Comparison of the efficacy of allogeneic bone transplantation versus three-dimensional-printed prosthesis for Campanacci grade Ⅲ or recurrent giant cell tumors in the distal radius
Objective:To investigate the clinical efficacy of allogeneic bone transplantation and three-dimensional(3D)-printed prosthesis for the treatment of giant cell tumor bone(GCTB)in the distal radius.Methods:A retrospective analysis was conducted on 42 patients with Campanacci grade Ⅲ or recurrent GCTB in the distal radius treated at West China Hospital of Sichuan University from March 2013 to July 2020.Nineteen patients who underwent allogeneic bone transplantation were included in the allograft group,and 23 patients who underwent 3D-printed prosthesis reconstruction were included in the custom prosthesis group.The wrist range of motion(ROM),visual analogue scale(VAS),grip strength,Mayo wrist function score and Musculoskeletal Tumor Society(MSTS)score were recorded in both groups before surgery and at the final follow-up,as well as wrist degeneration and complications during the follow-up period.Results:The follow-up period for the allograft group ranged from 37 to 120 months,with an average of(74.6±29.0)months;for the prosthesis group,it ranged from 37 to 88 months,with an average of(68.9±17.1)months.At the final follow-up,the ROM(extension,flexion,supination,pronation),grip strength,VAS score,Mayo wrist function score and MSTS score were significantly improved in both groups than those before surgery(all P<0.05).Compared with the allograft group,the prosthesis group demonstrated higher ROM(extension,flexion),Mayo wrist function score and MSTS score at the final follow-up(all P<0.05).The complications in the allograft group included one case of long-term infection,one case of allograft resorption and four cases of wrist subluxation.All patients in this group developed wrist degenerative changes,with an average duration of(8.8±2.9)months.In the prosthesis group,there were three cases of wrist subluxation,three cases of distal radioulnar joint separation,and no cases of wrist degeneration.Conclusions:Compared with allogeneic bone transplantation reconstruction,3D-printed prosthesis reconstruction can better preserve part of the function of the wrist joint,and has certain advantages in the treatment of Campanacci grade Ⅲ or recurrent GCTB in the distal radius.
Allogeneic Bone Transplantation3D-printedProsthesisGiant Cell Tumor of BoneDistal Radius
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