Surgical treatment of pelvic bone tumors using personalized implants. Experience in 20 patients

Introduction. Bone tumors of the pelvic ring often have a poor prognosis because of late diagnosis and difficult treatment. The treatment of pelvic sarcoma poses a huge surgical challenge for reconstruction. Purpose. To assess the surgical technic and early results using patient specific 3D-printed implants for reconstruction of pelvic ring. Materials and Methods. Twenty patients with primary bone tumors involving pelvic bones were treated with personalized 3D-printed prosthesis after enbloc resection between 2018 and 2019. The study included 12 male and 8 female, age range 26-66, mean age was 47 years. Most frequent indications for surgical treatment were chondrosarcoma and osteosarcoma of pelvic bones. Functional results were estimated by MSTS scoring system. All resections were performed with patient specific instrumentation. In 18 cases acetabulum and hip joint reconstructions were necessary. Results. The mean surgical time was 7 hours and bloodloss was 2500ml. The mean follow-up was 6 months, from 1 to 16 months. In 9 cases with primary surgery and reconstruction were clear surgical margin and one case was R1. MSTS functional score of patients was mean 19 points and ranged from 0 to 29 points. All patient specific 3D-printed implants were available within mean 12 days (from 7 to 21 days) after the formal order. Conclusion. Pelvic bone defect reconstruction following tumor resection using 3Dprinted implants can obtain acceptable oncological and functional results. This study has the following limitations: short followup period and small cohort of patients. However, we believe that reconstruction with 3D-printed implants will provide acceptable result.

3D-принтинг, sarcoma, pelvic bone, prosthetic reconstruction, 3D-printing, additive technology, prototyping, computer simulation