April 14, 2020
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3D-printed prostheses may improve outcomes of giant cell tumors of the distal radius

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Use of 3D-printed cementless prosthesis reconstruction for treatment of Campanacci III or recurrent giant cell tumors of the distal radius may provide improved outcomes compared with allograft reconstruction, according to published results.

Researchers collected pre- and postoperative active range of motion of the wrist, VAS score, grip strength, degenerative change of the wrist, Mayo wrist score and Musculoskeletal Tumor Society (MTS) score among 30 patients with Campanacci III or recurrent giant cell tumors of the distal radius who underwent either osteoarticular allograft reconstruction (n=15) or cementless 3D-printed prosthesis reconstruction (n=15). Researchers evaluated complications using the Henderson classification.

Results showed significantly increased postoperative range of motion, grip strength, Mayo score and MTS score in both groups. However, researchers found significantly higher extension, flexion, MTS score and Mayo score in the prosthesis group. Researchers also noted no significant difference between the two groups with grip strength and VAS. Late infection occurred in one patient, resorption of allograft without allograft bone fracture in one patient and wrist subluxation in four patients in the allograft group, while the prosthesis group had wrist subluxation in three patients and separation of the distal radioulnar joint in three patients, according to results. Researchers found all patients in the allograft group and no patients in the prosthesis group had degenerative changes.

“Despite including subluxation cases, 3D-printed prosthesis replacement at short-term follow-up can partially preserve better wrist function than osteoarticular allograft reconstruction at short-term and even median-term follow-up,” the authors wrote. “During the 3D-printed prosthesis design, preoperative morphological assessment of the affected proximal row carpal is helpful to control for postoperative dislocation. In addition, considering the relative instability of joint capsule reconstruction, properly delayed rehabilitation is recommended.” – by Casey Tingle

Disclosures: The authors report no relevant financial disclosures.