3D Printing in Orthopedic Oncology - Workflow and Outcomes of 59 Cases

3D printing has become an integral part of orthopedic oncology. Yet the penetration of this technology is very low owing to a lack of understanding of workflow or early failure due to variables that were not considered during the planning stage. To report preliminary results and pitfalls and describe a workflow based on our experience. This is a descriptive, observation study of 59 cases done by assistance of 3D printing from March 2016 to September 2021. An account of basic workflow, tips, and pitfalls in planning and institutional protocols is described. We categorized and analyzed cases based on clinical parameters such as resection margin, operation time, and blood loss. Several cases that had planning pitfalls also have been identified. Resection via 3D-printed jigs resulted in an average resection margin of 1.2 mm. Operating time was lesser by an average of 25 min (p-value 0.049) for 3D-printed implants, though there was no significant difference in blood loss (p-value 0.24). 3D-planned aids had to be abandoned in three cases due to unforeseen intra-operative challenges. In lower limb 3D-printed plates, the average time to union was 4 months. There were no cases of nonunion or delayed union. Fluoroscopy exposure was reduced significantly. 3D printing-assisted resection keeps resection to a minimum by providing adequate oncological clearance. It also helps reduce operating time and fluoroscopy exposure.