Hanoi: A 63-year-old man with bone cancer that invaded the entire structure around the hip joint and pelvis was treated by doctors and engineers who designed artificial bones.
On January 22, Prof. Dr. Tran Trung Dung, Director of the Center for Orthopedics and Sports Medicine, Vinmec Hospital, said that for the first time in Vietnam, experts simultaneously replaced the pelvis and part of the femur in one surgery to treat a rare type of bone cancer.
"The surgery used a new 3D-printed artificial bone design designed by a team of Vietnamese doctors and engineers, tested through nearly 100 simulation situations to achieve the highest level of optimization, helping to save lives and speed up recovery time for patients," said Professor Dung.
The patient, who is from Thanh Hoa, was found to have bone cancer, which is very rare in the pelvic bone. Meanwhile, the cancer had invaded the entire structure around the hip joint, including the pelvis, joint capsule, and upper end of the femur. Because it is a complex disease, many hospitals do not have an optimal solution, most of them only recommend surgery to remove one side of the pelvis. However, this method leaves many limitations such as the body being disabled, lying in one place, severe psychological effects, low survival rate after surgery, and the patient refusing treatment.
When receiving the case, Dr. Dung determined that the key was that after radical surgery to remove the malignant tissue, the pelvic and femoral bone defects had to be reconstructed, helping the patient move and walk. The most difficult problem was choosing the type of material and the method of artificial bone grafting to recreate the shape and function of the bone in the area that bears the greatest weight of the body after it was removed.
There have been several cases of 3D printed titanium pelvic bone replacement reported worldwide. However, to date, there has been no case of simultaneous pelvic bone and upper femur replacement for cancer treatment, according to Professor Dung. Other bone shaping solutions such as using screws and plates, PEEK bone grafts cannot create a biological connection with the pelvic bone, or are not strong enough to withstand the body's gravity, and it is difficult to restore tendon attachment points. Therefore, after surgery, the patient's ability to sit, stand or walk is very limited.
Finally, the team came up with a solution to design their own artificial bone implant for this patient because he needed surgery as soon as possible to prevent the tumor from progressing and invading.
Dr. Pham Trung Hieu, Deputy Director of the Center for 3D Technology in Medicine, VinUni University, said that after more than 2 weeks of racing against time, continuously testing on nearly 100 samples of different shapes and structures, the team selected the most optimal design for the case. The surgery was carried out promptly, just after nearly a month of the patient being hospitalized.
The patient was able to move skillfully with crutches up to 50m after 10 days of surgery. Photo: Le Nga
The surgery on both sites was successful after 8 hours, without complications. Normally, if only the pelvic bone is replaced, the surgery time can last 8-12 hours.
On the second postoperative day, the patient was able to sit up steadily and walk with crutches up to 50 m after 10 days. The recovery time in this case, when compared with some domestic and international reports on artificial hip replacement, was shortened to only 1/3 of the time.
"When I watched the computer simulation before the surgery, my hope of being able to walk was just a little bit. Now, I can actually walk again," the patient said.
Le Nga
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