Treatment of giant cell tumor of bone around knee joint with three-dimensional printing personalized prosthesis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAN Fengping ¹ , LUO Xiang ^1,2 , CHEN Guoping ¹ , XIE Zhaolin ¹ , JIANG Jianzhong ¹ , YANG Keqin ¹ ,  TAN Haitao ^1,2

1. Department of Orthopaedics, Guigang City People’s Hospital, Guigang Guangxi, 537100, P.R.China;
2. Guangxi Clinical Research Center for Digital Medicine and 3D Printing, Guigang Guangxi, 537100, P.R.China;

Corresponding?author：

TAN Haitao, Email: tanhaitao99@hotmail.com

Keywords：

Knee; giant cell tumor of bone; personalized prosthesis; three-dimensional printing technique; bone defect

DOI：

10.7507/1002-1892.201909109

Video：

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Objective To investigate the short-term effectiveness of three-dimensional (3D) printing personalized prosthesis in the treatment of giant cell tumor of bone around knee joint.Methods A clinical data of 9 patients with giant cell tumor of bone around knee joints and met the inclusive criteria between May 2014 and August 2017 was retrospectively analysed. There were 4 males and 5 females, with an average age of 35.8 years (range, 24-50 years). The lesion located at the distal femur in 4 cases and at the proximal tibia in 5 cases. The disease duration was 5-25 months (mean, 12.9 months). According to Campanacci grading, there were 2 patients of grade Ⅰ and 7 of grade Ⅱ. The 3D printing personalized prosthesis was designed based on the CT scanning and 3D reconstruction prepared before operation. All patients were treated with the tumor resection and 3D printing personalized prosthesis reconstruction. The radiological examination was taken to observe the tumor recurrence and the Musculoskeletal Tumor Society 1993 (MSTS93) score was used to evaluate the knee function.Results All operations were successful and all incisions healed by first intention without early complications. All patients were followed up 24-40 months (mean, 31.2 months). At last follow-up, no complication such as pain, pathological fracture, prosthesis loosening, or tumor recurrence occurred. The MSTS93 score was 20-29 (mean, 24.7). The knee function was rated as excellent in 6 cases and good in 3 cases, with the excellent and good rate of 100%. Conclusion For giant cell tumor of bone around knee joint, 3D printing personalized prosthesis has the advantages of bio-fusion with host bone, mechanical stability, good joint function, and ideal short-term effectiveness. But the middle- and long-term effectiveness still need to be further observed.

Citation： GAN Fengping, LUO Xiang, CHEN Guoping, XIE Zhaolin, JIANG Jianzhong, YANG Keqin, TAN Haitao. Treatment of giant cell tumor of bone around knee joint with three-dimensional printing personalized prosthesis. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(6): 751-755. doi: 10.7507/1002-1892.201909109 Copy

1.	Guo L, Jia P, Hu YC, et al. Measurement of morphological parameters of giant cell tumor of bone in the knee. Oncol Lett, 2019, 17(4): 3867-3873.
2.	Jamshidi K, Bahrabadi M, Bagherifard A, et al. Surgical treatment outcome of giant cell tumor of distal ulna: En bloc resection vs. curettage and bone graft. Med J Islam Repub Iran, 2018, 32: 44.
3.	Tang H, Moro A, Feng W, et al. Giant cell tumors combined with secondary aneurysmal bone cysts are more likely to develop postoperative recurrence: A retrospective study of 256 cases. J Surg Oncol, 2019, 120(3): 359-365.
4.	Yilmaz M, Sorensen MS, Saebye C, et al. Long-term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb-sparing bone resections in orthopedic oncologic conditions: Results from a national cohort. J Surg Oncol, 2019, 120(2): 183-192.
5.	Vaishya R, Pokhrel A, Agarwal AK, et al. Current status of bone cementing and bone grafting for giant cell tumour of bone: a systemic review. Ann R Coll Surg Engl, 2019, 101(2): 79-85.
6.	曹武, 葉招明, 林秾, 等. 膝關節周圍骨巨細胞瘤刮除后填充骨水泥對關節軟骨影響的臨床研究. 中國修復重建外科雜志, 2014, 28(12): 1459-1463.
7.	趙星, 余黎, 陶圣祥, 等. 3D 打印技術在嚴重肱骨遠端骨缺損治療中的應用觀察. 中國修復重建外科雜志, 2018, 32(12): 1534-1539.
8.	Lu M, Min L, Xiao C, et al. Uncemented three-dimensional-printed prosthetic replacement for giant cell tumor of distal radius: a new design of prosthesis and surgical techniques. Cancer Manag Res, 2018, 10: 265-277.
9.	黃俊琪, 畢文志, 韓綱, 等. 大段同種異體骨單髁置換術治療膝關節周圍骨腫瘤療效觀察. 中國修復重建外科雜志, 2017, 31(8): 908-912.
10.	Greenberg DD, Lee FY. Bisphosphonate-loaded bone cement as a local adjuvant therapy for giant cell tumor of bone. Am J Clin Oncol, 2019, 42(3): 231-237.
11.	Gupta SP, Garg G. Curettage with cement augmentation of large bone defects in giant cell tumors with pathological fractures in lower-extremity long bones. J Orthop Traumatol, 2016, 17(3): 239-247.
12.	Caubère A, Harrosch S, Fioravanti M, et al. Does curettage-cement packing for treating giant cell tumors at the knee lead to osteoarthritis? Orthop Traumatol Surg Res, 2017, 103(7): 1075-1079.
13.	嚴曉波, 林秾, 黃鑫, 等. 單中心 281 例肢體長骨骨巨細胞瘤的個體化治療及臨床結果分析. 中華骨科雜志, 2018, 38(18): 1116-1125.
14.	聶治軍, 袁啟令, 董向輝, 等. 病灶刮除植骨術治療中青年膝關節周圍骨巨細胞瘤的療效分析. 現代腫瘤醫學, 2018, 26(24): 4001-4003.
15.	Lu M, Wang J, Tang F, et al. A three-dimensional printed porous implant combined with bone grafting following curettage of a subchondral giant cell tumour of the proximal tibia: a case report. BMC Surg, 2019, 19(1): 29.
16.	Wang X, Xu S, Zhou S, et al. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review. Biomaterials, 2016, 83: 127-141.
17.	Omlor GW, Lange J, Streit M, et al. Retrospective analysis of 51 intralesionally treated cases with progressed giant cell tumor of the bone: local adjuvant use of hydrogen peroxide reduces the risk for tumor recurrence. World J Surg Oncol, 2019, 17(1): 73.

1. Guo L, Jia P, Hu YC, et al. Measurement of morphological parameters of giant cell tumor of bone in the knee. Oncol Lett, 2019, 17(4): 3867-3873.
2. Jamshidi K, Bahrabadi M, Bagherifard A, et al. Surgical treatment outcome of giant cell tumor of distal ulna: En bloc resection vs. curettage and bone graft. Med J Islam Repub Iran, 2018, 32: 44.
3. Tang H, Moro A, Feng W, et al. Giant cell tumors combined with secondary aneurysmal bone cysts are more likely to develop postoperative recurrence: A retrospective study of 256 cases. J Surg Oncol, 2019, 120(3): 359-365.
4. Yilmaz M, Sorensen MS, Saebye C, et al. Long-term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb-sparing bone resections in orthopedic oncologic conditions: Results from a national cohort. J Surg Oncol, 2019, 120(2): 183-192.
5. Vaishya R, Pokhrel A, Agarwal AK, et al. Current status of bone cementing and bone grafting for giant cell tumour of bone: a systemic review. Ann R Coll Surg Engl, 2019, 101(2): 79-85.
6. 曹武, 葉招明, 林秾, 等. 膝關節周圍骨巨細胞瘤刮除后填充骨水泥對關節軟骨影響的臨床研究. 中國修復重建外科雜志, 2014, 28(12): 1459-1463.
7. 趙星, 余黎, 陶圣祥, 等. 3D 打印技術在嚴重肱骨遠端骨缺損治療中的應用觀察. 中國修復重建外科雜志, 2018, 32(12): 1534-1539.
8. Lu M, Min L, Xiao C, et al. Uncemented three-dimensional-printed prosthetic replacement for giant cell tumor of distal radius: a new design of prosthesis and surgical techniques. Cancer Manag Res, 2018, 10: 265-277.
9. 黃俊琪, 畢文志, 韓綱, 等. 大段同種異體骨單髁置換術治療膝關節周圍骨腫瘤療效觀察. 中國修復重建外科雜志, 2017, 31(8): 908-912.
10. Greenberg DD, Lee FY. Bisphosphonate-loaded bone cement as a local adjuvant therapy for giant cell tumor of bone. Am J Clin Oncol, 2019, 42(3): 231-237.
11. Gupta SP, Garg G. Curettage with cement augmentation of large bone defects in giant cell tumors with pathological fractures in lower-extremity long bones. J Orthop Traumatol, 2016, 17(3): 239-247.
12. Caubère A, Harrosch S, Fioravanti M, et al. Does curettage-cement packing for treating giant cell tumors at the knee lead to osteoarthritis? Orthop Traumatol Surg Res, 2017, 103(7): 1075-1079.
13. 嚴曉波, 林秾, 黃鑫, 等. 單中心 281 例肢體長骨骨巨細胞瘤的個體化治療及臨床結果分析. 中華骨科雜志, 2018, 38(18): 1116-1125.
14. 聶治軍, 袁啟令, 董向輝, 等. 病灶刮除植骨術治療中青年膝關節周圍骨巨細胞瘤的療效分析. 現代腫瘤醫學, 2018, 26(24): 4001-4003.
15. Lu M, Wang J, Tang F, et al. A three-dimensional printed porous implant combined with bone grafting following curettage of a subchondral giant cell tumour of the proximal tibia: a case report. BMC Surg, 2019, 19(1): 29.
16. Wang X, Xu S, Zhou S, et al. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review. Biomaterials, 2016, 83: 127-141.
17. Omlor GW, Lange J, Streit M, et al. Retrospective analysis of 51 intralesionally treated cases with progressed giant cell tumor of the bone: local adjuvant use of hydrogen peroxide reduces the risk for tumor recurrence. World J Surg Oncol, 2019, 17(1): 73.

Chinese Journal of Reparative and Reconstructive Surgery

Treatment of giant cell tumor of bone around knee joint with three-dimensional printing personalized prosthesis

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