Matched comparative study of 3D printed microporous tantalum prosthesis versus autologous bone graft in the final stage of Masquelet induced membrane surgery

Introduction: Masquelet induced membrane surgery is a viable option for the reconstruction of extensive bone defects. This study aimed to comprehensively compare the clinical efficacy of 3D printed microporous tantalum prosthesis and autologous bone graft in the final stage of Masquelet induced membrane surgery during the treatment of lower extremity osteomyelitis with large segmental bone defect. Methods A prospective analysis was conducted on 43 patients with large segmental bone defect caused by lower extremity osteomyelitis treated with Masquelet induced membrane surgery. Among these, 21 patients were implanted 3D printed microporous tantalum prosthesis (Prosthesis group), while 22 patients were implanted autologous bone graft (Autologous bone group) in the final-stage surgery. Follow-up was conducted for 12 months postoperatively. Clinical efficacy was evaluated using the Paley grade for bone defect healing, Visual analog scale (VAS), Lower extremity functional scale (LEFS), Fernandez-Esteve eschar score, and time to full weight-bearing. The clinical outcomes between the two treatment groups were compared. Results Postoperatively, the scores of VAS and LEFS significantly improved compared to preoperative values in both groups (all P < 0.001). Compared to the Autologous bone group, the Prosthesis group demonstrated significantly higher LEFS scores and Fernandez-Esteve eschar scores, along with a significantly shorter time to full weight-bearing (all P < 0.05). Conclusion Both implants show remarkable efficacy in the reconstruction of large segmental bone defect caused by lower extremity osteomyelitis. However, 3D printed microporous tantalum prosthesis exhibits certain advantages over the autologous bone graft in terms of limb function recovery, bone callus growth, and early weight-bearing.