Background:Joint-sparing resection of juxta-articular knee tumors is challenging. With the development of 3D printing technology, custom-made cutting guides were introduced with the aim to improve the accuracy of tumor resection margins and to shape the allograft for adequate matching in biological reconstruction.Materials and Methods:Between December 2017 and July 2023, 13 patients underwent joint-sparing juxta-articular resection of the knee for a primary bone tumor at our institution. Resection was performed using a custom-made 3D-printed titanium alloy cutting guide and reconstruction was performed using a custom-shaped allograft. The mean follow up was 50 months (min 14–max 81). The study of cutting accuracy was performed by digital examination of CT images of the resection specimen in eight patients.Results:The average cutting error was 2.3 mm. Surgical margins were wide in all patients. Four patients developed postoperative complications that led to the removal of the allograft in one case. The average functional result according to the Musculoskeletal Tumor Society Score was 26 (min 14–max 30), and according to the Oxford Knee Score it was 44 (min 22–max 48).Conclusions:Custom-made titanium cutting guides resulted effective in improving the accuracy of joint-sparing juxta-articular resection of the knee and allograft matching.
背景：膝关节周围肿瘤的保关节切除术具有挑战性。随着3D打印技术的发展，定制化截骨导板被引入，旨在提高肿瘤切除边缘的精确度，并塑形同种异体移植物以实现生物重建中的充分匹配。 材料与方法：2017年12月至2023年7月期间，我院对13例原发性骨肿瘤患者实施了膝关节周围保关节切除术。手术采用定制3D打印钛合金截骨导板进行肿瘤切除，并使用定制塑形的同种异体移植物进行重建。平均随访时间为50个月（最短14个月，最长81个月）。通过对其中8例患者切除标本的CT图像进行数字化分析，评估了截骨精确度。 结果：平均截骨误差为2.3毫米。所有患者均获得广泛外科切缘。4例患者出现术后并发症，其中1例因此移除了移植物。根据肌肉骨骼肿瘤协会评分系统，平均功能评分为26分（最低14分，最高30分）；根据牛津膝关节评分系统，平均评分为44分（最低22分，最高48分）。 结论：定制钛合金截骨导板能有效提高膝关节周围保关节切除术的精确度及移植物匹配度。
肿瘤(癌症)患者之家