{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:57:02Z","timestamp":1793408222004,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"JSPS KAKENHI","award":["24K1045306 and 25K2266007"],"award-info":[{"award-number":["24K1045306 and 25K2266007"]}]},{"DOI":"10.13039\/501100012330","name":"Okayama University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012330","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study evaluated the accuracy of resection of bone tumours and the fit between host bone and massive bone allograft (MBA) in children with malignant bone tumours of lower limb who underwent surgery using in-house 3-dimensional (3D)-printed patient-specific  instruments (PSIs)\u00a0for tumour resection and graft-specific  instruments (GSIs)\u00a0for shaping the MBA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included seven\u00a0children (3 males, 4 females; median age 13) with malignant bone tumours of the lower limb who underwent intercalary resection and reconstruction with MBA between September 2023 and March 2025 using in-house designed 3D-printed PSIs and GSIs. Tumours were located in the femur\u00a0(5 children) and tibia\u00a0(2 children). We analysed the accuracy of bone resection, complications of reconstruction, and function of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All resections achieved R0 margins. The median planned resection length was 16.5\u00a0cm versus 16.8\u00a0cm\u00a0actually resected\u00a0(median difference 0.2\u00a0cm). Bone union was achieved in 13 of 14 (92.9%) osteotomy sites. Bone union was faster at metaphyseal junctions (median 5.9\u00a0months) than diaphyseal junctions (median 8.4\u00a0months) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). One of the osteotomy sites (7.1%) had a delayed union requiring secondary bone grafting. The median Musculoskeletal Tumour Society score was 30 at the last follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>3D-printed PSIs and GSIs\u00a0appear to enhance\u00a0the accuracy of bone tumour resection and host bone-MBA fit,\u00a0thereby reducing\u00a0the risks of inadequate margins and non-union, respectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-026-06773-8","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T04:53:35Z","timestamp":1773723215000},"page":"1155-1163","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["In-house three dimensional-printed cutting guides improve surgical accuracy in children who underwent resection of malignant bone tumours of lower limb and reconstruction with allograft"],"prefix":"10.1007","volume":"50","author":[{"given":"Eiji","family":"Nakata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Alessandri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia Chiara","family":"Menozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayano","family":"Aso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Ozaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Trisolino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Maria","family":"Donati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costantino","family":"Errani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"6773_CR1","doi-asserted-by":"publisher","first-page":"3859","DOI":"10.3390\/curroncol30040292","volume":"30","author":"H Aiba","year":"2023","unstructured":"Aiba H, Spazzoli B, Tsukamoto S et al (2023) Current concepts in the resection of bone tumors using a patient-specific three-dimensional printed cutting guide. Curr Oncol 30:3859\u20133870. https:\/\/doi.org\/10.3390\/curroncol30040292","journal-title":"Curr Oncol"},{"key":"6773_CR2","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1007\/s00264-023-05759-0","volume":"47","author":"Z Lv","year":"2023","unstructured":"Lv Z, Li J, Yang Z et al (2023) A novel three-dimensional-printed patient-specific sacral implant for spinopelvic reconstruction in sacral giant cell tumour. Int Orthop 47:1619\u20131628. https:\/\/doi.org\/10.1007\/s00264-023-05759-0","journal-title":"Int Orthop"},{"key":"6773_CR3","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s00264-020-04787-4","volume":"45","author":"M\u0160 Jovi\u010di\u0107","year":"2021","unstructured":"Jovi\u010di\u0107 M\u0160, Vuleti\u0107 F, Ribi\u010di\u0107 T et al (2021) Implementation of the three-dimensional printing technology in treatment of bone tumours: a case series. Int Orthop 45:1079\u20131085. https:\/\/doi.org\/10.1007\/s00264-020-04787-4","journal-title":"Int Orthop"},{"key":"6773_CR4","doi-asserted-by":"publisher","first-page":"10665","DOI":"10.2147\/CMAR.S232051","volume":"11","author":"H Hu","year":"2019","unstructured":"Hu H, Liu W, Zeng Q et al (2019) The personalized shoulder reconstruction assisted by 3D printing technology after resection of the proximal humerus tumours. Cancer Manag Res 11:10665\u201310673. https:\/\/doi.org\/10.2147\/CMAR.S232051","journal-title":"Cancer Manag Res"},{"key":"6773_CR5","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1002\/jso.25826","volume":"121","author":"W Liu","year":"2020","unstructured":"Liu W, Shao Z, Rai S et al (2020) Three\u2010dimensional\u2010printed intercalary prosthesis for the reconstruction of large bone defect after joint\u2010preserving tumor resection. J Surg Oncol 121:570\u2013577. https:\/\/doi.org\/10.1002\/jso.25826","journal-title":"J Surg Oncol"},{"key":"6773_CR6","doi-asserted-by":"publisher","first-page":"4581","DOI":"10.3892\/ol.2017.6749","volume":"14","author":"F Wang","year":"2017","unstructured":"Wang F, Zhu J, Peng X, Su J (2017) The application of 3D printed surgical guides in resection and reconstruction of malignant bone tumor. Oncol Lett 14:4581\u20134584. https:\/\/doi.org\/10.3892\/ol.2017.6749","journal-title":"Oncol Lett"},{"key":"6773_CR7","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.jot.2021.05.009","volume":"29","author":"KC Wong","year":"2021","unstructured":"Wong KC, Sze LKY, Kumta SM (2021) Complex joint-preserving bone tumor resection and reconstruction using computer navigation and 3D-printed patient-specific guides: a technical note of three cases. J Orthop Translat 29:152\u2013162. https:\/\/doi.org\/10.1016\/j.jot.2021.05.009","journal-title":"J Orthop Translat"},{"key":"6773_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2022.101733","volume":"42","author":"C Dong","year":"2022","unstructured":"Dong C, Beglinger I, Krieg AH (2022) Personalized 3D-printed guide in malignant bone tumor resection and following reconstruction \u2013 17 cases in pelvic and extremities. Surg Oncol 42:101733. https:\/\/doi.org\/10.1016\/j.suronc.2022.101733","journal-title":"Surg Oncol"},{"key":"6773_CR9","doi-asserted-by":"publisher","DOI":"10.1038\/srep23335","volume":"6","author":"L Ma","year":"2016","unstructured":"Ma L, Zhou Y, Zhu Y et al (2016) 3D-printed guiding templates for improved osteosarcoma resection. Sci Rep 6:23335. https:\/\/doi.org\/10.1038\/srep23335","journal-title":"Sci Rep"},{"key":"6773_CR10","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1002\/jso.25236","volume":"118","author":"JW Park","year":"2018","unstructured":"Park JW, Kang HG, Lim KM et al (2018) Bone tumor resection guide using three\u2010dimensional printing for limb salvage surgery. J Surg Oncol 118:898\u2013905. https:\/\/doi.org\/10.1002\/jso.25236","journal-title":"J Surg Oncol"},{"key":"6773_CR11","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20211124-07","author":"MA Gasparro","year":"2022","unstructured":"Gasparro MA, Gusho CA, Obioha OA et al (2022) 3D-printed cutting guides for resection of long bone sarcoma and intercalary allograft reconstruction. Orthopedics. https:\/\/doi.org\/10.3928\/01477447-20211124-07","journal-title":"Orthopedics"},{"key":"6773_CR12","doi-asserted-by":"publisher","first-page":"6533","DOI":"10.2147\/CMAR.S228038","volume":"12","author":"DA M\u00fcller","year":"2020","unstructured":"M\u00fcller DA, Stutz Y, Vlachopoulos L et al (2020) The accuracy of three-dimensional planned bone tumor resection using patient-specific instrument. CMAR Volume 12:6533\u20136540. https:\/\/doi.org\/10.2147\/CMAR.S228038","journal-title":"CMAR Volume"},{"key":"6773_CR13","doi-asserted-by":"publisher","first-page":"3483","DOI":"10.1002\/cncr.24320","volume":"115","author":"C Wittekind","year":"2009","unstructured":"Wittekind C, Compton C, Quirke P et al (2009) A uniform residual tumor (R) classification: integration of the R classification and the circumferential margin status. Cancer 115:3483\u20133488. https:\/\/doi.org\/10.1002\/cncr.24320","journal-title":"Cancer"},{"key":"6773_CR14","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13121664","volume":"13","author":"G Trisolino","year":"2023","unstructured":"Trisolino G, Depaoli A, Menozzi GC et al (2023) Virtual surgical planning and patient-specific instruments for correcting lower limb deformities in pediatric patients: preliminary results from the in-office 3D printing point of care. J Pers Med 13:1664. https:\/\/doi.org\/10.3390\/jpm13121664","journal-title":"J Pers Med"},{"key":"6773_CR15","doi-asserted-by":"publisher","DOI":"10.3390\/polym16091216","volume":"16","author":"GC Menozzi","year":"2024","unstructured":"Menozzi GC, Depaoli A, Ramella M et al (2024) High-temperature polylactic acid proves reliable and safe for manufacturing 3D-printed patient-specific instruments in pediatric orthopedics\u2014results from over 80 personalized devices employed in 47 surgeries. Polymers 16:1216. https:\/\/doi.org\/10.3390\/polym16091216","journal-title":"Polymers"},{"key":"6773_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12122051","volume":"12","author":"G Alessandri","year":"2022","unstructured":"Alessandri G, Frizziero L, Santi GM et al (2022) Virtual surgical planning, 3D-printing and customized bone allograft for acute correction of severe genu varum in children. JPM 12:2051. https:\/\/doi.org\/10.3390\/jpm12122051","journal-title":"JPM"},{"key":"6773_CR17","doi-asserted-by":"publisher","DOI":"10.1097\/OI9.0000000000000093","volume":"4","author":"A Coburn","year":"2021","unstructured":"Coburn A, Shearer D, Albright P et al (2021) Evaluating reliability and validity of the modified radiographic union scale for tibia (mRUST) among North American and Tanzanian surgeons. OTA Int Open Access J Orthop Trauma 4:e093. https:\/\/doi.org\/10.1097\/OI9.0000000000000093","journal-title":"OTA Int Open Access J Orthop Trauma"},{"key":"6773_CR18","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1002\/pbc.20932","volume":"49","author":"VG Marchese","year":"2007","unstructured":"Marchese VG, Rai SN, Carlson CA et al (2007) Assessing functional mobility in survivors of lower\u2010extremity sarcoma: reliability and validity of a new assessment tool. Pediatr Blood Cancer 49:183\u2013189. https:\/\/doi.org\/10.1002\/pbc.20932","journal-title":"Pediatr Blood Cancer"},{"key":"6773_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2023.100503","volume":"42","author":"A Bruschi","year":"2023","unstructured":"Bruschi A, Donati DM, Di Bella C (2023) What to choose in bone tumour resections? Patient specific instrumentation versus surgical navigation: a systematic review. J Bone Oncol 42:100503. https:\/\/doi.org\/10.1016\/j.jbo.2023.100503","journal-title":"J Bone Oncol"},{"key":"6773_CR20","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-03553-7","volume":"18","author":"S Tsukamoto","year":"2023","unstructured":"Tsukamoto S, Mavrogenis AF, Masunaga T et al (2023) Megaprosthetic reconstruction of the distal femur with a short residual proximal femur following bone tumor resection: a systematic review. J Orthop Surg Res 18:68. https:\/\/doi.org\/10.1186\/s13018-023-03553-7","journal-title":"J Orthop Surg Res"},{"key":"6773_CR21","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16244185","volume":"16","author":"M Scorianz","year":"2024","unstructured":"Scorianz M, Scoccianti G, Guariento L et al (2024) Joint-sparing resection of juxta-articular primary tumors of the knee using titanium alloy 3D-printed cutting guides and allograft reconstruction. Cancers 16:4185. https:\/\/doi.org\/10.3390\/cancers16244185","journal-title":"Cancers"},{"key":"6773_CR22","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1302\/0301-620X.105B2.BJJ-2022-0585.R2","volume":"105-B","author":"SH Lee","year":"2023","unstructured":"Lee SH, Kim W, Lee JS (2023) What are the resection accuracy and guide-fitting errors associated with 3D-printed, patient-specific resection guides for bone tumour resections? Bone Joint J 105-B:190\u2013197. https:\/\/doi.org\/10.1302\/0301-620X.105B2.BJJ-2022-0585.R2","journal-title":"Bone Joint J"},{"key":"6773_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jcot.2021.04.033","volume":"19","author":"C Errani","year":"2021","unstructured":"Errani C, Tsukamoto S, Almunhaisen N et al (2021) Intercalary reconstruction following resection of diaphyseal bone tumors: a systematic review. J Clin Orthop Trauma 19:1\u201310. https:\/\/doi.org\/10.1016\/j.jcot.2021.04.033","journal-title":"J Clin Orthop Trauma"},{"key":"6773_CR24","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20260106-02","author":"ZR Butler","year":"2026","unstructured":"Butler ZR, Riley DJ, Gusho CA et al (2026) Long-term outcomes of 3-dimensional\u2013printed cutting guides for long bone sarcoma resection and intercalary allograft reconstruction: an updated case series. Orthopedics. https:\/\/doi.org\/10.3928\/01477447-20260106-02","journal-title":"Orthopedics"},{"key":"6773_CR25","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1007\/s11999-014-4028-5","volume":"473","author":"L Aponte-Tinao","year":"2015","unstructured":"Aponte-Tinao L, Ayerza MA, Muscolo LD, Farfalli GL (2015) Survival, recurrence, and function after epiphyseal preservation and allograft reconstruction in osteosarcoma of the knee. Clin Orthop Relat Res 473:1789\u20131796. https:\/\/doi.org\/10.1007\/s11999-014-4028-5","journal-title":"Clin Orthop Relat Res"},{"key":"6773_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-023-03045-2","volume":"21","author":"M Huang","year":"2023","unstructured":"Huang M, Ma Z, Yu J et al (2023) Does joint-sparing tumor resection jeopardize oncologic and functional outcomes in non-metastatic high-grade osteosarcoma around the knee? World J Surg Oncol 21:185. https:\/\/doi.org\/10.1186\/s12957-023-03045-2","journal-title":"World J Surg Oncol"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-026-06773-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00264-026-06773-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-026-06773-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:00:41Z","timestamp":1778904041000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00264-026-06773-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["6773"],"URL":"https:\/\/doi.org\/10.1007\/s00264-026-06773-8","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"28 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This prospective study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was obtained from the Institutional Review Board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}