PMC10090529_01
(A-D) Lower left extremity imaging examination.
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F1
The X-ray and computed tomography (CT) scan of the left tibia and fibula showed that there was a mass occupying the proximal end of the left tibia (Figure 1A and B). MRI showed multiple mass-occupying masses in the proximal left tibia, which may be benign (Figure 1C).
Design and printing of bioactive bone.
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F2
The bioprinted active bone was designed and printed with the CT scan data obtained before the surgery (Figure 2), and the whole process of printing was carried out in a 10,000 level GMP laboratory.
Tumor resection of the left tibia and implantation process of the bioprinted active bone.
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F3
PRP was prepared by two rounds of centrifugation. PCL/beta-TCP composite material and autologous PRP gel were then printed layer by layer through dual channels to obtain bioprinted active bone with a porosity of approximately 55% (Figure 3A), which was then placed in normal saline for later use. The marginal tissue of the inner wall of the tibia was removed with a grinding drill and rinsed repeatedly with hydrogen peroxide and normal saline (Figure 3B). PCL/beta-TCP/PRP active bone scaffold was taken and implanted into the proximal tibial bone defect, and an 8-hole tibial locking plate was implanted externally, followed by screw fixation (Figure 3C and D). Post-operative pathological testing revealed that the condition was osteofibrous dysplasia; in addition, the patient had a good post-operative wound recovery and normal results in routine blood tests.
Post-operative X-ray and CT examination of the lower left extremity. (A-C) Two days after the operation. (D-F) Seven-month follow-up.
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F4
After reviewing the X-ray and CT scan, we found that the plate screw was in place (Figure 4A-C). After 7 months, the implant was well integrated, and new bone formation was detectable by X-ray and CT (Figure 4D-F).