and a half hours, and the tibia dry bone cement originally in the lower leg was temporarily The prosthesis is taken out, and then the carefully designed and repeatedly modified personalized prosthesis is placed in, and it is closely attached to the residual tibial platform, and the fixation is precise and reliable. It is reported that as of yesterday, the patient's knee joint can be passively active and can already be partially Walking down the ground, the body shape and function were all satisfactorily restored.

Personalized prosthesis

Open up a new way for the treatment of bone tumors. This is the first international reconstruction of bone defect with the special customized tibia dry metal trabecular prosthesis with 3D printing. It has opened up a new way for the reconstruction of bone defects after the removal of bone-bearing malignant tumors of lower limbs. Way. Professor Tu Zhongqi told reporters that in recent years, with the maturity and popularity of 3D printing technology, this technology has been gradually applied to the customization and design of prosthesis, and there are reports on pelvis, humerus and scapula prosthesis. However, because these bone structures are more dispersed when subjected to force, they can be used as the primary choice for initial clinical trials and evaluation of 3D printed prostheses. "The 3D printed trabecular humeral dry prosthesis we completed this time is different. The tibia is a load-bearing bone and often requires a lot of stress. Therefore, the success of this operation made the 3D printed prosthesis technology break through the original limitations. Take an important step." The prosthesis is designed to precisely match the patient's residual tibial plateau, fully retaining its knee function. The design of the trabecular structure can be fully fused with the proximal end, and its surface has a metal pore structure. It can allow bone cells or tissues to grow into the void metal, which facilitates the connection of the prosthesis to the residual platform and the distal humerus, and is more in line with the functional reconstruction of the biomechanical structure. During the operation, the bone marrow tissue can be applied to the prosthetic joint surface, such as stem cell transplantation. The intramedullary rich growth factor can stimulate bone growth and achieve long-term biological healing.

According to Professor Tu Zhongqi, the 3D printed trabecular metal dry prosthesis has the advantages that can not be compared with various reconstruction methods. It can be further promoted and applied in the surgical treatment of lower limb weight-bearing malignant tumors in the future, and promote the level of resection and reconstruction of limb malignant tumors. Continuous improving.

(Editor)

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