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Effectiveness of Three-Dimensional Printing in the Management of Orthopedic Sarcoma Patients: A Systematic Review
Mohamed Elgamal1, Ahmed Elnewishy2, Sohaib Shah3
1Trauma and Orthopaedics, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.
Abstract:
Orthopedic sarcomas present unique surgical challenges due to their anatomical complexity and the need to balance oncologic control with functional preservation. Three-dimensional (3D) printing has emerged as a promising technology to improve surgical precision through patient-specific planning and reconstruction. This systematic review aimed to evaluate the effectiveness, safety, and clinical applications of 3D printing in the management of orthopedic sarcomas. Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Scopus, Google Scholar, and institutional databases for studies published between 2016 and 2025. Twenty studies involving 296 patients with primary bone sarcomas treated using 3D-printed implants, resection guides, or hybrid constructs were included. The most common anatomical sites were the pelvis, sacrum, and long bones. The majority of studies reported high rates of negative surgical margins, with at least 14 of 18 studies achieving R0 resections in over 90% of cases. Functional outcomes were favorable, with pooled Musculoskeletal Tumor Society (MSTS) scores averaging 78-80% of normal limb function, particularly in reconstructions of the ankle, femur, and tibia. The overall complication rate was 22%, with wound morbidity and infection being the most frequent adverse events. Comparative cohorts demonstrated improved surgical accuracy and lower complication rates in the 3D-assisted groups. While early outcomes are promising and support the utility of 3D printing in enhancing personalized oncologic surgery, further prospective studies with standardized outcome measures are needed to validate long-term benefits and inform wider clinical adoption.
Insights
Three-dimensional (3D) printing enhances orthopedic sarcoma surgery by improving precision and functional outcomes. This technology shows promise for personalized oncologic surgery, with early results indicating high rates of successful tumor removal and limb function preservation.
Area of Science:
- Orthopedic Oncology
- Biomedical Engineering
- Surgical Technology
Background:
- Orthopedic sarcomas pose significant surgical challenges requiring oncologic control and functional preservation.
- Three-dimensional (3D) printing offers patient-specific solutions for complex anatomical reconstructions.
- Its role in managing orthopedic sarcomas warrants systematic evaluation.
Purpose of the Study:
- To systematically review the effectiveness, safety, and clinical applications of 3D printing in orthopedic sarcoma management.
- To assess the impact of 3D printing on surgical precision, oncologic outcomes, and functional results.
- To identify areas for future research and clinical adoption.
Main Methods:
- A systematic literature search adhering to PRISMA guidelines was performed across major databases (PubMed, Scopus, Google Scholar).
- Studies published between 2016-2025 involving 3D-printed implants, guides, or constructs for primary bone sarcomas were included.
- Data extraction focused on oncologic control, functional outcomes (MSTS scores), complication rates, and surgical accuracy.
Main Results:
- Twenty studies with 296 patients were analyzed, focusing on pelvic, sacral, and long bone sarcomas.
- High rates of R0 resections (negative margins) were reported, exceeding 90% in most studies.
- Favorable functional outcomes (78-80% MSTS scores) and improved surgical accuracy were noted, particularly in complex reconstructions.
- The overall complication rate was 22%, with infection and wound morbidity as primary concerns.
Conclusions:
- 3D printing demonstrates significant potential in enhancing personalized oncologic surgery for orthopedic sarcomas.
- Early outcomes suggest improved oncologic control and functional preservation.
- Further prospective studies with standardized metrics are necessary to confirm long-term benefits and guide clinical implementation.
