"In-house" Design and Use of 3-dimensional Printed Patient-specific Bone Tumor Resection Guides for Geometric Osteotomies in Sarcoma Surgery

Three-dimensional printing technology has rapidly advanced as a promising technology for preoperative planning, education, and surgical execution in orthopedic surgery. Use of patient-specific instrumentation in orthopedic oncology sarcoma cases can streamline complex osteotomies while providing safe margins based on predetermined osteotomy levels. We describe use of an "in-house" protocol to create patient-specific bone tumor resection guides for use in orthopedic oncology cases. The described protocol bypasses expensive outsourcing options and facilitates use of preoperative surgical simulation and intimate involvement of the surgical team in the guide design. We report on the successful design and use of three-dimensional printed patient-specific bone tissue resection guides in a case of proximal tibial parosteal osteosarcoma resection and reconstruction with a size-matched allograft, and in a case of a secondary pelvic chondrosarcoma resection.