Virtual reality

3D Printing in Modern Orthopaedic Oncology

Orthopaedic oncology balances two opposing principles in cancer surgery: maximal removal of cancerous tissue and preservation of function and appearance. While complete excision ensures the elimination of cancerous cells, it risks impairing the functionality and aesthetics of the affected area. Conversely, conservative removal preserves these aspects but may leave residual cancer. Navigating this delicate balance has been revolutionized by 3D printing technology, which constructs three-dimensional objects layer by layer based on digital models. This advancement has significantly enhanced both the planning and execution phases of bone cancer surgeries.

Enhanced Preoperative Planning

3D printing has greatly benefited bone cancer surgery by allowing the creation of accurate models of tumor-bearing bones. This is particularly advantageous for non-geometrically shaped bones such as the pelvis, sacrum, and spine. These detailed replicas provide orthopaedic oncologists with a better understanding of the tumor’s spatial relationship with the surrounding bone, leading to more precise clinicoradiological correlations.

Key benefits include:

• Superior Preoperative Planning: Detailed models enable meticulous surgical planning, ensuring that all aspects of the tumor and its surrounding tissue are thoroughly considered.
• Improved Team Communication: Surgeons and their teams can collaborate more effectively, using the 3D model as a tangible reference point during preoperative discussions.
• Intraoperative Reference: The model serves as a constant reference during surgery, helping to guide decisions in real-time.
• Clear Communication with Implant Manufacturers: Surgeons can convey their requirements more accurately to manufacturers, ensuring that custom implants meet the specific needs of the surgery.

Intraoperative Navigation

One significant challenge in bone cancer surgery is making precise cuts on the bone. Traditional methods often result in the removal of too much or too little bone. However, 3D printed jigs, which are customized guides for saw blades, have addressed this issue. These jigs ensure that cuts are made exactly as planned, based on preoperative consultations with radiologists.

Custom Implants for Reconstruction

3D printing is invaluable for creating custom implants used in limb salvage surgeries. Specific plates and prostheses can be designed to match the exact anatomical features of the affected bone. This is particularly crucial for:

• Young Children: Custom plates are necessary to accommodate growing bones.
• Irregular Bones: Prostheses for complex structures like pelvic bones, the talus, and the scapula require precise customization.
• Joint-Sparing Implants: Unique implants that preserve joint function can be tailored to the patient’s anatomy.

Future of 3D Printing in Orthopaedic Oncology

Combined with computer navigation, 3D printing has become indispensable in orthopaedic oncology surgery. Its increasing adoption is transforming it from a novel innovation to a standard tool, promising enhanced patient care and superior surgical outcomes. As the technology evolves, it will further refine surgical precision, improve recovery rates, and optimize overall treatment effectiveness, marking a significant advancement in the fight against bone cancer.