Custom Three-Dimensional-Printed Implants for Tibial and Femoral Segmental Defects: A Systematic Review and Meta-Analysis
-
Seyyed Hadi Kalantar
,
Omid Salkhori
,
Nima Bagheri
,
Seyyed Saeed Khabiri
,
Aidin Arabzadeh
,
Alireza Talebi
,
Hadi Jahanbin
,
Seyed Mohammadjavad Mortazavi
,
Hamed Naghizadeh
Abstract
Background: Segmental bone defects of the lower extremity, particularly involving the femur and tibia, remain a major reconstructive challenge. Traditional techniques such as the Ilizarov method, Masquelet’s induced membrane, and vascularized fibular grafts are effective but often associated with prolonged treatment duration and significant morbidity. Recent advances in additive manufacturing have introduced patient-specific three-dimensional (3D)-printed implants as a promising alternative.
Methods: This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was conducted to collect current knowledge on 3D-printed implants of the tibia and femur. Databases including PubMed, Scopus, Embase, and Web of Science were searched from January 2000 to April 2025 for studies reporting outcomes of treatment of tibial or femoral segmental bone defects. Primary outcomes included bone union rate and complications. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) tool, and pooled data were analyzed using a random-effects model.
Results: Seventeen studies involving 174 patients were included. The mean bone defect length was 12.3 cm, and the mean follow-up was 27.2 months. The pooled union rate was 92.4% [95% confidence interval (CI): 89.0%-94.8%], with no statistically significant heterogeneity (I2 = 0%). The mean time to radiological union was 7.66 months. The pooled complication rate was 23.5% (95% CI: 15.6%- 33.8%), with reoperation, deep infection, and device-related events being the most common. Assessment of publication bias revealed no statistically significant effect.
Conclusion: Custom-made 3D-printed implants represent a highly effective and safe option for the reconstruction of segmental bone defects in the lower extremity. The high union rate and acceptable complication profile support their utility in managing complex cases. Further prospective studies are needed to confirm these findings and define optimal indications.
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2. Chen Z, Xing Y, Li X, Liu B, Liu N, Huo Y, et al. 3D-printed titanium porous prosthesis combined with the Masquelet technique for the management of large femoral bone defect caused by osteomyelitis. BMC Musculoskelet Disord. 2024;25(1):474. doi: 10.1186/s12891-024-07576-x. [PubMed: 38880911]. [PubMed Central: PMC11181595].
3. Woon CY, Chong KW, Wong MK. Induced membranes--a staged technique of bone-grafting for segmental bone loss: a report of two cases and a literature review. J Bone Joint Surg Am. 2010;92(1):196-201. doi: 10.2106/jbjs.I.00273. [PubMed: 20048113].
4. Levin LS. Vascularized fibula graft for the traumatically induced long-bone defect. J Am Acad Orthop Surg. 2006;14(10 Spec No.):S175-6. doi: 10.5435/00124635-200600001-00038. [PubMed: 17003193].
5. YinP,JiQ,LiT,LiJ,LiZ,LiuJ,etal.ASystematicReviewand Meta-Analysis of Ilizarov Methods in the Treatment of Infected Nonunion of Tibia and Femur. PLoS One. 2015;10(11):e0141973. doi: 10.1371/journal.pone.0141973. [PubMed: 26529606]. [PubMed Central: PMC4631548].
6. Liu B, Tan Q, Wang Z, Hou G, Wang C, Tian Y. Applying 3D-Printed Porous Ti6Al4V Prostheses to Repair Osteomyelitis-Induced Partial Bone Defects of Lower Limbs: Finite Element Analysis and Clinical Outcomes. Orthop Surg. 2025;17(1):115-24. doi: 10.1111/os.14268. [PubMed: 39429061]. [PubMed Central: PMC11735359].
7. Chen Z, Yang Y, Liu B, Li X, Tian Y. Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases. BMC Musculoskelet Disord. 2024;25(1):1090. doi: 10.1186/s12891-024-08248-6. [PubMed: 39736569]. [PubMed Central: PMC11687145].
8. Wu Y, Shi X, Zi S, Li M, Chen S, Zhang C, et al. The clinical application of customized 3D-printed porous tantalum scaffolds combined with Masquelet’s induced membrane technique to reconstruct infective segmental femoral defect. J Orthop Surg Res. 2022;17(1):479. doi: 10.1186/s13018-022-03371-3. [PubMed: 36335402]. [PubMed Central: PMC9636627].
9. Liu B, Wang L, Li X, Chen Z, Hou G, Zhou F, et al. Applying 3D-printed prostheses to reconstruct critical-sized bone defects of tibial diaphysis (> 10 cm) caused by osteomyelitis and aseptic non-union. J Orthop Surg Res. 2024;19(1):418. doi: 10.1186/s13018-024-04926-2. [PubMed: 39033286]. [PubMed Central: PMC11264997].
10. Tetsworth K, Woloszyk A, Glatt V. 3D printed titanium cages combined with the Masquelet technique for the reconstruction of segmental femoral defects: Preliminary clinical results and molecular analysis of the biological activity of human-induced membranes. OTA Int. 2019;2(1):e016. doi: 10.1097/oi9.0000000000000016. [PubMed: 33937652]. [PubMed Central: PMC7953522].
11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021;372:n71. doi: 10.1136/bmj.n71. [PubMed: 33782057]. [PubMed Central: PMC8005924].
12. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712-6. doi: 10.1046/j.1445-2197.2003.02748.x. [PubMed: 12956787].
13. Attias N, Thabet AM, Prabhakar G, Dollahite JA, Gehlert RJ, DeCoster TA. Management of extra-articular segmental defects in long bone using a titanium mesh cage as an adjunct to other methods of fixation. Bone Joint J. 2018;100-B(4):646-51. doi: 10.1302/0301-620x.100b5.Bjj-2017-0817.R2. [PubMed: 29701099].
14. Gamieldien H, Ferreira N, Birkholtz FF, Hilton T, Campbell N, Laubscher M. Filling the gap: a series of 3D-printed titanium truss cages for the management of large, lower limb bone defects in a developing country setting. Eur J Orthop Surg Traumatol. 2023;33(3):497-505. doi: 10.1007/s00590-022-03434-5. [PubMed: 36385681].15. Ma XY, Yuan H, Cui D, Liu B, Han TY, Yu HL, et al. Management of segmental defects post open distal femur fracture using a titanium cage combined with the Masquelet technique A single- centre report of 23 cases. Injury. 2023;54(12):111130. doi: 10.1016/j.injury.2023.111130. [PubMed: 37890289].
16. Gavaskar AS, Parthasarathy S, Balamurugan J, Raj RV, Chander VS, Ananthkrishnan LK. A load-sharing nail - cage construct may improve outcome after induced membrane technique for segmental tibial defects. Injury. 2020;51(2):510-5. doi: 10.1016/j.injury.2019.11.031. [PubMed: 31787329].
17. Attias N, Lindsey RW. Case reports: management of large segmental tibial defects using a cylindrical mesh cage. Clin Orthop Relat Res. 2006;450:259-66. doi: 10.1097/01.blo.0000223982.29208.a4. [PubMed: 16702918].
18. Lodewijks A, Blokhuis T, van Griensven M, Poeze M. The Treatment of Very Large Traumatic Bone Defects of the Tibia with a Polycaprolactone-Tricalcium Phosphate 3D-Printed Cage: A Review of Three Cases. Cureus. 2024;16(8):e66256. doi: 10.7759/cureus.66256. [PubMed: 39238727]. [PubMed Central: PMC11375482].
19. LiuB,HouG,YangZ,LiX,ZhengY,WenP,etal.Repairof critical diaphyseal defects of lower limbs by 3D printed porous Ti6Al4V scaffolds without additional bone grafting: a prospective clinical study. J Mater Sci Mater Med. 2022;33(9):64. doi: 10.1007/s10856-022-06685-0. [PubMed: 36104513]. [PubMed Central: PMC9474430].
20. Caravelli S, Ambrosino G, Vocale E, Di Ponte M, Puccetti G, Perisano C, et al. Custom-Made Implants in Ankle Bone Loss: A Retrospective Assessment of Reconstruction/Arthrodesis in Sequelae of Septic Non-Union of the Tibial Pilon. Medicina (Kaunas). 2022;58(11). doi: 10.3390/medicina58111641. [PubMed: 36422180]. [PubMed Central: PMC9692516].
21. Beatti MA, Zublin Guerra CM, Guichet DM, Pellecchia TS. Defectos óseos segmentarios: uso de implantes de titanio trabecular diseñados a medida. Rev Asoc Argent Ortop Traumatol 2022;87(2):219-37. doi: 10.15417/issn.1852- 7434.2022.87.2.1436.
22. Liu B, Li X, Qiu W, Liu Z, Zhou F, Zheng Y, et al. Mechanical Distribution and New Bone Regeneration After Implanting 3D Printed Prostheses for Repairing Metaphyseal Bone Defects: A Finite Element Analysis and Prospective Clinical Study. Front Bioeng Biotechnol. 2022;10:921545. doi: 10.3389/fbioe.2022.921545. [PubMed: 35721863]. [PubMed Central: PMC9204204].
23. Blum AL, BongioVanni JC, Morgan SJ, Flierl MA, dos Reis FB. Complications associated with distraction osteogenesis for infected nonunion of the femoral shaft in the presence of a bone defect: A retrospective series. J Bone Joint Surg Br. 2010;92(4):565-70. doi: 10.1302/0301-620x.92b4.23475. [PubMed: 20357336].
24. Hamiti Y, Yushan M, Yalikun A, Lu C, Yusufu A. Matched comparative study of trifocal bone transport versus induced membrane followed by trifocal bone transport in the treatment of segmental tibial defects caused by posttraumatic osteomyelitis. BMC Musculoskelet Disord. 2022;23(1):572. doi: 10.1186/s12891-022-05501-8. [PubMed: 35701789]. [PubMed Central: PMC9195234].
25. Khaled A, El-Gebaly O, El-Rosasy M. Masquelet-Ilizarov technique for the management of bone loss post debridement of infected tibial nonunion. Int Orthop. 2022;46(9):1937-44. doi: 10.1007/s00264-022-05494-y. [PubMed: 35773530]. [PubMed Central: PMC9372116].
26. Gupta S, Malhotra A, Mittal N, Garg SK, Jindal R, Kansay R. The management of infected nonunion of tibia with a segmental defect using simultaneous fixation with a monorail fixator and a locked plate. Bone Joint J. 2018;100-b(8):1094-9. doi: 10.1302/0301-620x.100b8.Bjj-2017-1442.R1. [PubMed: 30062945].
27. Mayfield CK, Ayad M, Lechtholz-Zey E, Chen Y, Lieberman JR. 3D-Printing for Critical Sized Bone Defects: Current Concepts and Future Directions. Bioengineering (Basel). 2022;9(11). doi: 10.3390/bioengineering9110680. [PubMed: 36421080]. [PubMed Central: PMC9687148].
28. Li J, Li M, Wang W, Li B, Liu L. Evolution and Development of Ilizarov Technique in the Treatment of Infected Long Bone Nonunion with or without Bone Defects. Orthop Surg. 2022;14(5):824-30. doi: 10.1111/os.13218. [PubMed: 35343060]. [PubMed Central: PMC9087454].
29. Xu YQ, Fan XY, He XQ, Wen HJ. Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: experience from 31 cases. BMC Musculoskelet Disord. 2021;22(1):34. doi: 10.1186/s12891-020-03894-y. [PubMed: 33413256]. [PubMed Central: PMC7788851].
30. Liu K, Liu Y, Cai F, Fan C, Ren P, Yusufu A. Efficacy comparison of trifocal bone transport using unilateral external fixator for femoral and tibial bone defects caused by infection. BMC Surg. 2022;22(1):141. doi: 10.1186/s12893-022-01586-z. [PubMed: 35413897]. [PubMed Central: PMC9004006].
31. RenC,LiM,MaT,LiZ,XuY,SunL,etal.Ameta-analysisofthe Masquelet technique and the Ilizarov bone transport method for the treatment of infected bone defects in the lower extremities. J Orthop Surg (Hong Kong). 2022;30(2):10225536221102685. doi: 10.1177/10225536221102685. [PubMed: 35655431].
32. Xie L, Huang Y, Zhang L, Si S, Yu Y. Ilizarov method and its combined methods in the treatment of long bone defects of the lower extremity: systematic review and meta-analysis. BMC Musculoskelet Disord. 2023;24(1):891. doi: 10.1186/s12891- 023-07001-9. [PubMed: 37968675]. [PubMed Central: PMC10652567].
33. Yajima H, Kobata Y, Shigematsu K, Kawamura K, Kawate K, Tamai S, et al. Vascularized fibular grafting in the treatment of methicillin-resistant Staphylococcus aureus osteomyelitis and infected nonunion. J Reconstr Microsurg. 2004;20(1):13-20. doi: 10.1055/s-2004-818044. [PubMed: 14973770].
34. Paul S, Vathulya M, Kandwal P, Jagtap M, Behl R. Comparative analysis of free vascularized fibula grafting and Ilizarov bone transport in management of segmental long bone defect of the lower limb: A systematic review and meta-analysis. J Orthop. 2024;50:84-91. doi: 10.1016/j.jor.2023.12.001. [PubMed: 38179434]. [PubMed Central: PMC10762458].
35. Kachare A, Goregaonkar AB, Purohit S, Munde K, Renthlei L, Gaur B. Surgical Planning and 3D-Printed Mesh Implant for Effective Bone Gap Management: A Case Report. J Orthop Case Rep. 2024;14(11):203-7. doi: 10.13107/jocr.2024.v14.i11.4968. [PubMed: 39524287]. [PubMed Central: PMC11546020].
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39. Foukas AF, Hadjimichael AC, Nicolaou C, Savvidou OD, Papagelopoulos PJ. A 3D-printed load sharing implant achieved union of a 9-cm femoral segmental bone defect within three months using a hybrid Masquelet induction membrane technique. A case-report. Trauma Case Rep. 2024;49:100978. doi: 10.1016/j.tcr.2024.100978. [PubMed: 38312114]. [PubMed Central: PMC10835288].
2. Chen Z, Xing Y, Li X, Liu B, Liu N, Huo Y, et al. 3D-printed titanium porous prosthesis combined with the Masquelet technique for the management of large femoral bone defect caused by osteomyelitis. BMC Musculoskelet Disord. 2024;25(1):474. doi: 10.1186/s12891-024-07576-x. [PubMed: 38880911]. [PubMed Central: PMC11181595].
3. Woon CY, Chong KW, Wong MK. Induced membranes--a staged technique of bone-grafting for segmental bone loss: a report of two cases and a literature review. J Bone Joint Surg Am. 2010;92(1):196-201. doi: 10.2106/jbjs.I.00273. [PubMed: 20048113].
4. Levin LS. Vascularized fibula graft for the traumatically induced long-bone defect. J Am Acad Orthop Surg. 2006;14(10 Spec No.):S175-6. doi: 10.5435/00124635-200600001-00038. [PubMed: 17003193].
5. YinP,JiQ,LiT,LiJ,LiZ,LiuJ,etal.ASystematicReviewand Meta-Analysis of Ilizarov Methods in the Treatment of Infected Nonunion of Tibia and Femur. PLoS One. 2015;10(11):e0141973. doi: 10.1371/journal.pone.0141973. [PubMed: 26529606]. [PubMed Central: PMC4631548].
6. Liu B, Tan Q, Wang Z, Hou G, Wang C, Tian Y. Applying 3D-Printed Porous Ti6Al4V Prostheses to Repair Osteomyelitis-Induced Partial Bone Defects of Lower Limbs: Finite Element Analysis and Clinical Outcomes. Orthop Surg. 2025;17(1):115-24. doi: 10.1111/os.14268. [PubMed: 39429061]. [PubMed Central: PMC11735359].
7. Chen Z, Yang Y, Liu B, Li X, Tian Y. Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases. BMC Musculoskelet Disord. 2024;25(1):1090. doi: 10.1186/s12891-024-08248-6. [PubMed: 39736569]. [PubMed Central: PMC11687145].
8. Wu Y, Shi X, Zi S, Li M, Chen S, Zhang C, et al. The clinical application of customized 3D-printed porous tantalum scaffolds combined with Masquelet’s induced membrane technique to reconstruct infective segmental femoral defect. J Orthop Surg Res. 2022;17(1):479. doi: 10.1186/s13018-022-03371-3. [PubMed: 36335402]. [PubMed Central: PMC9636627].
9. Liu B, Wang L, Li X, Chen Z, Hou G, Zhou F, et al. Applying 3D-printed prostheses to reconstruct critical-sized bone defects of tibial diaphysis (> 10 cm) caused by osteomyelitis and aseptic non-union. J Orthop Surg Res. 2024;19(1):418. doi: 10.1186/s13018-024-04926-2. [PubMed: 39033286]. [PubMed Central: PMC11264997].
10. Tetsworth K, Woloszyk A, Glatt V. 3D printed titanium cages combined with the Masquelet technique for the reconstruction of segmental femoral defects: Preliminary clinical results and molecular analysis of the biological activity of human-induced membranes. OTA Int. 2019;2(1):e016. doi: 10.1097/oi9.0000000000000016. [PubMed: 33937652]. [PubMed Central: PMC7953522].
11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021;372:n71. doi: 10.1136/bmj.n71. [PubMed: 33782057]. [PubMed Central: PMC8005924].
12. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712-6. doi: 10.1046/j.1445-2197.2003.02748.x. [PubMed: 12956787].
13. Attias N, Thabet AM, Prabhakar G, Dollahite JA, Gehlert RJ, DeCoster TA. Management of extra-articular segmental defects in long bone using a titanium mesh cage as an adjunct to other methods of fixation. Bone Joint J. 2018;100-B(4):646-51. doi: 10.1302/0301-620x.100b5.Bjj-2017-0817.R2. [PubMed: 29701099].
14. Gamieldien H, Ferreira N, Birkholtz FF, Hilton T, Campbell N, Laubscher M. Filling the gap: a series of 3D-printed titanium truss cages for the management of large, lower limb bone defects in a developing country setting. Eur J Orthop Surg Traumatol. 2023;33(3):497-505. doi: 10.1007/s00590-022-03434-5. [PubMed: 36385681].15. Ma XY, Yuan H, Cui D, Liu B, Han TY, Yu HL, et al. Management of segmental defects post open distal femur fracture using a titanium cage combined with the Masquelet technique A single- centre report of 23 cases. Injury. 2023;54(12):111130. doi: 10.1016/j.injury.2023.111130. [PubMed: 37890289].
16. Gavaskar AS, Parthasarathy S, Balamurugan J, Raj RV, Chander VS, Ananthkrishnan LK. A load-sharing nail - cage construct may improve outcome after induced membrane technique for segmental tibial defects. Injury. 2020;51(2):510-5. doi: 10.1016/j.injury.2019.11.031. [PubMed: 31787329].
17. Attias N, Lindsey RW. Case reports: management of large segmental tibial defects using a cylindrical mesh cage. Clin Orthop Relat Res. 2006;450:259-66. doi: 10.1097/01.blo.0000223982.29208.a4. [PubMed: 16702918].
18. Lodewijks A, Blokhuis T, van Griensven M, Poeze M. The Treatment of Very Large Traumatic Bone Defects of the Tibia with a Polycaprolactone-Tricalcium Phosphate 3D-Printed Cage: A Review of Three Cases. Cureus. 2024;16(8):e66256. doi: 10.7759/cureus.66256. [PubMed: 39238727]. [PubMed Central: PMC11375482].
19. LiuB,HouG,YangZ,LiX,ZhengY,WenP,etal.Repairof critical diaphyseal defects of lower limbs by 3D printed porous Ti6Al4V scaffolds without additional bone grafting: a prospective clinical study. J Mater Sci Mater Med. 2022;33(9):64. doi: 10.1007/s10856-022-06685-0. [PubMed: 36104513]. [PubMed Central: PMC9474430].
20. Caravelli S, Ambrosino G, Vocale E, Di Ponte M, Puccetti G, Perisano C, et al. Custom-Made Implants in Ankle Bone Loss: A Retrospective Assessment of Reconstruction/Arthrodesis in Sequelae of Septic Non-Union of the Tibial Pilon. Medicina (Kaunas). 2022;58(11). doi: 10.3390/medicina58111641. [PubMed: 36422180]. [PubMed Central: PMC9692516].
21. Beatti MA, Zublin Guerra CM, Guichet DM, Pellecchia TS. Defectos óseos segmentarios: uso de implantes de titanio trabecular diseñados a medida. Rev Asoc Argent Ortop Traumatol 2022;87(2):219-37. doi: 10.15417/issn.1852- 7434.2022.87.2.1436.
22. Liu B, Li X, Qiu W, Liu Z, Zhou F, Zheng Y, et al. Mechanical Distribution and New Bone Regeneration After Implanting 3D Printed Prostheses for Repairing Metaphyseal Bone Defects: A Finite Element Analysis and Prospective Clinical Study. Front Bioeng Biotechnol. 2022;10:921545. doi: 10.3389/fbioe.2022.921545. [PubMed: 35721863]. [PubMed Central: PMC9204204].
23. Blum AL, BongioVanni JC, Morgan SJ, Flierl MA, dos Reis FB. Complications associated with distraction osteogenesis for infected nonunion of the femoral shaft in the presence of a bone defect: A retrospective series. J Bone Joint Surg Br. 2010;92(4):565-70. doi: 10.1302/0301-620x.92b4.23475. [PubMed: 20357336].
24. Hamiti Y, Yushan M, Yalikun A, Lu C, Yusufu A. Matched comparative study of trifocal bone transport versus induced membrane followed by trifocal bone transport in the treatment of segmental tibial defects caused by posttraumatic osteomyelitis. BMC Musculoskelet Disord. 2022;23(1):572. doi: 10.1186/s12891-022-05501-8. [PubMed: 35701789]. [PubMed Central: PMC9195234].
25. Khaled A, El-Gebaly O, El-Rosasy M. Masquelet-Ilizarov technique for the management of bone loss post debridement of infected tibial nonunion. Int Orthop. 2022;46(9):1937-44. doi: 10.1007/s00264-022-05494-y. [PubMed: 35773530]. [PubMed Central: PMC9372116].
26. Gupta S, Malhotra A, Mittal N, Garg SK, Jindal R, Kansay R. The management of infected nonunion of tibia with a segmental defect using simultaneous fixation with a monorail fixator and a locked plate. Bone Joint J. 2018;100-b(8):1094-9. doi: 10.1302/0301-620x.100b8.Bjj-2017-1442.R1. [PubMed: 30062945].
27. Mayfield CK, Ayad M, Lechtholz-Zey E, Chen Y, Lieberman JR. 3D-Printing for Critical Sized Bone Defects: Current Concepts and Future Directions. Bioengineering (Basel). 2022;9(11). doi: 10.3390/bioengineering9110680. [PubMed: 36421080]. [PubMed Central: PMC9687148].
28. Li J, Li M, Wang W, Li B, Liu L. Evolution and Development of Ilizarov Technique in the Treatment of Infected Long Bone Nonunion with or without Bone Defects. Orthop Surg. 2022;14(5):824-30. doi: 10.1111/os.13218. [PubMed: 35343060]. [PubMed Central: PMC9087454].
29. Xu YQ, Fan XY, He XQ, Wen HJ. Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: experience from 31 cases. BMC Musculoskelet Disord. 2021;22(1):34. doi: 10.1186/s12891-020-03894-y. [PubMed: 33413256]. [PubMed Central: PMC7788851].
30. Liu K, Liu Y, Cai F, Fan C, Ren P, Yusufu A. Efficacy comparison of trifocal bone transport using unilateral external fixator for femoral and tibial bone defects caused by infection. BMC Surg. 2022;22(1):141. doi: 10.1186/s12893-022-01586-z. [PubMed: 35413897]. [PubMed Central: PMC9004006].
31. RenC,LiM,MaT,LiZ,XuY,SunL,etal.Ameta-analysisofthe Masquelet technique and the Ilizarov bone transport method for the treatment of infected bone defects in the lower extremities. J Orthop Surg (Hong Kong). 2022;30(2):10225536221102685. doi: 10.1177/10225536221102685. [PubMed: 35655431].
32. Xie L, Huang Y, Zhang L, Si S, Yu Y. Ilizarov method and its combined methods in the treatment of long bone defects of the lower extremity: systematic review and meta-analysis. BMC Musculoskelet Disord. 2023;24(1):891. doi: 10.1186/s12891- 023-07001-9. [PubMed: 37968675]. [PubMed Central: PMC10652567].
33. Yajima H, Kobata Y, Shigematsu K, Kawamura K, Kawate K, Tamai S, et al. Vascularized fibular grafting in the treatment of methicillin-resistant Staphylococcus aureus osteomyelitis and infected nonunion. J Reconstr Microsurg. 2004;20(1):13-20. doi: 10.1055/s-2004-818044. [PubMed: 14973770].
34. Paul S, Vathulya M, Kandwal P, Jagtap M, Behl R. Comparative analysis of free vascularized fibula grafting and Ilizarov bone transport in management of segmental long bone defect of the lower limb: A systematic review and meta-analysis. J Orthop. 2024;50:84-91. doi: 10.1016/j.jor.2023.12.001. [PubMed: 38179434]. [PubMed Central: PMC10762458].
35. Kachare A, Goregaonkar AB, Purohit S, Munde K, Renthlei L, Gaur B. Surgical Planning and 3D-Printed Mesh Implant for Effective Bone Gap Management: A Case Report. J Orthop Case Rep. 2024;14(11):203-7. doi: 10.13107/jocr.2024.v14.i11.4968. [PubMed: 39524287]. [PubMed Central: PMC11546020].
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| Files | ||
| Issue | Vol 12 No 1 (2026) | |
| Section | Research Articles | |
| Keywords | ||
| Three-Dimensional Printing Tibia Femur Orthopedics | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kalantar SH, Salkhori O, Bagheri N, Khabiri SS, Arabzadeh A, Talebi A, Jahanbin H, Mortazavi SM, Naghizadeh H. Custom Three-Dimensional-Printed Implants for Tibial and Femoral Segmental Defects: A Systematic Review and Meta-Analysis. J Orthop Spine Trauma. 2026;12(1):37-42.
