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Use of 3D Printing in Orthopedic Oncology

By Dr. Akshay Tiwari in Musculoskeletal Oncology

Jul 29 , 2022 | 1 min read

Modern-day orthopaedic oncology works on the balance between two contradictory philosophies of any cancer surgery. On the one hand, maximal removal ensures complete cancer removal with its "roots" in the surrounding tissue. On the other hand, it removes only as much as is needed to preserve the function and cosmesis of the affected part.

In this context, 3-D printing, the technology of making a three-dimensional object as a replica of a three-dimensional digital model by laying down the material in layers, has come in very handy for bone cancer surgery, for both meticulous planning and accurate execution of that plan. 

Bone cancer surgery has benefitted from 3D printing in more ways than one. For starters, orthopaedic oncologists can now order 3-D printed models of tumour-bearing bones to better understand the three-dimensional orientation of the tumour concerning the affected bone, particularly for non-geometrically shaped bones like the pelvic bones, sacrum, and the spine.

This has led to more meaningful clinicoradiological correlation, which leads to:

  1. Superior preoperative planning 

  2. Better communication amongst members of the operating team

  3. Ready intraoperative reference 

  4. A better understanding of the surgeon's requirements by implant manufacturers. 

Another important use of 3D printing is intraoperative navigation. During bone cancer surgery, the surgeon may not always accurately identify the point on the bone where they had planned the cut, thereby removing too much or too little bone. 3-D printed "jigs" have solved this problem by allowing the surgeon to make accurate cuts per the preoperative plan in consultation with the radiologist. This is achieved by 3D printed model along with a 3D printed jig that has slots for placement of cutting saw blades. 

Besides better planning and better execution of the preop plan for resection, 3-D printing has proven invaluable for making implants used for reconstruction in limb salvage surgery. This applies to situations where we need to order specific plates or prostheses exactly matching the anatomical details of the affected bone; like plates for fixation in young children, specific prosthetic implants for irregular bones like pelvic bones, talus, scapula etc., or implants with unique specifications like joint sparing implants. 

Combined with computer navigation, 3D printing for orthopaedic oncology surgery is here to stay. As its use increases, it is becoming a "must-have" for orthopaedic oncology surgery, which will ultimately lead to better patient care and superior outcomes.

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