新型3D打印踝关节融合假体治疗胫骨远端骨肉瘤的病例报告

A new 3D-printed ankle fusion prosthesis for the treatment of osteosarcoma in the distal tibia:a case report

报告采用新型3D打印踝关节融合假体进行保肢治疗的3例胫骨远端骨肉瘤短期临床疗效。患者于2020年1月至2021年6月就诊于上海市第一人民医院骨肿瘤科,男1例、女2例,年龄分别为18、12、14岁,均诊断为胫骨远端骨肉瘤(Ennecking分期Ⅱb期)。采用自行设计的新型踝关节融合假体行胫骨远端骨肉瘤切除及假体重建术。记录手术时间、出血量、术后美国足踝外科协会评分(American Orthopaedic Foot and Ankle Society Score,AOFAS)及踝关节活动度。3例患者均顺利完成手术并获得随访,随访时间分别为22、18和12个月。手术时间分别为140、110、200 min,出血量分别为200、200和350 ml。末次随访时AOFAS分别为86、90、95分,踝关节屈伸活动度分别为30°、15°和30°。末次随访时局部无复发,肺部未见转移。胫骨远端采用新型3D打印踝关节融合假体重建胫骨远端骨肉瘤切除后骨缺损安全、有效,术后早期功能满意。

To report the short-term clinical outcome of three cases of distal tibial osteosarcoma treated with a novel 3D-printed ankle fusion prosthesis for limb preservation.The patients were admitted to the Department of Bone Tumor,Shanghai General Hospital from January 2020 to June 2021,with one male and two female cases,aged 18,12,and 14 years,respectively,all diagnosed with distal tibial osteosarcoma(Ennecking stage Ⅱb).A new self-designed ankle fusion prosthesis was used to perform osteosarcoma resection and prosthetic reconstruction of the distal tibia.The operation time,blood loss,postoperative American Orthopedic Foot and Ankle Society Score(AOFAS)and ankle range of motion were recorded.All the 3 patients successfully completed the operation and were followed up for 22 months,18 months and 12 months,respectively.The operation time was 140 min,110 min and 200 min,and the blood loss was 200 ml,200 ml and 350 ml,respectively.At the last follow-up,the AOFAS were 86,90 and 95 points,and the range of motion of ankle flexion and extension were 30°,15°and 30°.There was no local recurrence or lung metastasis at the last follow-up.The novel 3D-printed ankle fusion prosthesis in the distal tibia is safe and effective for the reconstruction of bone defects after resection of osteosarcoma in the distal tibia,and the early postoperative function is satisfactory.