Use of three-dimensional printing and intraoperative navigation in the surgical resection of metastatic acetabular osteosarcoma

BMJ Case Rep. 2019 Sep 30;12(9):e230238. doi: 10.1136/bcr-2019-230238.

Abstract

A 21-year-old man underwent a joint-preserving posterior acetabular resection of metastatic osteosarcoma using a three-dimensional (3D) printed model and intraoperative navigation. The combined application of these advanced technologies can allow for surgical planning of osteotomies involving complex anatomy and help guide resections intraoperatively. They can maximise the achievement of negative oncological margins, preservation of native hip stability and critical neurovascular structures, and optimal postoperative function in an effort to resect all clinically evident disease. For this particular patient, with secondary bony metastases, they allowed for a safe and well-tolerated procedure that ultimately afforded him palliative benefit, improved quality of life and, conceivably, prolonged survival in the setting of a devastating prognosis. Although he, sadly, has since passed away, he survived for over 2 years after initial metastasis with preserved hip stability and the ability to graduate college, stay active and maintain a quality of life that addressed his goals of care.

Keywords: end of life decisions (palliative care); orthopaedic and trauma surgery; orthopaedics; palliative care; palliative procedures.

Publication types

  • Case Reports

MeSH terms

  • Acetabulum / pathology*
  • Acetabulum / surgery
  • Bone Neoplasms / secondary*
  • Bone Neoplasms / surgery
  • Fatal Outcome
  • Humans
  • Male
  • Margins of Excision
  • Osteosarcoma / secondary*
  • Osteosarcoma / surgery
  • Osteotomy
  • Palliative Care
  • Printing, Three-Dimensional / instrumentation*
  • Quality of Life
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed
  • Young Adult