Recently, the orthopedic team at Tonglu County Traditional Chinese Medicine Hospital successfully completed the first case in the county of hip joint revision surgery using a titanium alloy 3D printed pelvic prosthesis. The success of this surgery not only marks a revolutionary breakthrough in the field of complex bone and joint injury repair and reconstruction at our hospital but also demonstrates that our orthopedic treatment level has reached an advanced level within the province.
Ten Years of Old Injury with New DamagePatients and Doctors Overcoming Difficulties Together
The patient, Ms. Xi (pseudonym), had previously undergone total hip arthroplasty over ten years ago due to a fracture of the left femoral neck. Unfortunately, more than ten days ago, she fell again, resulting in severe pain and limited movement in her left hip. A CT scan from an external hospital indicated: loosening and displacement of the left acetabular prosthesis, accompanied by an acetabular fracture. Seeking further treatment, she came to the orthopedic department of Tonglu County Traditional Chinese Medicine Hospital.
After being admitted to the ward, Associate Chief Physician Ying Jianwei inquired in detail about her medical history and reviewed the imaging comprehensively, discovering that the prosthesis in her left acetabulum was severely loosened and displaced, accompanied by an acetabular fracture. Notably, there was extensive bone dissolution and bone loss around the prosthesis, leading to catastrophic damage to the pelvic structure. Traditional surgical methods were inadequate to address such a complex situation, and the prognosis was not optimistic.
Faced with this severe challenge, the department team repeatedly discussed and unanimously agreed that the use of the cutting-edge “3D printed personalized titanium alloy pelvic prosthesis reconstruction technology” in the field of orthopedic wound repair could provide the best treatment outcome for the patient.
3D Printed Pelvic Prosthesis
However, this also means that a prosthesis must be “tailored” for the patient, requiring precise design and manufacturing of a titanium alloy prosthesis that perfectly matches the defect area, significantly increasing the technical difficulty and surgical risk.
Faced with this situation, Ms. Xi expressed her willingness to undergo this high-difficulty surgery, stating: “The orthopedic department at the county hospital has a well-recognized reputation, and I have confidence in you.”
Confronting Extreme DifficultyClimbing the “Everest” of Orthopedic Surgery
The 3D printed pelvic reconstruction surgery is regarded as the “Everest” in the orthopedic field, with extraordinary difficulty.
1. Difficulty in Design and Manufacturing: It requires precise CT data of the patient to create a three-dimensional model, reconstructing a prosthesis that is a 1:1 match to the anatomical structure; any slight deviation could lead to surgical failure.
2. Difficulty in Surgical Operation: During the surgery, precise operations must be performed amidst the complex pelvic nerves and vascular bundles to completely remove the loose prosthesis, clean the damaged bone tissue, and implant the new 3D printed prosthesis with millimeter precision, which is a test of the chief surgeon’s experience, skills, and psychological resilience.
3. High Perioperative Risks: Postoperative complications such as infection, flap necrosis, joint dislocation, and deep vein thrombosis are common, and any oversight could lead to failure.
Close Multidisciplinary CollaborationPostoperative Recovery Exceeds Expectations
To ensure the surgery’s success, the hospital initiated a multidisciplinary collaboration (MDT) model. Before the surgery, experts from orthopedics, anesthesiology, the operating room, radiology, and critical care medicine gathered for a comprehensive consultation, formulating a detailed surgical plan, emergency response plan, and postoperative rehabilitation plan tailored for Ms. Xi.
On the day of the surgery, under the guidance of experts from a higher-level hospital, the surgical team faced the challenge head-on. The anesthesiology and surgical nursing teams worked closely together, and Chief Physician Tian Xiaojun led the team to perform meticulous dissection and precise implantation in the “zone of life,” successfully implanting the 3D printed titanium alloy pelvic prosthesis that was a 1:1 accurate reconstruction into the defect area, achieving both structural and functional reconstruction.
Postoperatively, under the careful treatment and care of the medical team, Ms. Xi successfully overcame multiple challenges such as wound infection, flap necrosis, joint dislocation, and deep vein thrombosis, recovering well and has now been discharged.
Expert Introduction
Tian Xiaojun
Chief Physician, leader of the joint specialty at the hospital, and head of the joint disease ward (Ward 4). He is a member of the Osteoporosis Professional Committee of the Zhejiang Province Rehabilitation Medicine Association, a member of the Orthopedic Branch of the Hangzhou Medical Association, and a member of the Tuberculosis Surgery Committee of the Hangzhou Chinese and Western Medicine Association. He has published multiple professional papers in national and provincial academic journals and has led and participated in several municipal and county-level projects.
With over 30 years of clinical experience in orthopedics, he has frequently studied joint replacement surgery and traditional Chinese medicine conservative treatment at higher-level hospitals, gaining rich experience in the combined treatment of knee osteoarthritis and avascular necrosis of the femoral head.
He specializes in hip and knee joint replacement surgeries, various traumatic fractures, joint fractures, arthritis, spinal diseases, and age-related osteoporotic fractures. Advocating for “precise assessment and individualized treatment,” he is committed to providing patients with the least traumatic and fastest recovery treatment plans.
Consultation Hours: Every Wednesday morning
Ying Jianwei
Associate Chief Physician, Master’s degree, Deputy Director of the Orthopedic Ward 4 at Tonglu County Traditional Chinese Medicine Hospital, trained under Professor Yao Xinmiao, a renowned traditional Chinese medicine expert in Zhejiang Province. He is a successor of the seventh batch of national renowned old Chinese medicine experts, a member of the Osteoporosis and Bone Mineral Disease Professional Committee of the Zhejiang Province Medical Association, a member of the first session of the Wound Repair Professional Committee of the Zhejiang Province Medical Association, a seventh session youth member of the Orthopedic Branch of the Zhejiang Province Chinese Medicine Association, a second session youth committee member of the Spinal Manipulation Branch of the Zhejiang Province Chinese Medicine Association, and a second-tier high-level talent in Hangzhou. He has received honors such as “Most Beautiful Doctor in Tonglu County” and has published over ten papers in core journals, leading five municipal and county-level projects.
He has frequently studied hip and knee joint replacement techniques under Professor He Rongxin at the Second Affiliated Hospital of Zhejiang University School of Medicine, obtaining a standardized training certificate in joint replacement techniques in Zhejiang Province; he has also studied chronic ulcers and infected wound repair techniques under Professor Shen Lifeng at the Shao Yifu Hospital of Zhejiang University School of Medicine.
He specializes in the combined treatment of limb fractures, osteoarthritis, osteoporosis, chronic ulcers, and infections. His unique therapies include small needle knife treatment for shoulder periarthritis, tenosynovitis, arthritis, and neck, shoulder, waist, and leg pain.
Consultation Hours: Every Friday afternoon and Sunday morning
Dai Min
Associate Chief Physician of Integrated Traditional Chinese and Western Medicine, has published five papers in core journals and led one county-level project.With nearly 20 years of clinical experience in orthopedics, he specializes in trauma orthopedics,joint surgery, and the treatment of osteoporosis.
Consultation Hours: Every Tuesday morningEND
Source | Ward 4
Editor | Yuan Shuqian
Reviewer | Yang Jun
