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3D-Printed Cut Guides and Custom Prostheses for Pelvic Reconstruction in Bone Sarcoma Patients: Complications,
Luca Cevolani1, Benedetta Spazzoli1, Eric Lodewijk Staals1
1Unit of 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Orthopaedic Surgery
|December 29, 2025
Summary
3D-printed custom prostheses improve pelvic reconstruction in bone sarcoma patients, achieving good functional outcomes despite a high reoperation rate. Further advancements are needed to reduce complications like infection and mechanical failure.
Area of Science:
- Orthopedic Oncology
- Biomedical Engineering
- Surgical Innovation
Background:
- Pelvic reconstruction after bone sarcoma resection is complex.
- 3D-printed custom prostheses and cutting guides aim to enhance surgical precision and functional results.
- Periacetabular reconstructions present unique challenges in orthopedic oncology.
Purpose of the Study:
- Evaluate reoperation incidence and failure risk factors in custom 3D-printed acetabular prosthesis reconstructions for primary bone sarcoma.
- Assess if 3D cutting guides and custom prostheses achieve safe margins and anatomical fit.
- Determine Musculoskeletal Tumor Society (MSTS) scores and the impact of resection type and tumor volume on outcomes.
Main Methods:
- Retrospective review of 24 patients with primary bone sarcomas treated between January 2013 and December 2023.
- Utilized 3D-printed custom cutting guides and prostheses based on high-resolution imaging and CAD.
- Custom prostheses were tailored to individual patient anatomy.
Main Results:
- A 46% reoperation rate was observed, mainly due to infection (8%) and mechanical failures (e.g., aseptic loosening).
- Local recurrence occurred in 21% of patients (5 patients) at a median of 5 months post-surgery.
- The average Musculoskeletal Tumor Society (MSTS) score was 83.7%, indicating high functional recovery.
Conclusions:
- 3D printing integration in pelvic reconstruction for bone sarcomas improves anatomical and functional outcomes.
- Further refinement of 3D printing technology is necessary to decrease complication rates.
- Advancements in materials and techniques are crucial for maximizing the benefits in orthopedic oncology.
