3D打印生物型多孔肱骨干假体治疗肱骨近端超极限瘤性骨缺损的早期疗效分析  

Short-term outcomes of three-dimensional-printed porous prosthesis for the joint-sparing reconstruction of the proximal for tumorous defect

作　　者：叶镪 张瑀琦 何宣虹 虎鑫 王杰[1] 龚涛军 李壮壮 卢敏勋 周勇[1] 罗翼[1] 屠重棋[1] 闵理[1] YE Qiang;ZHANG Yu-qi;HE Xuan-hong;HU Xin;WANG Jie;GONG Tao-jun;LI Zhuang-zhuang;LU Min-xun;ZHOU Yong;LUO Yi;TU Chong-qi;MIN Li(Department of Orthopedics,West China Hospital,Sichuan University,Chengdu,Sichuan,610041,China)

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中国骨与关节杂志》2023年第12期896-903,共8页Chinese Journal of Bone and Joint

基　　金：成都市科技项目(2017-CY02-00032-GX);四川大学华西医院卓越学科1·3·5项目(ZYJC18036);四川大学青岛研究院“8122计划”基金。

摘　　要：目的报道经治的13例3D打印生物型多孔肱骨干假体治疗肱骨近端超极限瘤性骨缺损的早期疗效并介绍生物型多孔肱骨干假体的设计理念。方法回顾性分析接受肱骨近端恶性肿瘤瘤段整体切除同时超极限关节保留联合3D打印多孔肱骨干假体重建术患者的基线资料、手术相关资料、肿瘤学预后、骨整合情况、假体相关并发症及术后功能状态。结果患者的平均年龄为(20.2±3.8)岁,中位随访期为48.0个月。残留的肱骨近端长度平均为(17.6±1.1)mm。所有的患者均保留了肱骨头,大部分的肩袖保留完整。患侧肩关节平均活动范围(range of motion,ROM)为前屈84.8°,外展为79.5°,后伸为26.8°,内收为16.2°。肌肉骨骼肿瘤协会评分(Musculoskeletal Tumor Society,MSTS)平均得分94.4%,在骨与假体的界面上观察到良好的骨整合。结论3D打印生物型多孔肱骨干假体治疗肱骨近端超极限瘤性骨缺损,术后近期随访,功能满意,为肱骨近端超极限瘤性缺损患者的关节保留重建提供了一种新的选择。Objective To report the early curative effect of 13 cases with proximal humeral ultra-critical sized bone defect treated by 3D printed porous humerus prosthesis and introduce the design concept of porous intercalary prosthesis.Methods Baseline data,operative data,oncology prognosis,osseointegration,prosthesis-related complications,and postoperative function were retrospectively analyzed in patients who underwent total resection of proximal humeral malignant tumors combined with extreme joint preservation and 3D-printed porous intercalary prosthesis reconstruction.Results The mean age of the patients was(20.2±3.8)years,and the median follow-up was 48.0 months.The remaining proximal humerus length averaged(17.6±1.1)mm.All patients retained the humerus head and most of the rotator cuff was intact.The mean range of motion(ROM)of the affected shoulder joint was buckling,84.8°;spread,79.5°;extension,26.8°;adduction,16.2°.The Musculoskeletal Tumor Society(MSTS)score averaged 94.4%,and favorable osteointegration was observed on the bone-prosthesis interface.Conclusions The short-term postoperative follow-up showed that the prosthesis was functionally satisfactory for ultra-critical sized bone defect in the proximal humerus.The 3D-printed porous humerus prosthesis provides a new option for joint preservation and reconstruction of patients with proximal humerus limiting tumor defect.

关 键 词：打印 三维 肩关节假体 骨肿瘤 假体设计 假体植 肱骨 

分 类 号：R687.3[医药卫生—骨科学]