Custom designed and 3D-printed titanium pelvic implants for acetabular reconstruction after tumour resection

Area of Science:

• Orthopedic oncology
• Reconstructive surgery
• Biomedical engineering

Background:

• Reconstruction after pelvic tumor resection, especially around the hip joint, presents significant surgical challenges.
• Large pelvic tumors often necessitate extensive resection, including the hip joint, leading to complex reconstructive needs.

Purpose of the Study:

• To evaluate the outcomes of internal hemipelvectomy and reconstruction using custom 3D-printed titanium pelvic implants (3DPPI).
• To assess peri-operative results, functional outcomes, complication rates, and short-term implant survival in patients with pelvic tumors.

Main Methods:

• Retrospective case series of 15 patients undergoing internal hemipelvectomy and 3DPPI reconstruction between August 2013 and January 2018.
• Analysis of patient demographics, tumor characteristics, surgical data, functional scores (MSTS, NRS, HOOS-PS), complications, and implant survival.

Main Results:

• The majority of patients (86.7%) had malignant pelvic tumors.
• Median follow-up was 33.8 months, with a median MSTS score of 63.3% and HOOS-PS of 76.6%.
• Implant survival rate was 73.3%, with 26.6% of patients experiencing implant-specific complications, including dislocation, structural failure, infection, and tumor recurrence.

Conclusions:

• Custom 3D-printed titanium pelvic implants (3DPPI) offer acceptable short-term functional results and implant survival following hemipelvectomy for complex pelvic tumors.
• The study demonstrates the feasibility of this reconstructive technique in a challenging patient population.
• Careful patient selection and surgical planning are crucial for managing complications and optimizing outcomes.