Oncologists have used 3D printing technique to save the knee joint and limb of an eight-year-old boy diagnosed with bone cancer. Akhilan of Ramanathapuram underwent biological reconstruction.
He was diagnosed with non-metastatic osteosarcoma of his left upper tibia. He had undergone neoadjuvant chemotherapy for five months and approached the Apollo Proton Cancer Centre (APCC) for local site surgery, according to Vishnu Ramanujan, consultant orthopaedic oncologist.
The tumour was very close to the knee joint but a clear area of 0.5 cm of normal bone was present between them. “This is where 3D printing helped us….The 3D model helped us to visualise and understand the surgical challenges so that we could reconstruct for the exact fit,” he added.
The child underwent MRI and CT scan to map out the tumour area. The images were fused to create a three-dimensional view of the bone containing the tumour. A 3D-printed cutting jig allowed the surgeon pinpoint accuracy while obtaining the bone cut and saved the native knee joint, a press release said.
During surgery, the bone was removed, put through a large dose of radiation and implanted using a 3D printed plate, enabling near normal growth of his bone, Dr. Ramanujan said.
Srinivas Chilukuri, senior consultant radiation oncologist (paediatric), said normally, the affected bone would be removed and an implant would be put in. “In this, we sterilised the bone completely. In extracorporeal radiation, the bone was taken from the body, and given to us. It was then irradiated. This very high dose is for complete destruction of the tumour,” he said. He added that the boy would be able to walk on his own in a few weeks.
Noting that APCC had a tumour board, Radhakrishnan Satheesan, senior consultant paediatric surgeon, said a multidisciplinary tumour board was important to come up with an evidence-based standard of care.
Rakesh Jalali, medical director and lead, neuro oncology, APCC, and Harish Trivedi, chief executive officer, APCC, were present.
