BACKGROUND Giant cell tumor(GCT)is a benign lesion and rarely involves the patella.This disease is characterized by a relatively high recurrence rate after primary treatment.En bloc resection has been a predominant op...BACKGROUND Giant cell tumor(GCT)is a benign lesion and rarely involves the patella.This disease is characterized by a relatively high recurrence rate after primary treatment.En bloc resection has been a predominant option for recurrent GCT.However,total patellectomy can lead to disruption of the knee.Therefore,exploration of functional reconstruction of the extensor mechanism is worthwhile.CASE SUMMARY A 54-year-old woman presented with right knee pain and swelling,and was diagnosed as having a GCT in the patella following curettage and autograft.Medical imaging revealed a lytic and expanded lesion involving the whole patella with focal cortical breaches and pathological fracture.Based on the combination of histological,radiological,and clinical features,a diagnosis of recurrent GCT in the patella was made(Campanacci grade III).After a multidisciplinary team discussion,three-dimensional(3D)-printed custom-made patellar endoprosthesis was performed following en bloc resection for reconstructing the extensor mechanism.The patient was followed for 35 mo postoperatively.No evidence of local recurrence,pulmonary metastasis,or osteoarthritis of the right knee was observed.The active flexion arc was 0°-120°,and no extension lag was detected.A favorable patellar tracking and height(Insall-Salvati ratio 0.93)were detected by radiography.CONCLUSION We depict a case of a GCT at the right patella,which was successfully treated by patellectomy and 3D-printed custom-made endoprosthetic replacement.The patella normal reconstruction,the precise-fit articular design,and gastrocnemius flap augmentation could lead to satisfactory knee function and a low rate of complications in the short-term follow-up.展开更多
Bone defect repairs are based on bone graft fusion or replacement.Current large bone defect treatments are inadequate and lack of reliable technology.Therefore,we aimed to investigate a simple technique using three-di...Bone defect repairs are based on bone graft fusion or replacement.Current large bone defect treatments are inadequate and lack of reliable technology.Therefore,we aimed to investigate a simple technique using three-dimensional(3D)-printed individualized porous implants without any bone grafts,osteoinductive agents,or surface biofunctionalization to treat large bone defects,and systematically study its long-term therapeutic effects and osseointegration characteristics.Twenty-six patients with large bone defects caused by tumor,infection,or trauma received treatment with individualized porous implants;among them,three typical cases underwent a detailed study.Additionally,a large segmental femur defect sheep model was used to study the osseointegration characteristics.Immediate and long-term biomechanical stability was achieved,and the animal study revealed that the bone grew into the pores with gradual remodeling,resulting in a long-term mechanically stable implant-bone complex.Advantages of 3D-printed microporous implants for the repair of bone defects included 1)that the stabilization devices were immediately designed and constructed to achieve early postoperative mobility,and 2)that osseointegration between the host bone and implants was achieved without bone grafting.Our osseointegration method,in which the“implant-bone”interface fusion concept was used instead of“bone-bone”fusion,subverts the traditional idea of osseointegration.展开更多
Three-dimensional(3D)-printed porous Ti6Al4V implants play an important role in the reconstruction of bone defects.However,its osseointegration capacity needs to be further improved,and related methods are inadequate,...Three-dimensional(3D)-printed porous Ti6Al4V implants play an important role in the reconstruction of bone defects.However,its osseointegration capacity needs to be further improved,and related methods are inadequate,especially lacking customized surface treatment technology.Consequently,we aimed to design an omnidirectional radiator based on ultraviolet(UV)photofunctionalization for the surface treatment of 3D-printed porous Ti6Al4V implants,and studied its osseointegration promotion effects in vitro and in vivo,while elucidating related mechanisms.Following UV treatment,the porous Ti6Al4V scaffolds exhibited significantly improved hydrophilicity,cytocompatibility,and alkaline phosphatase activity,while preserving their original mechanical properties.The increased osteointegration strength was further proven using a rabbit condyle defect model in vivo,in which UV treatment exhibited a high efficiency in the osteointegration enhancement of porous Ti6Al4V scaffolds by increasing bone ingrowth(BI),the bone-implant contact ratio(BICR),and the mineralized/osteoid bone ratio.The advantages of UV treatment for 3D-printed porous Ti6Al4V implants using the omnidirectional radiator in the study were as follows:1)it can significantly improve the osseointegration capacity of porous titanium implants despite the blocking out of UV rays by the porous structure;2)it can evenly treat the surface of porous implants while preserving their original topography or other morphological features;and 3)it is an easy-to-operate low-cost process,making it worthy of wide clinical application.展开更多
基金National Key Research and Development Program of China,No.2016YFC1102003Science and Technology Research Program of Sichuan Province,No.2020YFS0036+2 种基金Chengdu Science and Technology Program Projects,No.2017-CY02-00032-GXNational Natural Science Foundation of China,No.81801852National Key Research and Development Program of China,No.2017YFB0702604.
文摘BACKGROUND Giant cell tumor(GCT)is a benign lesion and rarely involves the patella.This disease is characterized by a relatively high recurrence rate after primary treatment.En bloc resection has been a predominant option for recurrent GCT.However,total patellectomy can lead to disruption of the knee.Therefore,exploration of functional reconstruction of the extensor mechanism is worthwhile.CASE SUMMARY A 54-year-old woman presented with right knee pain and swelling,and was diagnosed as having a GCT in the patella following curettage and autograft.Medical imaging revealed a lytic and expanded lesion involving the whole patella with focal cortical breaches and pathological fracture.Based on the combination of histological,radiological,and clinical features,a diagnosis of recurrent GCT in the patella was made(Campanacci grade III).After a multidisciplinary team discussion,three-dimensional(3D)-printed custom-made patellar endoprosthesis was performed following en bloc resection for reconstructing the extensor mechanism.The patient was followed for 35 mo postoperatively.No evidence of local recurrence,pulmonary metastasis,or osteoarthritis of the right knee was observed.The active flexion arc was 0°-120°,and no extension lag was detected.A favorable patellar tracking and height(Insall-Salvati ratio 0.93)were detected by radiography.CONCLUSION We depict a case of a GCT at the right patella,which was successfully treated by patellectomy and 3D-printed custom-made endoprosthetic replacement.The patella normal reconstruction,the precise-fit articular design,and gastrocnemius flap augmentation could lead to satisfactory knee function and a low rate of complications in the short-term follow-up.
基金the grant from the Ministry of Science and Technology of the People’s Republic of China(grant number 2016YFB1101501)Beijing Municipal Science&Technology Commission(Project Z181100001718195)。
文摘Bone defect repairs are based on bone graft fusion or replacement.Current large bone defect treatments are inadequate and lack of reliable technology.Therefore,we aimed to investigate a simple technique using three-dimensional(3D)-printed individualized porous implants without any bone grafts,osteoinductive agents,or surface biofunctionalization to treat large bone defects,and systematically study its long-term therapeutic effects and osseointegration characteristics.Twenty-six patients with large bone defects caused by tumor,infection,or trauma received treatment with individualized porous implants;among them,three typical cases underwent a detailed study.Additionally,a large segmental femur defect sheep model was used to study the osseointegration characteristics.Immediate and long-term biomechanical stability was achieved,and the animal study revealed that the bone grew into the pores with gradual remodeling,resulting in a long-term mechanically stable implant-bone complex.Advantages of 3D-printed microporous implants for the repair of bone defects included 1)that the stabilization devices were immediately designed and constructed to achieve early postoperative mobility,and 2)that osseointegration between the host bone and implants was achieved without bone grafting.Our osseointegration method,in which the“implant-bone”interface fusion concept was used instead of“bone-bone”fusion,subverts the traditional idea of osseointegration.
基金The authors acknowledge the grant from the Ministry of Science and Technology of the People’s Republic of China(grant number 2016YFB1101501)Beijing Municipal Science&Technology Commission(Project Z181100001718195).Teng Zhang was supported in part by the Postdoctoral Fellowship of Peking-Tsinghua Center for Life Sciences.We also received research and financial support from the Beijing AKEC Medical Co.,Ltd.
文摘Three-dimensional(3D)-printed porous Ti6Al4V implants play an important role in the reconstruction of bone defects.However,its osseointegration capacity needs to be further improved,and related methods are inadequate,especially lacking customized surface treatment technology.Consequently,we aimed to design an omnidirectional radiator based on ultraviolet(UV)photofunctionalization for the surface treatment of 3D-printed porous Ti6Al4V implants,and studied its osseointegration promotion effects in vitro and in vivo,while elucidating related mechanisms.Following UV treatment,the porous Ti6Al4V scaffolds exhibited significantly improved hydrophilicity,cytocompatibility,and alkaline phosphatase activity,while preserving their original mechanical properties.The increased osteointegration strength was further proven using a rabbit condyle defect model in vivo,in which UV treatment exhibited a high efficiency in the osteointegration enhancement of porous Ti6Al4V scaffolds by increasing bone ingrowth(BI),the bone-implant contact ratio(BICR),and the mineralized/osteoid bone ratio.The advantages of UV treatment for 3D-printed porous Ti6Al4V implants using the omnidirectional radiator in the study were as follows:1)it can significantly improve the osseointegration capacity of porous titanium implants despite the blocking out of UV rays by the porous structure;2)it can evenly treat the surface of porous implants while preserving their original topography or other morphological features;and 3)it is an easy-to-operate low-cost process,making it worthy of wide clinical application.
