Osteosarcoma is an aggressive, primary bone malignancy, with an Australian incidence of approximately 400 cases per year. It occurs during periods of rapid bone growth and thus mainly affects children and young adults. Surgical treatment of osteosarcoma can include full or partial limb amputation, or limb-salvage-surgery.
Limb-salvage surgery is the preferred method, as it has been linked to an increased 5-year survival rate, as well as providing the patient with improved quality of life post-surgery. However, the application of limb-salvage surgery can be limited by the size and location of the tumour and the availability of a suitable prosthesis to replace the removed bone. Current surgical techniques require the removal of a significant volume of healthy bone surrounding the tumour, and commercially available protheses may be ill-fitting and unable to accurately accommodate the strain of the surrounding bone.
The Just-in-time implants project is combining specialised imaging techniques, 3D printing and robotic-assisted surgery to address these issues, and therefore increase the feasibility and success of limb-salvage surgery.
The robotic assisted surgery allows for the excision of complex tumour morphologies, while reducing the surgical margin, leaving a greater volume of healthy bone intact. Additive manufacturing allows the design of novel geometries and complex lattice structures, without the constraints associated with traditional manufacturing methods. The personalised lattice provides a light-weight, perfectly fitting prothesis, that can match the mechanical properties of the surrounding bone.
By improving the surgical accuracy and prosthesis options, the Just-in-time workflow will allow surgeons to offer more patients limb-salvage surgery, and thus improve long term outcomes for these patients.