Limb Sparing in Dogs using Individualized 3D-Printed Endoprostheses and Cutting Guides for Distal Radial Osteosarcoma: A Pilot Study

 

Introduction: Using 3D-printed “personalized” implants may reduce the risk of complications for limb sparing in dogs. A disadvantage is the time required to manufacture the implant. The goals were to assess the feasibility and outcome of using 3D-printed implants and cutting-guides in the clinical setting for dogs with distal radial osteosarcoma.

Materials and Methods: Data from a CT scan of both thoracic limbs were used to manufacture a cutting-guide and endoprosthesis. Intra-arterial carboplatin was administered after the CT starting with the second dog. A second CT was repeated before surgery where limb sparing was performed. Dogs were monitored postoperatively with physical examinations and chest and limb radiographs.

Results: Five dogs participated and 4 received intra-arterial carboplatin. For all dogs that received intra-arterial chemotherapy, no tumor substantially increased in dimension between initial CT and surgery. All specimens had complete margins. Four dogs had a complication: 4 had an infection and one each had a skin laceration, skin necrosis, fracture of the radius, implant pulling out of the radius, and local recurrence. Two dogs required an amputation. One dog had a survival time of 192 days. The other 4 dogs were alive with a follow-up period of 293 to 377 days.

Discussion/Conclusion: 3D-printed personalized implants were successfully manufactured in the clinical setting. To allow more time between CT and surgery without the tumor getting significantly larger, intra-arterial carboplatin was administered. Intra-arterial carboplatin appears to be an effective strategy to prevent the tumor to grow excessively during the design and manufacturing periods. Complications remained common.

Acknowledgment: VOI Inc.