PDF(Pubmed)
Abstract：
OBJECTIVE: Parosteal Osteosarcoma is a well-differentiated, low-grade bone sarcoma. It most commonly occurs in the third decade of life, usually in the distal femur. This study aims to perform a literature review about the types of reconstructions reported and to analyze the results of an updated technique of resection using custom-made 3D-printed cutting guides.
METHODS: We perform a systematic literature review about parosteal osteosarcoma, evaluating treatments, margins, local recurrence, complications, and functional results when available. We also report a case treated in our Center with a revisited technique introducing custom-made 3D-printed cutting guides.
RESULTS: We analyzed 12 studies with a total of 151 patients. The distal femur was the most frequently reported site (81.5%). After distal femur resection, reconstruction was performed with graft in most cases (48%), followed by prosthetic reconstruction (40%). Margins were wide in 85.5% of cases. The total incidence of local recurrence was 11%. Functional results were excellent in all cases, with a mean MSTS score of 86%. In our case, with the help of the jigs, the surgical technique was relatively easy, graft fusion excellent and fast, margins wide, and functional results excellent.
CONCLUSIONS: In the literature, the most commonly used type of reconstruction after resection is biological with graft. Indeed, despite the increasing number of prosthetic reconstructions, the historical diaphysometaphyseal hemiresection and graft is still indicated in parosteal osteosarcoma of the distal femur. New technologies, such as the jigs we used, allow significant advantages during the procedure: reduce the resection and graft preparation time, allow a better match between components, and help to obtain safer margins, sparing as much bone as possible.
METHODS: We perform a systematic literature review about parosteal osteosarcoma, evaluating treatments, margins, local recurrence, complications, and functional results when available. We also report a case treated in our Center with a revisited technique introducing custom-made 3D-printed cutting guides.
RESULTS: We analyzed 12 studies with a total of 151 patients. The distal femur was the most frequently reported site (81.5%). After distal femur resection, reconstruction was performed with graft in most cases (48%), followed by prosthetic reconstruction (40%). Margins were wide in 85.5% of cases. The total incidence of local recurrence was 11%. Functional results were excellent in all cases, with a mean MSTS score of 86%. In our case, with the help of the jigs, the surgical technique was relatively easy, graft fusion excellent and fast, margins wide, and functional results excellent.
CONCLUSIONS: In the literature, the most commonly used type of reconstruction after resection is biological with graft. Indeed, despite the increasing number of prosthetic reconstructions, the historical diaphysometaphyseal hemiresection and graft is still indicated in parosteal osteosarcoma of the distal femur. New technologies, such as the jigs we used, allow significant advantages during the procedure: reduce the resection and graft preparation time, allow a better match between components, and help to obtain safer margins, sparing as much bone as possible.
摘要：
目的：骨旁骨肉瘤是一种分化良好的骨肉瘤，低级骨肉瘤.它最常见于生命的第三个十年，通常在股骨远端。本研究旨在对报告的重建类型进行文献综述，并分析使用定制的3D打印切割指南进行更新的切除技术的结果。
方法：我们对骨旁骨肉瘤，评估治疗，边距,局部复发,并发症,和功能结果（如果可用）。我们还报告了我们中心的一个案例，该案例采用了一种重新访问的技术，该技术引入了定制的3D打印切割指南。
结果：我们分析了12项研究，共151例患者。股骨远端是最常报告的部位（81.5%）。股骨远端切除后,在大多数情况下（48％）使用移植物进行重建，其次是假体重建（40％）。在85.5%的病例中，利润率很高。局部复发的总发生率为11%。在所有情况下功能结果都非常好，平均MSTS得分为86%。在我们的案例中,在夹具的帮助下,手术技术相对容易，移植物融合优异和快速，边距宽，和功能结果优秀。
结论：在文献中，切除后最常用的重建类型是生物移植。的确,尽管假体重建的数量越来越多，在股骨远端的骨旁骨肉瘤中，仍有历史上的骨解剖半切除和移植物。新技术,比如我们使用的夹具，在手术过程中允许显著的优势：减少切除和移植物准备时间，允许组件之间更好的匹配，并有助于获得更安全的利润，尽可能多地保留骨头。
方法：我们对骨旁骨肉瘤，评估治疗，边距,局部复发,并发症,和功能结果（如果可用）。我们还报告了我们中心的一个案例，该案例采用了一种重新访问的技术，该技术引入了定制的3D打印切割指南。
结果：我们分析了12项研究，共151例患者。股骨远端是最常报告的部位（81.5%）。股骨远端切除后,在大多数情况下（48％）使用移植物进行重建，其次是假体重建（40％）。在85.5%的病例中，利润率很高。局部复发的总发生率为11%。在所有情况下功能结果都非常好，平均MSTS得分为86%。在我们的案例中,在夹具的帮助下,手术技术相对容易，移植物融合优异和快速，边距宽，和功能结果优秀。
结论：在文献中，切除后最常用的重建类型是生物移植。的确,尽管假体重建的数量越来越多，在股骨远端的骨旁骨肉瘤中，仍有历史上的骨解剖半切除和移植物。新技术,比如我们使用的夹具，在手术过程中允许显著的优势：减少切除和移植物准备时间，允许组件之间更好的匹配，并有助于获得更安全的利润，尽可能多地保留骨头。
