Custom-made dynamic 3-dimensional-printed prostheses for chest wall reconstruction: A multicenter study.

Abstract

<h4>Objective</h4>To assess the technical feasibility and surgical safety of dynamic, 3-dimensional (3D) customized prostheses for complex chest wall reconstruction across a multicenter experience.<h4>Methods</h4>We conducted a retrospective, descriptive observational study involving 51 patients from 5 hospitals in Spain who underwent chest wall reconstruction via a custom-designed, spring-like 3D-printed titanium implants between 2016 and 2023. Data collected included surgical indication (oncologic, traumatic, or infectious), patient demographics, prosthesis type, operative time, hospital stay, complications, and follow-up outcomes.<h4>Results</h4>Indications included 35 oncologic, 11 traumatic, 3 infectious, and 2 functional cases (winged scapula). A total of 51 prostheses were implanted, including bilateral and unilateral sternocostal, costal, costovertebral, sternoclavicular, and scapulothoracic reconstructions. The mean operative time was 270 minutes (range, 75-720 minutes), and median follow-up was 2.5 years (range, 3 months to 8 years). Four minor complications were recorded, none requiring implant removal. No cases of prosthesis failure occurred independently of patient death.<h4>Conclusions</h4>Dynamic 3D-customized prostheses provide a structurally stable yet flexible alternative to conventional rigid implants for chest wall reconstruction. Their spring-like geometry allows anatomical adaptation and facilitates intraoperative placement, contributing to safe and reproducible reconstruction in selected cases, with favorable medium-term outcomes. This multicenter experience suggests they may be a feasible and safe option in anatomically complex or functionally demanding thoracic reconstructions.