3D打印金属假体修复骨肿瘤切除后骨关节缺损的应用现状与展望  

Using 3D printing endoprosthesis for reconstruction after resection of bone tumor

作　　者：郭卫[1] Guo Wei(Musculoskeletal Tumor Center,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院骨与软组织肿瘤治疗中心,100044

出　　处：《中华骨科杂志》2020年第12期755-759,共5页Chinese Journal of Orthopaedics

摘　　要：骨肿瘤因部位不同,切除后导致的大范围骨缺损形态不一致,个体差异大,针对每例患者的不同特点进行有效的个性化人工假体重建是现有机械加工技术难以实现的。如何提高假体-骨整合质量也是研究的热点,因整合质量直接影响患者的远期重建效果。而3D打印制造技术能够有效适形匹配骨肿瘤切除后骨缺损的形态,并可通过假体-骨接触面的特殊制造技术促进假体-骨整合,因而能够有效解决骨肿瘤切除后大段骨关节缺损重建的现有问题。目前3D打印金属假体已广泛应用于骨肿瘤切除重建领域中,如骨盆、肩关节周围、长骨骨干、踝关节周围、肘关节周围、腕关节周围、骶骨及脊柱骨肿瘤的切除重建。在骨盆、骶骨及脊柱肿瘤切除后骨缺损重建中的应用相对成熟,重建效果良好,且不增加手术风险。但针对特定骨缺损形态定制3D打印假体制作周期较长,对肿瘤患者来说其应用存在时效性差的不足。The resection of bone tumor commonly leads to massive bone defects with diverse morphology.Endoprosthesis with corresponding shape of bone defects in specific patients could be hardly manufactured via conventional technique.Furthermore,given that the endoprosthesis-bone integration determines the long-term outcomes of the reconstruction;new technique which could be able to improve the integration has become one of the research hotspots in reconstruction after bone tumor resection.Thus,novel manufacturing technique is urgently required.Endoprosthesis manufactured via 3D printing technique can match the shape of the bone defects after bone tumor resection precisely.Moreover,the structure on the bone contacting surfaces processed by 3D printing technique has been demonstrated to be able to improve the osseointegration.Therefore,3D printing technique can serve as an ideal manufacturing method for endoprosthesis reconstructing the bone defects after bone tumor resection.Currently,3D printing endoprosthesis has been widely used in reconstruction of bone defects after bone tumor resection,especially on special anatomic locations such as pelvis,shoulder,long bone diaphysis,ankle,elbow,wrist,sacrum and spine.Using 3D printing endoprosthesis for reconstruction after pelvic,sacral and spinal tumor resection has been used in case-series studies,which demonstrated satisfied reconstructive outcomes without increasing the surgical risk.However,the longer manufacturing duration of 3D printing prosthesis customized for specific bone defects could limit its application in patients with tumor who has to be operated as soon as possible.

关 键 词：人工假体 脊柱肿瘤 骨整合 3D打印 骶骨 骨缺损 制作周期 骨肿瘤 

分 类 号：TP391.73[自动化与计算机技术—计算机应用技术] R738.1[自动化与计算机技术—计算机科学与技术]