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The Accuracy of Three-Dimensional Planned Bone Tumor Resection Using Patient-Specific Instrument

Authors Müller DA, Stutz Y, Vlachopoulos L, Farshad M, Fürnstahl P

Received 20 August 2019

Accepted for publication 23 June 2020

Published 29 July 2020 Volume 2020:12 Pages 6533—6540


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Chien-Feng Li

Daniel A Müller,1 Yannik Stutz,1 Lazaros Vlachopoulos,1 Mazda Farshad,1 Philipp Fürnstahl2

1Department of Orthopedic Surgery, Balgrist University Hospital, Zürich 8008, Switzerland; 2Computer Assisted Research & Development Group, Balgrist University Hospital, Zürich 8008, Switzerland

Correspondence: Daniel A Müller
Balgrist University Hospital, Forchstrasse 340, Zürich CH-8008, Switzerland
Tel +41 44 386 11 11
Fax +41 44 386 11 09

Introduction: Although treatment of bone tumors is multidisciplinary, the complete surgical resection of bone tumors remains the mainstay of the treatment. Patient-specific instruments (PSI) are personalized tools, which help the surgeon to perform tumor resections accurately. The aim of this study is to evaluate how precise the planned resection can be intraoperatively executed with the use of PSI.
Patients and Methods: Eleven patients who underwent a resection of bone tumor using PSI were analyzed. A preoperative model of the tumor and the affected bone was created from acquired CT scans and MRI. After defining the resection planes, PSI were produced by a 3D printer. The resected piece of bone was scanned and imported in the original planning model enabling the assessment of the distance between the planned resection plane and the realized osteotomy in every direction.
Results: In overall, the combined error of an osteotomy ranges from 0.74 ± 0.96 mm to 3.60 ± 2.46 mm. The average errors observed in situations with one resection plane (simple osteotomy) are lower than in complex curved osteotomies with multiple planes, in which we also found a greater variance.
Conclusion: 3D planned bone tumor resections using PSI show promising results for precise resection at different anatomical regions. Even if the found error range in this series is slightly higher than reported, PSI remain a valuable tool to facilitate complex bone tumor resections.

Keywords: bone tumor, patient-specific instruments, 3D resection, surgical guide, limb salvage surgery

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