Abstract / Summary
Abstract Background: Segmental reconstruction after joint-preserving resection of a proximal tibial malignancy requires immediate stability while retaining the native knee. Evidence for patient-specific porous cages in this setting remains limited. Case presentation: A 43-year-old man presented with a 3-month history of progressive right calf pain. Imaging showed a 20 × 17 × 37 mm destructive lesion in the proximal tibia with cortical breach and a soft-tissue component. Core-needle biopsy supported a malignant mesenchymal neoplasm, and staging showed no distant metastasis. The tumor-bearing segment was resected en bloc and reconstructed using a custom 3D-printed porous titanium cage packed with autologous and allogeneic bone graft and stabilized with a locking plate. Operative time was 3 h and estimated blood loss was 200 mL. At 12 months, the construct remained stable, no local recurrence was detected on surveillance imaging, and the MSTS-93 score was 27/30. No wound or implant-related complication was recorded. Conclusion: This case illustrates a joint-preserving option for a selected proximal tibial defect when the articular surface can be retained. Longer follow-up and larger comparative studies are required before durability or superiority over established reconstructions can be inferred.