Three-dimensional-printed custom-made patellar endoprosthesis for recurrent giant cell tumor of the patella: A case report and review of the literature |
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Authors: | Jie Wang Yong Zhou Yi-Tian Wang Li Min Yu-Qi Zhang Min-Xun Lu Fan Tang Yi Luo Ya-Han Zhang Xian-Liang Zhang Chong-Qi Tu |
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Institution: | Jie Wang, Yong Zhou, Yi-Tian Wang, Li Min, Yu-Qi Zhang, Min-Xun Lu, Fan Tang, Yi Luo, Chong-Qi Tu, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, ChinaYa-Han Zhang, Xian-Liang Zhang, Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China |
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Abstract: | BACKGROUNDGiant cell tumor (GCT) is a benign lesion and rarely involves the patella. This disease is characterized by a relatively high recurrence rate after primary treatment. En bloc resection has been a predominant option for recurrent GCT. However, total patellectomy can lead to disruption of the knee. Therefore, exploration of functional reconstruction of the extensor mechanism is worthwhile.CASE SUMMARYA 54-year-old woman presented with right knee pain and swelling, and was diagnosed as having a GCT in the patella following curettage and autograft. Medical imaging revealed a lytic and expanded lesion involving the whole patella with focal cortical breaches and pathological fracture. Based on the combination of histological, radiological, and clinical features, a diagnosis of recurrent GCT in the patella was made (Campanacci grade III). After a multidisciplinary team discussion, three-dimensional (3D)-printed custom-made patellar endoprosthesis was performed following en bloc resection for reconstructing the extensor mechanism. The patient was followed for 35 mo postoperatively. No evidence of local recurrence, pulmonary metastasis, or osteoarthritis of the right knee was observed. The active flexion arc was 0°-120°, and no extension lag was detected. A favorable patellar tracking and height (Insall-Salvati ratio 0.93) were detected by radiography.CONCLUSIONWe depict a case of a GCT at the right patella, which was successfully treated by patellectomy and 3D-printed custom-made endoprosthetic replacement. The patella normal reconstruction, the precise-fit articular design, and gastrocnemius flap augmentation could lead to satisfactory knee function and a low rate of complications in the short-term follow-up. |
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Keywords: | Giant cell tumor of bone Patellectomy Three-dimensional-printed Endoprosthesis Biological reconstruction Extensor mechanism Case report |
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