Computer-aided Design and 3D-printed Personalized Stem-plate Composite for Precision Revision of the Proximal Humerus Endoprosthetic Replacement: A Technique Note

Orthop Surg. 2023 Nov;15(11):3000-3005. doi: 10.1111/os.13857. Epub 2023 Sep 18.

Abstract

Background: Aseptic loosening is considered to be a rather uncommon complication in proximal humerus endoprosthetic replacement (PHER). However, patients with aseptic loosening often suffer severe bone loss, which poses a great challenge in following revision. Under this situation, a standard stemmed endoprosthesis is unavailable for revision limb salvage. Computer-aided design and 3D-printed personalized implants are an emerging solution for reconstructing complex bone defects.

Case presentation: Here, we present a 67-year-old male who underwent PHER after tumor resection and developed aseptic loosening with severe periprosthetic osteolysis around the stem. Computer-aided design and 3D-printed personalized stem-plate composite was used for the precision revision of this patient. During the follow-up, encouraging results were observed, with good endoprosthetic stability and satisfactory limb function.

Conclusion: Computer-aid design and 3D-printed personalized stem-plate composite used in the present case could help to achieve good endoprosthetic stability and satisfactory limb function. This 3D-printed personalized stem-plate composite seems to be an effective method for the precise revision of PHER in patients with severe periprosthetic osteolysis. In addition, it also provides a novel method for similar revision surgery of other joints or primary endoprosthetic replacement with severe bone defects.

Keywords: 3D-printed; Aseptic loosening; Endoprosthetic replacement; Proximal humerus; Revision.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Neoplasms* / pathology
  • Bone Neoplasms* / surgery
  • Computer-Aided Design
  • Humans
  • Humerus / surgery
  • Male
  • Osteolysis* / surgery
  • Printing, Three-Dimensional
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation / methods
  • Retrospective Studies
  • Treatment Outcome