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Wang J, Zhou Y, Wang YT, Min L, Zhang YQ, Lu MX, Tang F, Luo Y, Zhang YH, Zhang XL, Tu CQ. Three-dimensional-printed custom-made patellar endoprosthesis for recurrent giant cell tumor of the patella: A case report and review of the literature. World J Clin Cases 2021; 9:2524-2532. [PMID: 33889617 PMCID: PMC8040175 DOI: 10.12998/wjcc.v9.i11.2524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/04/2021] [Accepted: 02/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Giant 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 SUMMARY A 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.
CONCLUSION We 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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Affiliation(s)
- Jie Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yong Zhou
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Tian Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Li Min
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Qi Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Min-Xun Lu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Fan Tang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Luo
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ya-Han Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xian-Liang Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chong-Qi Tu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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