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定制式3D打印骨盆肿瘤假体设计与临床应用专家共识

Expert consensus on design and clinical application of customized 3D printed pelvic tumor prosthesis

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【作者】 闵理； 孙伟； 杨毅； 李浩淼； 李小康； 于胜吉； 张清； 屠重棋； 郭卫； 蔡郑东； 蔡建强； 董扬； 胡永成； 李建民； 林建华； 牛晓辉； 曲国蕃； 沈靖南； 邵增务； 王国文； 叶招明； 张伟滨； 郭征；

【Author】 MIN Li;SUN Wei;YANG Yi;LI Haomiao;LI Xiaokang;YU Shengji;ZHANG Qing;TU Chongqi;GUO Wei;CAI Zhengdong;CAI Jianqiang;DONG Yang;HU Yongcheng;LI Jianmin;LIN Jianhua;NIU Xiaohui;QU Guofan;SHEN Jingnan;SHAO Zengwu;WANG Guowen;YE Zhaoming;ZHANG Weibin;GUO Zheng;Pelvic Oncology Group,Sarcoma Professional Committee,Chinese Anti-Cancer Association;Innovation and Transformation Group,Sarcoma Professional Committee,Chinese Anti-Cancer Society;Repair and Reconstruction Group of Bone Tumor and Bone Metastases Professional Committee,Chinese Anti-cancer Association;Department of Orthopaedics,Orthopaedic Research Institute,West China Hospital,Sichuan University;Department of Orthopaedics,Shanghai General Hospital,Shanghai Jiao Tong University;Musculoskeletal Tumor Center,Peking University People’s Hospital;Department of Orthopaedics,The Third Affiliated Hospital of Southern Medical University;Department of Orthopaedics,Tangdu Hospital,Air Force Medical University;Department of Orthopaedics,Cancer Hospital,Chinese Academy of Medical Sciences;Department of Orthopaedic Oncology,Beijing Jishuitan Hospital;Department of Hepatobiliary Surgery,Cancer Hospital,Chinese Academy of Medical Sciences;Department of Orthopaedic Surgery,Shanghai Sixth People’s Hospital;Department of Bone Tumor,Tianjin Hospital;Department of Orthopaedics,Qilu Hospital of Shandong University;Department of Orthopaedics,The First Affiliated Hospital of Fujian Medical University;Department of Orthopaedics,Harbin Medical University Cancer Hospital;Department of Musculoskeletal Oncology,The First Affiliated Hospital,Sun Yat-Sen University;Department of Orthopaedics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology;Department of Bone and Soft Tissue Tumors,Tianjin Medical University Cancer Institute and Hospital;Department of Orthopaedics,The Second Affiliated Hospital,Zhejiang University School of Medicine;Department of Orthopaedics,Ruijin Hospital,Shanghai Jiao Tong University,School of Medicine;

【通讯作者】 郭征;

【机构】 中国抗癌协会肉瘤专业委员会骨盆肿瘤学组； 中国抗癌协会肉瘤专业委员会创新与转化学组； 中国抗癌协会骨肿瘤和骨转移瘤专业委员会修复重建学组； 四川大学华西医院骨科骨科研究所； 上海交通大学附属第一人民医院骨科； 北京大学人民医院骨肿瘤科； 南方医科大学第三附属医院骨科； 空军军医大学唐都医院骨科； 中国医学科学院肿瘤医院骨科； 北京积水潭医院骨肿瘤科； 中国医学科学院肿瘤医院肝胆外科； 上海市第六人民医院骨科； 天津医院骨肿瘤科； 山东大学齐鲁医院骨科； 福建医科大学附属第一医院骨科； 哈尔滨医科大学附属肿瘤医院骨科； 中山大学附属第一医院骨肿瘤科； 华中科技大学同济医学院附属协和医院骨科； 天津医科大学肿瘤医院骨与软组织肿瘤科； 浙江大学医学院附属第二医院骨科； 上海交通大学医学院附属瑞金医院骨科；

【摘要】 功能性重建骨盆肿瘤切除后残留的巨大骨缺损是骨肿瘤外科医师必须面对的巨大挑战。骨盆假体因具有较好的初始稳定性、外形更易被接受、以及功能恢复相对较快等特点，近年来逐渐成为骨盆恶性或侵袭性肿瘤切除后的主要重建手段。但传统骨盆假体仍然存在断裂、松动等风险。随着3D打印技术的发展，采用3D打印定制类骨小梁多孔结构骨盆假体已成功应用于临床，获得了较好的力学支撑和界面骨整合，而假体的设计优劣和应用是否规范直接影响使用效果。本共识以循证医学证据为基础，经全国骨肿瘤专家商议讨论，从定制式3D打印骨盆肿瘤假体的设计和临床应用等关键技术环节形成推荐意见，为此类假体的有效使用提供参考。

【Abstract】 Functional reconstruction of large residual bone defects after resection of pelvic tumors is a great challenge for bone tumor surgeons. In recent years, hemipelvic prosthesis reconstruction has gradually accepted as a leading method in the treatment of pelvic malignant or aggressive tumors, due to its good initial stability, more acceptable appearance and relatively fast functional recovery.However, the traditional pelvic prosthesis still has the risk of fracture and loosening. With the development of 3D printed technology,3D printed customized hemipelvic prosthesis with trabecular bone like porous structure has been successfully applied in clinical practice, achieving better mechanical support and interfacial osseointegration. Importantly, the design and standardized application of this prosthesis directly can influence the outcomes. Based on the proofs of evidence-based medicine and detailed discussion by domestic bone tumor experts, this consensus formed specific recommendations from the design, clinical application and other key techniques of 3D printed customized hemipelvic prosthesis, so as to provide references for the standard and effective usage of such prosthesis.

【关键词】 骨盆肿瘤； 3D打印； 假体；
【Key words】 Pelvic Tumor； 3D Printing； Prosthesis；
  • 【文献出处】 中华骨与关节外科杂志 ,Chinese Journal of Bone and Joint Surgery , 编辑部邮箱 ,2022年07期
  • 【分类号】R738.1
  • 【下载频次】167
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