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Статьи | Клиника Ихилов

Innovative Articulating Prosthetic Design for Large Bone Defects

Innovative Articulating Prosthetic Design for Large Bone Defects Head Of Surgical Innovation and 3D Printing Unit&Deputy Director of Orthopaedic Oncology Department at Tel Aviv Medical center A 6 year old boy with high grade Osteosarcoma of his left femur. At presentation, the femur bone was massively involved therefore he went through total femur resection.

08, Jan 2019

Reconstruction after a total femur resection is challenging in all age groups. At the age of 6, it’s almost mission impossible. A standard lengthening prosthesis will need to be revised at least 3 to 4 times up to puberty, not to mention its high complication rate.

In this case we demonstrate innovative approach to “gain time” for the final reconstruction by using a standard IM nail combined with a 3D printed customized femoral neck, to preform unique arthrodesis spacer.

At first, we insert a temporary solution that was a combination of IM nail, a bended pin and a metal 28mm femoral head and cement, to create an arthrodesis spacer that preserves hip movements.

After 8 months this improvised solution had failed. The main mechanical problem was the attachment of the pin to the IM nail.

This mechanical problem was addressed by 3D printing technology. A 3D printed femoral neck component was designed to fit the Proximal part of the IM nail and on the other side to embrace a standard femoral head. The tapping mechanism was taken into consideration as well as a locking screw to fix the 3D printed component to IM nail.

Two years later, the child is ambulating with no assistance and full stability. No signs of loosening or breakage and a stable hip is confirmed by follow-up X-rays.

Although this innovative solution was created according to the specific needs of this patient, it can be appropriate for a variety of long bone defect cases requiring temporary reconstructions due to reasons such as infection.

This case demonstrates the effectiveness of an in-house lab where designers and engineers can translate the ideas of the surgeons immediately.

Thanks to Synergy3Dmed team who designed this component according to the specific nail that was already in the patient’s body.

Surgeons: Dr. Yair Gortzak and Dr. Solomon Dadia at Tel Aviv Medical Center, Israel

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