Three-dimensional-printing Technology in Hip and Pelvic Surgery: Current Landscape.
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.
Citations
More filters
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: In this article, a review of the use cases of machine learning in biomaterials is presented, followed by a discussion of how machine learning can be applied in the development and design process.
Abstract: Biomaterials is an exciting and dynamic field, which uses a collection of diverse materials to achieve desired biological responses. While there is constant evolution and innovation in materials with time, biomaterials research has been hampered by the relatively long development period required. In recent years, driven by the need to accelerate materials development, the applications of machine learning in materials science has progressed in leaps and bounds. The combination of machine learning with high-throughput theoretical predictions and high-throughput experiments (HTE) has shifted the traditional Edisonian (trial and error) paradigm to a data-driven paradigm. In this review, each type of biomaterial and their key properties and use cases are systematically discussed, followed by how machine learning can be applied in the development and design process. The discussions are classified according to various types of materials used including polymers, metals, ceramics, and nanomaterials, and implants using additive manufacturing. Last, the current gaps and potential of machine learning to further aid biomaterials discovery and application are also discussed.
34 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
22 Apr 2021
TL;DR: In this article, the authors present the results of the integration of 3D printing technology in a manufacturing university hospital, where the most common printing material was polylactic acid, although biocompatible resin was introduced to produce surgical guides.
Abstract: The integration of 3D printing technology in hospitals is evolving toward production models such as point-of-care manufacturing. This study aims to present the results of the integration of 3D printing technology in a manufacturing university hospital. Observational, descriptive, retrospective, and monocentric study of 907 instances of 3D printing from November 2015 to March 2020. Variables such as product type, utility, time, or manufacturing materials were analyzed. Orthopedic Surgery and Traumatology, Oral and Maxillofacial Surgery, and Gynecology and Obstetrics are the medical specialties that have manufactured the largest number of processes. Working and printing time, as well as the amount of printing material, is different for different types of products and input data. The most common printing material was polylactic acid, although biocompatible resin was introduced to produce surgical guides. In addition, the hospital has worked on the co-design of custom-made implants with manufacturing companies and has also participated in tissue bio-printing projects. The integration of 3D printing in a university hospital allows identifying the conceptual evolution to “point-of-care manufacturing.”
12 citations
TL;DR: In this paper, the authors provide an overview of the clinical outcomes for each of these reconstructive options following pelvic tumor resections, including endoprosthetic reconstruction, allograft or autograft reconstruction, arthrodesis, and hip transposition.
Abstract: Limb-salvage surgery for pelvic sarcomas remains one of the most challenging surgical procedures for musculoskeletal oncologists. In the past several decades, various surgical techniques have been developed for periacetabular reconstruction following pelvic tumor resection. These methods include endoprosthetic reconstruction, allograft or autograft reconstruction, arthrodesis, and hip transposition. Each of these procedures has its own advantages and disadvantages, and there is no consensus or gold standard for periacetabular reconstruction. Consequently, this review provides an overview of the clinical outcomes for each of these reconstructive options following pelvic tumor resections. Overall, high complication rates are associated with the use of massive implants/grafts, and deep infection is generally the most common cause of reconstruction failure. Functional outcomes decline with the occurrence of severe complications. Further efforts to avoid complications using innovative techniques, such as antibiotic-laden devices, computer navigation, custom cutting jigs, and reduced use of implants/grafts, are crucial to improve outcomes, especially in patients at a high risk of complications.
10 citations
References
More filters
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: From 1982 to 1988, 147 cemented acetabular components were revised with cementless hemispheric press-fit components, with an average follow-up period of 5.7 years (range, 3-9 years); six of the 147 components were considered radiographically and clinically unstable, warranting revision.
Abstract: From 1982 to 1988, 147 cemented acetabular components were revised with cementless hemispherical press-fit components, with an average follow-up period of 5.7 years (range, 3–9 years). Acetabular defects were typed from 1 to 3 and reconstructed with a bulk or support allograft. Type 1 defects had bone lysis around cement anchor sites and required particulate graft. Type 2A and B defects displayed progressive bone loss superiorly and required particulate graft, femoral head bulk graft, or cup superiorization. Type 2C defects required medial wall repair with wafer femoral head graft. Type 3A and B defects demonstrated progressive amounts of superior rim deficiencies and were treated with structural distal femur or proximal tibia allograft. Six of the 147 components (4.0%), all type 3B, were considered radiographically and clinically unstable, warranting revision. Three of the six were revised. Moderate lateral allograft resorption was noted on radiographs, but host-graft union was confirmed at rerevision. Size, orientation, and method of fixation of the allografts play an important role in the integrity of structural allografts, while adequate remaining host-bone must be present to ensure bone ingrowth.
998 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 results indicate that the pore structure of the P600 implant is a suitable porous structure for orthopedic implants manufactured by SLM.
564 citations
TL;DR: It is shown that the fully porous implant with an optimized material micro‐structure can reduce the amount of bone loss secondary to stress shielding by 75% compared to a fully solid implant.
299 citations