Upper and Lower Body Orthopedic Oncology Solutions
Complex pelvic chondrosarcoma – Digital Planning, Models & Guides
A patient diagnosed with a complex chondrosarcoma arising from an
osteochondroma required surgery to partially remove areas of the right part of their pelvis. The large tumour involved numerous soft tissue structures and surgery would require a multi-disciplinary team. The surgeon requested surgical guides to help facilitate the safe and effective removal of the tumour and compromised anatomy, in the form of a hemipelvectomy from the right ilium (between the sciatic notch and the superior/inferior iliac spine) to the contralateral pubis.
Two surgical guides were devised once the optimum cutting planes were determined by the surgeon. The first guide transected from the sciatic notch, while the second transected through the contralateral pubis.
Outcome / Benefits
Together with the anatomical model these products gave the clinical team a deeper understanding of the patients anatomy both pre- and intraoperatively. The guides facilitated the resection with clear margins
and provided the potential for later custom reconstruction of the patient’s hip.
Custom Reconstruction Following Resection of Ewing’s Sarcoma – Digital Planning, Models & Guides & Implant
This adolescent patient presented with a tumour of the left pelvis which breached the acetabulum. A request was made by the clinical team for digital planning and patient-specific cutting guides to facilitate clear margins following the resection. A custom titanium acetabular implant was also requested to help restore some range of motion to the patient postoperatively
A virtual 3D model was created from overlayed CT and MRI scans of the patient. During a review with the surgeon a 10mm margin around the tumour was agreed and subsequent cutting planes approved. From this the insight surgery engineer constructed surgical cutting guides to resect the desired bone, and a patient-specific implant was designed to full the recess. This implant was printed in titanium and incorporated porous mesh at bone-contact surfaces to promote osseointegration and mirrored surface finish at the articular surface.
Outcomes and Benefits
The use of this implant allowed the surgical team to preserve the patient’s mobility rather than having to resort to a hanging-hip procedure which would greatly reduce the patient’s quality of life.