Reconstruction with a Custom-made 3D-printed Prosthesis for Limb Salvage and Joint Preservation after Resection of the Calf Myxofibrosarcoma Involving the Tibia: A Case Report and Literature Review.

INTRODUCTION: Myxofibrosarcoma (MFS) is a rare form of soft tissue sarcoma, distinguished by its local aggressiveness and a high recurrence rate. However, cases involving the lower leg and progressively affecting large segments of the tibia are infrequently reported in the literature. In this study, we report the case of a 76-year-old patient with MFS of the right calf, which progressively affected critical-sized tibial defects. The patient underwent surgical resection followed by reconstruction using an individualized three-dimensional (3D)-printed prosthesis, which preserved both the knee and ankle joints.

CASE PRESENTATION: This report describes the case of a 76-year-old Chinese woman with MFS of the right calf, which progressively invaded the mid-tibia. She underwent wide tumor resection and reconstruction using a customized 3D-printed prosthesis that preserved both the tibial epiphysis and ankle joint. The procedure successfully preserved the entire articular surface, providing a viable alternative for maintaining both the function and integrity of the affected limb. The patient maintained normal knee joint function, with no evidence of recurrence or metastasis observed during the 2-month postoperative follow-up.

CONCLUSION: Reconstruction of critical-sized tibial defects with a customized 3D-printed non-cemented prosthesis after resection of a large MFS tumor demonstrated excellent mechanical stability during the early follow-up period in this knee and ankle joint-preserving procedure. Further investigation into the durability and long-term complication rates is necessary before this approach can be incorporated into routine clinical practice.