Effectiveness of Three-Dimensional Printing in the Management of Orthopedic Sarcoma Patients: A Systematic Review.

Orthopedic sarcomas present unique surgical challenges due to their anatomical complexity and the need to balance oncologic control with functional preservation. Three-dimensional (3D) printing has emerged as a promising technology to improve surgical precision through patient-specific planning and reconstruction. This systematic review aimed to evaluate the effectiveness, safety, and clinical applications of 3D printing in the management of orthopedic sarcomas. Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Scopus, Google Scholar, and institutional databases for studies published between 2016 and 2025. Twenty studies involving 296 patients with primary bone sarcomas treated using 3D-printed implants, resection guides, or hybrid constructs were included. The most common anatomical sites were the pelvis, sacrum, and long bones. The majority of studies reported high rates of negative surgical margins, with at least 14 of 18 studies achieving R0 resections in over 90% of cases. Functional outcomes were favorable, with pooled Musculoskeletal Tumor Society (MSTS) scores averaging 78-80% of normal limb function, particularly in reconstructions of the ankle, femur, and tibia. The overall complication rate was 22%, with wound morbidity and infection being the most frequent adverse events. Comparative cohorts demonstrated improved surgical accuracy and lower complication rates in the 3D-assisted groups. While early outcomes are promising and support the utility of 3D printing in enhancing personalized oncologic surgery, further prospective studies with standardized outcome measures are needed to validate long-term benefits and inform wider clinical adoption.