Evolution of a Surgical Technique: A Brief Communication Regarding 5 Cases of Three-Dimensional Printed Sternums

This brief communication follows 5 individuals who underwent en bloc removal of the sternum and insertion of a customized 3-dimensonal printed implant. This paper focuses on the materials and operative techniques that were adopted to reconstruct and fit each of these sternums. A total of 5 patients underwent this procedure. Three of the patients were women who suffered from sternal damage due to oligometastasis from breast cancer. Another patient developed a metastasis from a thyroid cancer, and the final patient suffered from a chondrosarcoma of the sternum. All 5 operations were performed by 1 cardiothoracic surgeon. Of note, the surgical materials used by this surgeon shifted from titanium to StarPore over the course of performing the 5 operations. StarPore is a porous high-density polyethylene implant that can be customized to the patient. The main limitations of this implant are cost, potential delay to the operation and limited cases/evidence. With only a few cases of sternal reconstruction by 3D printing documented to date, this case series provides an important body of literature. This brief communication discusses the materials used and the operative technique that is most appropriate when reconstructing a sternum.