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One-step reconstruction with a 3D-printed, custom-made prosthesis after total en bloc sacrectomy: a technical note
1Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Summary
Three-dimensional (3D) printing simplifies complex sacrectomy reconstructions. A custom 3D-printed prosthesis enabled successful reconstruction after total en bloc sacrectomy, with good functional outcomes despite minor implant failure.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Oncology
Background:
- Malignancies of the upper sacrum necessitate total en bloc sacrectomy and complex reconstruction.
- Three-dimensional (3D) printing offers a potential solution to simplify these challenging surgical procedures.
Observation:
- A 62-year-old patient with recurrent sacral chordoma underwent a one-stage total en bloc sacrectomy.
- A custom-designed 3D-printed sacral prosthesis was utilized for immediate reconstruction.
Findings:
- The surgery and reconstruction were completed in 5 hours with 3400 ml blood loss.
- The patient achieved uneventful recovery, ambulating at 3 weeks.
- At 1-year follow-up, the patient was disease-free, pain-free, and ambulatory with crutches, despite an asymptomatic instrument failure.
Implications:
- 3D-printed prostheses can provide optimal reconstruction of the lumbosacral and pelvic ring.
- Porous surfaces of 3D-printed implants may promote bone ingrowth and enhance stability.
- Further research is needed to optimize screw placement and biomechanical properties for long-term validation.
