Clinical Applications of 3-Dimensional Printing Technology in Hip Joint.
TL;DR: 3D printing technology presents new potential for treating complex hip joint disease and could improve the surgeon's efficiency in the operating room, shorten operative times, and reduce exposure to radiation.
Abstract: Three-dimensional (3D) printing is a digital rapid prototyping technology based on a discrete and heap-forming principle. We identified 53 articles from PubMed by searching "Hip" and "Printing, Three-Dimensional"; 52 of the articles were published from 2015 onwards and were, therefore, initially considered and discussed. Clinical application of the 3D printing technique in the hip joint mainly includes three aspects: a 3D-printed bony 1:1 scale model, a custom prosthesis, and patient-specific instruments (PSI). Compared with 2-dimensional image, the shape of bone can be obtained more directly from a 1:1 scale model, which may be beneficial for preoperative evaluation and surgical planning. Custom prostheses can be devised on the basis of radiological images, to not only eliminate the fissure between the prosthesis and the patient's bone but also potentially resulting in the 3D-printed prosthesis functioning better. As an alternative support to intraoperative computer navigation, PSI can anchor to a specially appointed position on the patient's bone to make accurate bone cuts during surgery following a precise design preoperatively. The 3D printing technique could improve the surgeon's efficiency in the operating room, shorten operative times, and reduce exposure to radiation. Well known for its customization, 3D printing technology presents new potential for treating complex hip joint disease.
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TL;DR: A survey of the state-of-the-art of laser and electron beam powder bed fusion, 3D printing design, development, fabrication and applications of porous, or open-cellular metal and alloy personalized implants is presented in this paper.
Abstract: This overview presents a survey of the state-of-the-art of laser and electron beam powder bed fusion, 3D printing design, development, fabrication and applications of porous, or open-cellular metal and alloy personalized implants; and is particularly directed to materials and biomaterials students and professionals. Of particular importance is the application of metallurgy principles, especially the role played by traditional solidification fundamentals, in predicting and characterizing the microstructures and mechanical properties of additively manufactured implants representing a host of human skeletal reconstruction and replacement appliances. In addition to presenting important reviews highlighting very recent metallurgical processing strategies and current trends in the global development of hospital point-of-care, 3D printing centers creating surgical planning models in association with the fabrication of personalized, patient-specific implants are described.
102 citations
Cites background or methods from "Clinical Applications of 3-Dimensio..."
...Software such as Materialise Interactive Medical Image Control System (MIMICS), or 3D Slicer are common commercial packages for converting CT scans into CAD models [46]....
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...[46] have recently reviewed roughly 50 papers written since 2015 regarding clinical applications of 3D printing in hip arthroplasty devices, including patient-specific instrument fabrication in hospital point-of-care, 3D printing centers and surgical service centers....
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...[46] Xia R-Z, Zhai Z-J, Chang Y-Y, Li H-W....
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...Aside from key references describing fundamental and historical issues of significance in developing an understanding of metal and alloy implant development and the contributions of 3D printing to modern implant fabrication, this overview has focused primarily on contemporary and especially customized, porous implants [3,9,7,18,28,29,34,37,38,42,46]....
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TL;DR: A comprehensive overview of recent progress in the development of materials and techniques used in the additive manufacturing of bone scaffolds and clinical application, pre‐clinical trials and future prospects of AM based bone implants are summarized and discussed.
Abstract: Recent years have witnessed surging demand for bone repair/regeneration implants due to the increasing number of bone defects caused by trauma, cancer, infection, and arthritis worldwide. In addition to bone autografts and allografts, biomaterial substitutes have been widely used in clinical practice. Personalized implants with precise and personalized control of shape, porosity, composition, surface chemistry, and mechanical properties will greatly facilitate the regeneration of bone tissue and satiate the clinical needs. Additive manufacturing (AM) techniques, also known as 3D printing, are drawing fast growing attention in the fabrication of implants or scaffolding materials due to their capability of manufacturing complex and irregularly shaped scaffolds in repairing bone defects in clinical practice. This review aims to provide a comprehensive overview of recent progress in the development of materials and techniques used in the additive manufacturing of bone scaffolds. In addition, clinical application, pre-clinical trials and future prospects of AM based bone implants are also summarized and discussed.
62 citations
TL;DR: 3D printing has enormous potential for providing a pathway for a sustainable hip replacement and the use of scaffolds as another approach for implants is investigated, according to this review.
Abstract: There is a rising demand for replacement, regeneration of tissues and organ repairs for patients who suffer from diseased/damaged bones or tissues such as hip pains. The hip replacement treatment relies on the implant, which may not always meet the requirements due to mechanical and biocompatibility issues which in turn may aggravate the pain. To surpass these limitations, researchers are investigating the use of scaffolds as another approach for implants. Three-dimensional (3D) printing offers significant potential as an efficient fabrication technique on personalized organs as it is capable of biomimicking the intricate designs found in nature. In this review, the determining factors for hip replacement and the different fabrication techniques such as direct 3D printing, Fused Deposition Modelling (FDM), Selective Laser Sintering (SLS) and stereolithography (SLA) for hip replacement. The study also covers surface modifications of 3D printed implants and provides an overview on 3D tissue regeneration. To appreciate the current conventional hip replacement practices, the conventional metallic and ceramic materials are covered, highlighting their rationale as the material of choice. Next, the challenges, ethics and trends in the implants’ 3D printing are covered and conclusions drawn. The outlook and challenges are also presented here. The knowledge from this review indicates that 3D printing has enormous potential for providing a pathway for a sustainable hip replacement.
39 citations
TL;DR: Orthopaedic surgeons should develop guidelines to outline the most effective uses of 3D-printing technology to maximize patient benefits to improve surgical efficiency, shorten operation times and reduce exposure to radiation.
Abstract: The use of three-dimensional (3D) printing is becoming more common, including in the field of orthopaedic surgery. There are currently four primary clinical applications for 3D-printing in hip and pelvic surgeries: (i) 3D-printed anatomical models for planning and surgery simulation, (ii) patient-specific instruments (PSI), (iii) generation of prostheses with 3D-additive manufacturing, and (iv) custom 3D-printed prostheses. Simulation surgery using a 3D-printed bone model allows surgeons to develop better surgical approaches, test the feasibility of procedures and determine optimal location and size for a prosthesis. PSI will help inform accurate bone cuts and prosthesis placement during surgery. Using 3D-additive manufacturing, especially with a trabecular pattern, is possible to produce a prosthesis mechanically stable and biocompatible prosthesis capable of promoting osseointergration. Custom implants are useful in patients with massive acetabular bone loss or periacetabular malignant bone tumors as they may improve the fit between implants and patient-specific anatomy. 3D-printing technology can improve surgical efficiency, shorten operation times and reduce exposure to radiation. This technology also offers new potential for treating complex hip joint diseases. Orthopaedic surgeons should develop guidelines to outline the most effective uses of 3D-printing technology to maximize patient benefits.
37 citations
TL;DR: In this paper, the authors present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine.
Abstract: 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and to identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine. Observational, descriptive, retrospective and monocentric study of a total of 623 additive manufacturing processes carried out in a Department of Orthopedic Surgery and Traumatology from November 2015 to March 2020. Variables such as product type, utility, time or materials for manufacture were analyzed. The areas of expertise that have performed more processes are Traumatology, Reconstructive and Orthopedic Oncology. Pre-operative planning is their primary use. Working and 3D printing hours, as well as the amount of 3D printing material used, vary according to the type of product or material delivered to perform the process. The most commonly used 3D printing material for manufacturing is polylactic acid, although biocompatible resin has been used to produce surgical guides. In addition, the hospital has worked on the co-design of customized implants with manufacturing companies. The integration of 3D printing in a Department of Orthopedic Surgery and Traumatology allows identifying the conceptual evolution from “Do-It-Yourself” to “POC manufacturing”.
16 citations
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TL;DR: The history of 3D printing is encompassed, various printing methods are reviewed, current applications are presented, and the future direction and impact this technology will have on laboratory settings as 3D printers become more accessible is offered.
Abstract: Nearing 30 years since its introduction, 3D printing technology is set to revolutionize research and teaching laboratories. This feature encompasses the history of 3D printing, reviews various printing methods, and presents current applications. The authors offer an appraisal of the future direction and impact this technology will have on laboratory settings as 3D printers become more accessible.
1,381 citations
15 May 2010
TL;DR: Medical application of rapid prototyping is feasible for specialized surgical planning and prosthetics applications and has significant potential for development of new medical applications.
Abstract: Generation of graspable three-dimensional objects applied for surgical planning, prosthetics and related applications using 3D printing or rapid prototyping is summarized and evaluated. Graspable 3D objects overcome the limitations of 3D visualizations which can only be displayed on flat screens. 3D objects can be produced based on CT or MRI volumetric medical images. Using dedicated post-processing algorithms, a spatial model can be extracted from image data sets and exported to machine-readable data. That spatial model data is utilized by special printers for generating the final rapid prototype model. Patient–clinician interaction, surgical training, medical research and education may require graspable 3D objects. The limitations of rapid prototyping include cost and complexity, as well as the need for specialized equipment and consumables such as photoresist resins. Medical application of rapid prototyping is feasible for specialized surgical planning and prosthetics applications and has significant potential for development of new medical applications.
1,362 citations
TL;DR: A new periacetabular osteotomy of the pelvis has been used for the treatment of residual hip dysplasias in adolescents and adults and there was no evidence of vascular impairment of the osteotomized fragment.
Abstract: A new periacetabular osteotomy of the pelvis has been used for the treatment of residual hip dysplasias in adolescents and adults. The identification of the joint capsule is performed through a Smith-Petersen approach, which also permits all osteotomies to be performed about the acetabulum. This ost
1,154 citations
Journal Article•
TL;DR: 3D printing in medicine can provide many benefits, including: the customization and personalization of medical products, drugs, and equipment; cost-effectiveness; increased productivity; the democratization of design and manufacturing; and enhanced collaboration.
Abstract: 3D printing is expected to revolutionize health care through uses in tissue and organ fabrication; creation of customized prosthetics, implants, and anatomical models; and pharmaceutical research regarding drug dosage forms, delivery, and discovery.
716 citations
TL;DR: The success of hip arthroplasty is likely to be compromized if technical aspects of the surgery for appropriate component positioning and critical protocols to minimise complications such as infection are not given the proper attention.
Abstract: Primary total hip arthroplasties have reported success rates of greater than 95% in many series with a longer than 10-year follow-up. Revision total hip arthroplasty due to such factors as increased high-activity levels, younger patients undergoing the procedure and increasing life expectancy has become more prevalent. An understanding of the mechanisms and timing of total hip arthroplasty failure can direct efforts aimed at reducing revision rates. This study was conducted to evaluate the indications for revision hip arthroplasty and relate these to the time after the index primary hip arthroplasty. A review of all revision hip arthroplasties at two centres over a 6-year time period identified 225 patients who underwent 237 revisions. The overall mean time to revision was 83 months (range: 0–360 months). The cause of failure was aseptic loosening in 123 hips (51.9%), instability in 40 hips (16.9%) and infection in 37 hips (5.5%). When stratified into two groups (less than 5 years, more than 5 years after the index primary hip arthroplasty), 118 of 237 (50%) revisions occurred in less than 5 years, with 33% due to instability and 24% resulting from infection. The majority of the causes of failure within 5 years in these early revisions were instability and deep infection. The success of hip arthroplasty is likely to be compromized if technical aspects of the surgery for appropriate component positioning and critical protocols to minimise complications such as infection are not given the proper attention.
390 citations