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RESEARCH ARTICLE
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Design, characterisation, and clinical evaluation of a novel porous Ti-6Al-4V hemipelvic prosthesis based on Voronoi diagram

Zhuangzhuang Li1,2 ,  Yi Luo1,2 ,  Minxun Lu1,2 ,  Yitian Wang1,2 ,  Linsen Zhong3 ,  Yong Zhou1,2 ,  Zhenfeng Duan4 ,  Li Min1,2,* ,  Chongqi Tu1,2,*
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1 Orthopaedic Research Institute and Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
2 Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan Province, China
3 Tianqi Additive Manufacturing Co., Ltd, Chengdu, Sichuan Province, China
4 Department of Orthopaedic Surgery, Sarcoma Biology Laboratory, Sylvester Comprehensive Cancer Centre, and The University of Miami Miller School of Medicine, Miami, FL, USA
BMT 2024 , 5(3), 314–324; https://doi.org/10.12336/biomatertransl.2024.03.007
Submitted: 22 July 2024 | Revised: 28 August 2024 | Accepted: 13 September 2024 | Published: 28 September 2024
Copyright © 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution–NonCommercial–ShareAlike 4.0 License.
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Abstract

Three-dimensional printed Ti-6Al-4V hemipelvic prosthesis has become a current popular method for pelvic defect reconstruction. This paper presents a novel biomimetic hemipelvic prosthesis design that utilises patient-specific anatomical data in conjunction with the Voronoi diagram algorithm. Unlike traditional design methods that rely on fixed, homogeneous unit cell, the Voronoi diagram enables to create imitation of trabecular structure (ITS). The proposed approach was conducted for six patients. The entire contour of the customised prosthesis matched well with the residual bone. The porosity and pore size of the ITS were evaluated. The distribution of the pore size ranged from 500 to 1400 μm. Porosity calculations indicated the average porosity was 63.13 ± 0.30%. Cubic ITS samples were fabricated for micrograph and mechanical analysis. Scanning electron microscopy images of the ITS samples exhibited rough surface morphology without obvious defects. The Young’s modulus and compressive strength were 1.68 ± 0.05 GPa and 174 ± 8 MPa, respectively. Post-operative X-rays confirmed proper matching of the customised prostheses with the bone defect. Tomosynthesis-Shimadzu metal artifact reduction technology images indicated close contact between the implant and host bone, alongside favourable bone density and absence of resorption or osteolysis around the implant. At the last follow-up, the average Musculoskeletal Tumour Society score was 23.2 (range, 21–26). By leveraging additive manufacturing and Voronoi diagram algorithm, customised implants tailored to individual patient anatomy can be fabricated, offering wide distribution of the pore size, reasonable mechanical properties, favourable osseointegration, and satisfactory function.

Keywords
3D printing
biomimetic prosthesis
bone tumour
pelvic defect reconstruction
porous structure
Funding
This work was supported by Qingdao Research Institutes of Sichuan University, Research of Biomedical Materials and 3D Printing Related Products (No. 20GZ30301).
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Conflict of interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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