3D-Printed Cutting Guides for Resection of Long Bone Sarcoma and Intercalary Allograft Reconstruction

The use of 3-dimensional (3D)-printed cutting guides for resection of long bone sarcoma is a novel technique. These 3D-printed guides provide a potential benefit over navigational or freehand osteotomy. We evaluated whether the use of 3D-printed cutting guides in the resection of long bone sarcoma affects margin status and rates of union compared with historical controls. In this study, we performed a retrospective review of a prospectively maintained surgical database and reviewed 6 patients who underwent limb salvage for long bone sarcoma. We collected and analyzed clinicopathologic and surgical data. Six (100%) cases recorded negative margins, with mean postoperative follow-up of 108 weeks (range, 8-211 weeks). Time (mean±SD) to bony union was 20.5±10.5 weeks. Nine of 12 (75%) cumulative (proximal and distal) osteotomy sites went on to achieve union, with a nonunion rate of 25% per osteotomy. One (33%) nonunion occurred after adjuvant radiation therapy. Long-term complications were limited to 2 (33.3%) patients overall who had implant failure according to the Henderson classification system, and there were zero local recurrences at the conclusion of the study. Our institution has successfully performed limb salvage surgery with patient-specific 3D-printed technology. We show high rates of negative margin resection and junctional union that align with and improve on earlier findings. [Orthopedics. 2022;45(1):e35-e41.].