Computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee: outcomes of 12 cases.

Published on Nov 22, 2013in BMC Musculoskeletal Disorders2.355
· DOI :10.1186/1471-2474-14-331
Huan-Wen Ding1
Estimated H-index: 1
(SCUT: South China University of Technology),
Guang-wen Yu1
Estimated H-index: 1
+ 4 AuthorsYing-jun Wang1
Estimated H-index: 1
(SCUT: South China University of Technology)
Sources
Abstract
Background To report the outcomes of computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee.
References24
Newest
Background Small recent case series using CT-based navigation suggest such approaches may aid in surgical planning and improve accuracy of intended resections, but the accuracy and clinical use have not been confirmed.
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#1Kwok Chuen Wong (CUHK: The Chinese University of Hong Kong)H-Index: 16
#2Shekhar M. Kumta (CUHK: The Chinese University of Hong Kong)H-Index: 29
Background Joint-preserving surgery is performed in select patients with bone sarcomas of extremities and allows patients to retain the native joint with better joint function. However, recurrences may relate to achieving adequate margins and there is frequently little room for error in tumors close to the joint surface. Further, the tumor margin on preoperative CT and/or MR images is difficult to transpose to the actual extent of tumor in the bone in the operating room.
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#1Benjamin D. Foley (Vandy: Vanderbilt University)H-Index: 1
#2Wesly P. Thayer (Vandy: Vanderbilt University)H-Index: 1
Last. Steven G. Press (Vandy: Vanderbilt University)H-Index: 2
view all 5 authors...
Purpose The purpose of this study was to analyze the accuracy of virtual surgical planning in mandibular reconstruction. Materials and Methods This is a retrospective study involving 8 consecutive patients reconstructed with nonvascularized iliac crest bone grafts and free fibula osteomyocutaneous flaps. DICOM data from a maxillofacial skeleton computed tomography (CT) scan were sent to a medical modeling company and used to map the mandibular resection, anatomically place the mandibular reconst...
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#1Fazel Khan (SBU: Stony Brook University)H-Index: 3
#2Joseph D. Lipman (HSS: Hospital for Special Surgery)H-Index: 18
Last. John H. Healey (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 99
view all 5 authors...
Background Manual techniques of reproducing a preoperative plan for primary bone tumor resection using rudimentary devices and imprecise localization techniques can result in compromised margins or unnecessary removal of unaffected tissue. We examined whether a novel technique using computer-generated custom jigs more accurately reproduces a preoperative resection plan than a standard manual technique.
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#1Kwok Chuen Wong (CUHK: The Chinese University of Hong Kong)H-Index: 16
#2Shekhar M. Kumta (CUHK: The Chinese University of Hong Kong)H-Index: 29
Last. C.M. Wong (PolyU: Hong Kong Polytechnic University)H-Index: 1
view all 4 authors...
Computer navigation has recently been introduced for bone tumor surgery in the orthopedic field, with the aim of achieving increased accuracy and precision in tumor resection and in custom prosthetic reconstruction. However, the technique requires bulky navigation facilities, the presence of a system operator in the operating room, and surgeons with prior experience in navigated surgery. We describe a new and simple method of using a patient-specific computer-aided design/computer-aided modeling...
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#3Mimis Cohen (UIUC: University of Illinois at Urbana–Champaign)H-Index: 26
Computer aided design and manufacturing (CAD/CAM) technology today is the standard in manufacturing industry. The application of the CAD/CAM technology, together with the emerging 3D medical images based virtual surgical planning (VSP) technology, to craniomaxillofacial reconstruction has been gaining increasing attention to reconstructive surgeons. This article illustrates the components, system and clinical management of the VSP and CAD/CAM technology including: data acquisition, virtual surgi...
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About 30% of all malignant bone tumors occur in the distal femur and proximal tibia, and 70% of osteosarcomas, the commonest primary malignant bone tumor, occur around the knee joint 1 . In the last 30 years, with the progress and development of imaging techniques, combination therapy and surgical techniques, limb salvage surgery has gradually replaced amputation and become the primary surgical method for managing malignant bone tumors in the extremities. There are many reconstruction methods fo...
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#1Jamie P. Levine (NYU: New York University)H-Index: 47
#2Ashish PatelH-Index: 16
Last. David L. HirschH-Index: 17
view all 4 authors...
The goal of this article was to illustrate the ease in which virtual surgery and computer-aided design and manufacturing can be used by the craniomaxillofacial surgeon to create tremendously accurate postoperative results and provide confidence with even the most complex three-dimensional bony reconstructions. With advancements in software technology and three-dimensional printing, our ability to plan and execute precise bony reconstruction has become a reality. With this technology, guides can ...
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#1Wei Sun (Tongji University)H-Index: 10
#2Jian LiH-Index: 4
Last. Zhengdong Cai (Tongji University)H-Index: 27
view all 5 authors...
Abstract This is a retrospective analysis of 16 patients with primary malignant pelvic tumors who underwent wide resection of the hemipelvis and consequent reconstruction between 2003 and 2007. Mean patient age was 27 years, whereas median follow-up was 36 months (range, 23-62 months). Hemipelvic prostheses were individually designed for each patient based on preoperative computed tomographic scans and consequent surgical modeling. The 3-year prosthesis survival rate was 69%. There were 3 cases ...
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#1Erhan Sönmez (Hacettepe University)H-Index: 9
#2Haldun Onuralp Kamburoǧlu (Hacettepe University)H-Index: 1
Last. Abdullah Keçik (Hacettepe University)H-Index: 16
view all 7 authors...
Knee reconstruction with endoprosthesis after tumor resection is accepted as superior when compared with the other methods. But sometimes soft tissue reconstruction would be a challenging problem in this way of treatment. Five patients who were operated for tumor resection in this location, followed by reconstruction were presented with their one-year post operative results. Four latissimus dorsi and one rectus abdominis myocutaneous free flaps were used in these patients in order to manage soft...
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Cited By11
Newest
#1Matthew Jian-Qiao Peng (Guangzhou Medical University)H-Index: 5
#2XiongWei CaoH-Index: 1
Last. YongQiang LaoH-Index: 1
view all 7 authors...
Abstract Background and objectives To compare mechanical properties of femoral tumor treatments so that better operative strategy for limb tumors surgery is optimized. Methods Fourteen femoral CT images were randomly selected to rebuild 3D models by MIMICS. They were then executed by reverse engineering softwares for simulative modes. Mode #1: Intralesional curettage with cement filled plus fixator; Mode #2: Distal femur resection with tumorous prosthesis replaced. Finally, the mechanical aspect...
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#1Matthew Jian-Qiao Peng (Guangzhou Medical University)H-Index: 5
#2XiongWei CaoH-Index: 1
Last. Bo Bai (Guangzhou Medical University)H-Index: 2
view all 7 authors...
Abstract Background To compare mechanical properties of femoral tumor treatments to optimize operative strategies for limb tumor surgery of Giant Cell Tumor (GCT). Methods: Fourteen femoral CT images with GCT were randomly selected to rebuild 3D models by MIMICS. They were then executed by reverse engineering software for simulative modes: Mode #1: Intralesional curettage with cement-filled plus fixator and Mode #2: Distal femur resection with tumorous prosthesis replaced. Finally, the mechanica...
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Abstract Objective To report the outcomes of severe kyphoscoliosis secondary to ankylosing spondylitis (AS) corrected with 3D-printing individualized guiding templates. Methods Computer tomography (CT) data of patients with severe kyphoscoliosis secondary to AS were used to reconstruct 3D models of the spine and to develop a surgical plan. An asymmetric wedge pedicle subtraction osteotomy (PSO) was simulated using medical computer design software. Before the actual surgery, continual surgical si...
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#1Spencer SummersH-Index: 7
#2Erik C. ZachwiejaH-Index: 3
Last. Juan Pretell-MazziniH-Index: 13
view all 5 authors...
BACKGROUND: The proximal part of the tibia is a common location for primary bone tumors, and many options for reconstruction exist following resection. This anatomic location has a notoriously high complication rate, and each available reconstruction method is associated with unique risks and benefits. The most commonly utilized implants are metallic endoprostheses, osteoarticular allografts, and allograft-prosthesis composites. There is a current lack of data comparing the outcomes of these rec...
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#1Margaret Brennan Fournet (Athlone Institute of Technology)H-Index: 2
#2Farah Alwani Azaman (Athlone Institute of Technology)H-Index: 1
Last. Declan M. Devine (Athlone Institute of Technology)H-Index: 21
view all 5 authors...
Orthopaedic surgeries are commonly extremely challenging, and innovations are required to overcome a series of recognised difficulties and improve patient outcomes. Complications, in particular, the high occurrence of infections, often leads to prolonged patient pain, implant failure and loss of functions. 3D printing technology provides an ideal opportunity to integrate cutting edge technologies to address the major identified clinical problems directly. 3D-printed orthopaedic implants, designe...
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#1Naomi Winn (Robert Jones and Agnes Hunt Orthopaedic Hospital)H-Index: 7
#2Radhesh Lalam (Robert Jones and Agnes Hunt Orthopaedic Hospital)H-Index: 13
Limb salvage is a key goal of tumor management around the knee, with surgical, medical, and radiologic treatment options. Primary bone and soft tissue sarcomas are optimally treated in specialist tertiary centers; however, metastatic disease is encountered in all aspects of radiologic practice, with overlap in the management strategies. Both specialist and generalist radiologists therefore need to be familiar with the expected normal appearances following these therapies and be able to recognize...
Source
#1Xuejun PengH-Index: 1
#2Fengping WangH-Index: 1
Last. Jing SuH-Index: 1
view all 3 authors...
: This study was designed to evaluate the use of computer-assisted navigation with computed tomography (CT) images for bone reconstruction after resection in malignant bone tumor treatment. Forty-five patients with malignant bone tumors were recruited for this study. CT scan images in a computer-assisted navigation system were used to assist during the osteotomy, the pairing with allografts, and the monitoring of the allograft and joint lines to perform joint reconstruction. Our results show tha...
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#1Limin MaH-Index: 8
#2Ye ZhouH-Index: 5
Last. Chuanbin Mao (OU: University of Oklahoma)H-Index: 68
view all 8 authors...
Microwave ablation has been widely accepted in treating bone tumor. However, its procedure is time-consuming and usually results in postoperative fractures. To solve this problem, we designed and fabricated titanium plates customized to the patients’ bone structures. The personalized titanium plates were then used for fixation after the removal of tumorous tissue. Specifically, 3D models of tumor-bearing bone segments were constructed by using computed tomography (CT) and magnetic resonance imag...
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#1Mohamed Mediouni (Université de Sherbrooke)H-Index: 8
#2Daniel Schlatterer (Atlanta Medical Center)H-Index: 7
Abstract Little has been published about the complexity of orthopaedic tumors compared to others tumors. The current study in the literature treated this problem in terms of classification, surgical intervention and impact on the patient. In this article, factors risks of tumors will be we identified. A strategy based on three dimensional simulations will be explained in order to improve the clinical trials.
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Purpose This paper aims to provide an overview of applications of medical rapid prototyping (MRP)-assisted customized surgical guides (CSGs) and shows the potential of this technology in complex surgeries. This review paper also reports two case studies from open literature where MRP-assisted CSGs have been successfully used in complex surgeries. Design/methodology/approach Key publications from the past two decades have been reviewed. Findings This study concludes that the use of MRP-assisted C...
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