Preliminary application of three dimensional printing personalized navigation template in assisting total elbow replacement for patients with elbow tumor_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MIAO Qiuju ^1,2 ,  DING Huanwen ¹ , HUANG Minqiang ^1,2 , SHEN Jianjian ¹ , TU Qiang ¹ , HUANG Miaojun ³

1. Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010, P.R.China;
2. Graduate College, Traditional Chinese Medicine University of Guangzhou, Guangzhou Guangdong, 510010, P.R.China;
3. Guangdong University of Technology, Guangzhou Guangdong, 510006, P.R.China;

Corresponding?author：

DING Huanwen, Email: dhuanwen123@aliyun.com

Keywords：

Total elbow replacement; elbow prosthesis; three-dimensional printing technology; computer aided design; bone tumor

DOI：

10.7507/1002-1892.201611091

Video：

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Objective To explore the clinical methods of resection of elbow tumor and total elbow replacement with custom personalized prosthesis based on three dimensional (3-D) printing navigation template. Methods In August 2016, a 63-year-old male patient with left elbow joint tumor was treated, with the discovery of the left distal humerus huge mass over 3 months, with elbow pain, activity limitation of admission. Computer-assisted reduction technique combined with 3-D printing was used to simulate preoperative tumor resection, a customized personal prosthesis was developed; tumor was accurately excised during operation, and the clinical result was evaluated after operation. Results The time was 46 minutes for tumor resection, and was 95 minutes for personalized implant and allograft bone without fluoroscopy. X-ray and CT examination at 1 week after operation showed good position of artificial elbow joint; the anteversion of ulna prosthesis was 30° and the elbow carrying angle was 15°, which were consistent with the simulated results before surgery. The finger flexion was normal at 1 month after operation; the range of motion was 0-130° for elbow flexion and extension, 80° for forearm pronation, and 80° for forearm supination. The elbow function was able to meet the needs of daily life at 7 months after operation, and no recurrence and metastasis of tumor were observed. Conclusion For limb salvage of elbow joint, computer aided design can make preoperative surgical simulation; the navigation template can improve surgical precision; and the function of elbow joint can be reconstructed with customized and personlized prosthesis for total elbow replacement.

Citation： MIAO Qiuju, DING Huanwen, HUANG Minqiang, SHEN Jianjian, TU Qiang, HUANG Miaojun. Preliminary application of three dimensional printing personalized navigation template in assisting total elbow replacement for patients with elbow tumor. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(4): 385-391. doi: 10.7507/1002-1892.201611091 Copy

1.	?王克平, 李智明, 盛曉赟, 等. 全肘關節置換治療老年陳舊性肘關節骨折脫位.臨床骨科雜志, 2015, 18(4): 425-428.
2.	Fadero PE, Shah M. Three dimensional (3D) modelling and surgical planning in trauma and orthopaedics. Surgeon, 2014, 12(6): 328-333.
3.	Tang X, Guo W, Yang R, et al. Custom-made prosthesis replacement for reconstruction of elbow after tumor resection. J Shoulder Elbow Surg, 2009, 18(5): 796-803.
4.	Lenoir H, Chammas M, Micallef JP, et al. The effect of the anatomy of the distal humerus and proximal ulna on the positioning of the components in total elbow arthroplasty. Bone Joint J, 2015, 97-B(11): 1539-1545.
5.	Chia HN, Wu BM. Recent advances in 3D printing of biomaterials. J Biol Eng, 2015, 9(4): 1-14.
6.	Zerr J, Chatzinoff Y, Chopra R, et al. Three-dimensional printing for preoperative planning of total hip arthroplasty revision: case report. Skeletal Radiol, 2016, 45(10): 1431-1435.
7.	付軍, 郭征, 王臻, 等. 多種 3-D 打印手術導板在骨腫瘤切除重建手術中的應用. 中國修復重建外科雜志, 2014, 28(3): 304-308.
8.	韓娟, 楊明, 歐麗影, 等. 3D 打印技術輔助兒童脛骨遠端骨軟骨瘤的應用. 中國數字醫學, 2015, 10(7): 30-32.
9.	丁煥文, 易燦, 涂強, 等. 計算機輔助骨盆腫瘤精確切除和功能重建. 中國修復重建外科雜志, 2011, 25(10): 1218-1223.
10.	Figgie MP, Wright TM, Drinkwater D, et al. What design and material factors impact the wear and corrosion performance in total elbow arthroplasties. Clin Orthop Relat Res, 2014, 472(12): 3770-3776.
11.	Cesar M, Roussanne Y, Bonnel F, et al. GSB III total elbow replacement in rheumatoid arthritis. J Bone Joint Surg (Br), 2007, 89(3): 330-334.
12.	Ogino H, Ito H, Furu M, et al. Outcome of shortened extra-small ulnar component in linked total elbow arthroplasty for patients with rheumatoid arthritis. Mod Rheumatol, 2015, 25(6): 849-853.
13.	Qiao F, Li D, Jin Z, et al. Application of 3D printed customized external fixator in fracture reduction. Injury, 2015, 46(6): 1150-1155.
14.	劉宏偉, 翁益平, 張云坤, 等. 計算機輔助設計及電子束熔融快速成型金屬 3D 打印技術制備個性化股骨假體. 中國修復重建外科雜志, 2015, 29(9): 1088-1091.
15.	Kiene J, Wendlandt R, Heinritz M, et al. A physiological dynamic testing machine for the elbow joint. Open Orthop J, 2013, 7(1): 78-85.
16.	Ding HW, Yu GW, Tu Q, et al. Computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee: outcomes of 12 cases. BMC Musculoskeletal Disorders, 2013, 14(1): 331.
17.	潘露. 自體骨結合同種異體骨治療四肢惡性骨腫瘤的療效觀察. 實用癌癥雜志, 2015, 30(6): 824-827.
18.	Ma L, Zhou Y, Zhu Y, et al. 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep, 2016, 6: 1-9.

1. ?王克平, 李智明, 盛曉赟, 等. 全肘關節置換治療老年陳舊性肘關節骨折脫位.臨床骨科雜志, 2015, 18(4): 425-428.
2. Fadero PE, Shah M. Three dimensional (3D) modelling and surgical planning in trauma and orthopaedics. Surgeon, 2014, 12(6): 328-333.
3. Tang X, Guo W, Yang R, et al. Custom-made prosthesis replacement for reconstruction of elbow after tumor resection. J Shoulder Elbow Surg, 2009, 18(5): 796-803.
4. Lenoir H, Chammas M, Micallef JP, et al. The effect of the anatomy of the distal humerus and proximal ulna on the positioning of the components in total elbow arthroplasty. Bone Joint J, 2015, 97-B(11): 1539-1545.
5. Chia HN, Wu BM. Recent advances in 3D printing of biomaterials. J Biol Eng, 2015, 9(4): 1-14.
6. Zerr J, Chatzinoff Y, Chopra R, et al. Three-dimensional printing for preoperative planning of total hip arthroplasty revision: case report. Skeletal Radiol, 2016, 45(10): 1431-1435.
7. 付軍, 郭征, 王臻, 等. 多種 3-D 打印手術導板在骨腫瘤切除重建手術中的應用. 中國修復重建外科雜志, 2014, 28(3): 304-308.
8. 韓娟, 楊明, 歐麗影, 等. 3D 打印技術輔助兒童脛骨遠端骨軟骨瘤的應用. 中國數字醫學, 2015, 10(7): 30-32.
9. 丁煥文, 易燦, 涂強, 等. 計算機輔助骨盆腫瘤精確切除和功能重建. 中國修復重建外科雜志, 2011, 25(10): 1218-1223.
10. Figgie MP, Wright TM, Drinkwater D, et al. What design and material factors impact the wear and corrosion performance in total elbow arthroplasties. Clin Orthop Relat Res, 2014, 472(12): 3770-3776.
11. Cesar M, Roussanne Y, Bonnel F, et al. GSB III total elbow replacement in rheumatoid arthritis. J Bone Joint Surg (Br), 2007, 89(3): 330-334.
12. Ogino H, Ito H, Furu M, et al. Outcome of shortened extra-small ulnar component in linked total elbow arthroplasty for patients with rheumatoid arthritis. Mod Rheumatol, 2015, 25(6): 849-853.
13. Qiao F, Li D, Jin Z, et al. Application of 3D printed customized external fixator in fracture reduction. Injury, 2015, 46(6): 1150-1155.
14. 劉宏偉, 翁益平, 張云坤, 等. 計算機輔助設計及電子束熔融快速成型金屬 3D 打印技術制備個性化股骨假體. 中國修復重建外科雜志, 2015, 29(9): 1088-1091.
15. Kiene J, Wendlandt R, Heinritz M, et al. A physiological dynamic testing machine for the elbow joint. Open Orthop J, 2013, 7(1): 78-85.
16. Ding HW, Yu GW, Tu Q, et al. Computer-aided resection and endoprosthesis design for the management of malignant bone tumors around the knee: outcomes of 12 cases. BMC Musculoskeletal Disorders, 2013, 14(1): 331.
17. 潘露. 自體骨結合同種異體骨治療四肢惡性骨腫瘤的療效觀察. 實用癌癥雜志, 2015, 30(6): 824-827.
18. Ma L, Zhou Y, Zhu Y, et al. 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep, 2016, 6: 1-9.

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