Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases
Abstract Background Treating infectious bone defects combined with large soft-tissue lesions poses significant clinical challenges. Herein, we introduced a modified two-stage treatment approach involving the implantation of 3D-printed prostheses and flap repair to treat large segmental infectious ti...
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BMC
2024-12-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08248-6 |
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| author | Zhuo Chen Yiyuan Yang Bingchuan Liu Xingcai Li Yun Tian |
| author_facet | Zhuo Chen Yiyuan Yang Bingchuan Liu Xingcai Li Yun Tian |
| author_sort | Zhuo Chen |
| collection | DOAJ |
| description | Abstract Background Treating infectious bone defects combined with large soft-tissue lesions poses significant clinical challenges. Herein, we introduced a modified two-stage treatment approach involving the implantation of 3D-printed prostheses and flap repair to treat large segmental infectious tibial bone defects. Method We conducted a retrospective study of 13 patients treated at our center between April 2018 and March 2022 for tibial infections owing to posttraumatic infection and chronic osteomyelitis combined with soft tissue defects. The average defect length was 14.0 cm (range, 5.7–22.9 cm). The flap area ranged from 14 × 5 to 15 × 8 + 25 × 15 cm. Sural neurocutaneous, lesser saphenous neurocutaneous, and local fasciocutaneous flaps were used to repair the skin defects. In the second stage, 3D-printed prostheses were designed and implanted. Union rate, complications, and functional outcomes were assessed at the final follow-up. Result The average follow-up period was 31.1 months (range, 17–47 months), with an average interval of 208.1 days (range, 139–359 days) between the two stages. According to our criteria, 7 of the 13 patients achieved radiographic healing without intervention. Two patients developed prosthesis-related complications and underwent revision surgery. Two patients experienced recurrent infections leading to prosthesis removal and debridement surgery, with the infection ultimately eradicated in one and the other undergoing amputation. Three patients experienced noninfectious flap-related complications, however, all eventually healed through surgical intervention. Conclusion The use of 3D-printed porous titanium prostheses combined with flap soft-tissue repair for the treatment of infectious tibial bone defects did not increase the rate of infection recurrence and provided good functional recovery, offering more options for the treatment of infectious bone defects. |
| format | Article |
| id | doaj-art-d98ddf84554b43a4bdb2bc901e893894 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-d98ddf84554b43a4bdb2bc901e8938942025-01-05T12:04:41ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-0125111110.1186/s12891-024-08248-6Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 casesZhuo Chen0Yiyuan Yang1Bingchuan Liu2Xingcai Li3Yun Tian4Department of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, Peking University Third HospitalAbstract Background Treating infectious bone defects combined with large soft-tissue lesions poses significant clinical challenges. Herein, we introduced a modified two-stage treatment approach involving the implantation of 3D-printed prostheses and flap repair to treat large segmental infectious tibial bone defects. Method We conducted a retrospective study of 13 patients treated at our center between April 2018 and March 2022 for tibial infections owing to posttraumatic infection and chronic osteomyelitis combined with soft tissue defects. The average defect length was 14.0 cm (range, 5.7–22.9 cm). The flap area ranged from 14 × 5 to 15 × 8 + 25 × 15 cm. Sural neurocutaneous, lesser saphenous neurocutaneous, and local fasciocutaneous flaps were used to repair the skin defects. In the second stage, 3D-printed prostheses were designed and implanted. Union rate, complications, and functional outcomes were assessed at the final follow-up. Result The average follow-up period was 31.1 months (range, 17–47 months), with an average interval of 208.1 days (range, 139–359 days) between the two stages. According to our criteria, 7 of the 13 patients achieved radiographic healing without intervention. Two patients developed prosthesis-related complications and underwent revision surgery. Two patients experienced recurrent infections leading to prosthesis removal and debridement surgery, with the infection ultimately eradicated in one and the other undergoing amputation. Three patients experienced noninfectious flap-related complications, however, all eventually healed through surgical intervention. Conclusion The use of 3D-printed porous titanium prostheses combined with flap soft-tissue repair for the treatment of infectious tibial bone defects did not increase the rate of infection recurrence and provided good functional recovery, offering more options for the treatment of infectious bone defects.https://doi.org/10.1186/s12891-024-08248-63D Printed prosthesisInfectious bone defectsTibial bone defectSoft tissue lesionChronic osteomyelitisFlap transfer |
| spellingShingle | Zhuo Chen Yiyuan Yang Bingchuan Liu Xingcai Li Yun Tian Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases BMC Musculoskeletal Disorders 3D Printed prosthesis Infectious bone defects Tibial bone defect Soft tissue lesion Chronic osteomyelitis Flap transfer |
| title | Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases |
| title_full | Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases |
| title_fullStr | Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases |
| title_full_unstemmed | Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases |
| title_short | Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases |
| title_sort | application of 3d printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion a case series of 13 cases |
| topic | 3D Printed prosthesis Infectious bone defects Tibial bone defect Soft tissue lesion Chronic osteomyelitis Flap transfer |
| url | https://doi.org/10.1186/s12891-024-08248-6 |
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