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Custom-Made 3D-Printed Titanium Implants for Managing Segmental Distal Tibial Bone Defects: A Systematic Literature
Viktor Dietrich Schick1, Biagio Zampogna1,2,3, Giovanni Marrara1
1BIOMORF Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Section of Orthopaedic and Trauma Surgery, University of Messina, A.O.U. Policlinico "G. Martino"-Via Consolare Valeria 1, 98124 Messina, Italy.
Abstract:
Background: The management of diaphyseal and distal tibial defects and non-unions is a significant challenge. Traditional treatments, such as distraction osteogenesis or Masquelet, are characterized by extended treatment times and elevated complication rates. Innovative approaches, such as customized 3D-printed titanium implants, are often required to restore structural integrity and function. This systematic review aimed to analyze the results achieved to date with this technique. Methods: A systematic review of the literature written in English was performed in PubMed, Scopus, and Cochrane to identify all cases of tibial non-unions or defects treated with customized 3D-printed titanium implants, excluding defects from tumor resection. Studies with a minimum of 12 months of follow-up were included. Results: The causes of treatment were infection in 10 patients, non-union in 6 patients, and severe bone loss after trauma in 3 cases. The size of the defect ranged from 3 to 8.5 cm. Osteointegration was 100% in all studies. The mean time to union was 5.3 months. The complication rate was 16%. Conclusions: Good results were reported in most patients. However, the data are insufficient to define the role of customized 3D-printed implants compared to traditional techniques. Further studies comparing them are needed to draw explicit guidelines.
