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Case report
Use of three-dimensional printing and intraoperative navigation in the surgical resection of metastatic acetabular osteosarcoma
  1. Julia C Heunis1,
  2. Jonathan W Cheah1,
  3. Amit J Sabnis2 and
  4. Rosanna L Wustrack1
  1. 1 Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
  2. 2 Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Miss Julia C Heunis, julia.heunis{at}


A 21-year-old man underwent a joint-preserving posterior acetabular resection of metastatic osteosarcoma using a three-dimensional (3D) printed model and intraoperative navigation. The combined application of these advanced technologies can allow for surgical planning of osteotomies involving complex anatomy and help guide resections intraoperatively. They can maximise the achievement of negative oncological margins, preservation of native hip stability and critical neurovascular structures, and optimal postoperative function in an effort to resect all clinically evident disease. For this particular patient, with secondary bony metastases, they allowed for a safe and well-tolerated procedure that ultimately afforded him palliative benefit, improved quality of life and, conceivably, prolonged survival in the setting of a devastating prognosis. Although he, sadly, has since passed away, he survived for over 2 years after initial metastasis with preserved hip stability and the ability to graduate college, stay active and maintain a quality of life that addressed his goals of care.

  • orthopaedics
  • palliative procedures
  • palliative care
  • end of life decisions (palliative care)
  • orthopaedic and trauma surgery

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  • Contributors All authors contributed to the writing of the case report and final article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent obtained.