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Novel exploration of 3D printed wrist arthroplasty to solve the severe and complicated bone defect of wrist

Qing Han (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)
Yanguo Qin (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)
Yun Zou (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)
Chenyu Wang (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)
Haotian Bai (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)
Tao Yu (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)
Lanfeng Huang (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)
Jincheng Wang (Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China)

Rapid Prototyping Journal

ISSN: 1355-2546

Article publication date: 18 April 2017

462

Abstract

Purpose

Although proximal row carpectomy, wrist arthrodesis and even total wrist arthroplasty were developed to treat wrist disease using bone and cartilage of the wrist, severe and complicated bone defects caused by ferocious trauma and bone tumors remain a stubborn problem for surgeons. Development and application of the three-dimensional (3D) printing technology may provide possible solutions.

Design/methodology/approach

Computed tomography (CT) data of three cases with severe bone defects caused by either trauma or bone tumor were collected and converted into three-dimensional models. Prostheses were designed individually according to the residual anatomical structure of the wrist based on the models. Both the models and prostheses were produced using 3D printing technology. A preoperative design was prepared according to the models and prostheses. Then arthroplasty was performed after preoperative simulation with printed models and prostheses.

Findings

The diameter of the stem and radial medullary cavity, the direction and location of the prosthesis, and other components were checked during the preoperative design and simulation process phases. The three cases with 3D printed wrist all regained reconstruction of normal anatomy and part of the function after surgery. The average increasing Cooney score rate of Cases 2 and 3 was 133.34 ± 23.57 per cent, and that of Case 1 reached 85 per cent. The average declining rate of the Gartland and Werley Score in Cases 2 and 3 was 65.21 ± 18.89 per cent, and that of Case 1 dropped to 5 per cent in the last follow-up. The scores indicated that patients experienced pain relief and function regain. In addition, the degree of patient satisfaction improved.

Originality/value

3D printed wrist arthroplasty may provide an effective method for severe and complicated cases without sacrificing other bones. Personal customization can offer better anatomy and function than arthrodesis or other traditional surgical techniques.

Keywords

Citation

Han, Q., Qin, Y., Zou, Y., Wang, C., Bai, H., Yu, T., Huang, L. and Wang, J. (2017), "Novel exploration of 3D printed wrist arthroplasty to solve the severe and complicated bone defect of wrist", Rapid Prototyping Journal, Vol. 23 No. 3, pp. 465-473. https://doi.org/10.1108/RPJ-01-2016-0005

Publisher

:

Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited

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