3D Printing Applications in Orthopaedic Surgery: Clinical Experience and Opportunities

Abstract

Background: Three-dimensional (3D) printing is a technology capable of creating solid objects based on the reproduction of computerised images. This technology offers revolutionary impacts on surgical practice, especially in prosthetic and traumatological surgery. Methods: 20 patients with proximal humeral fractures were divided into two groups, one of which involved the processing of a 3D model. The model made it possible to plan the positioning and dimensions of the implants. The results were then compared with those obtained according to the usual procedures. We also reported the irreparable case of a custom revision implants acetabular bone loss treated with a 3D-printed, custom-made implant. Results: In the processed 3D proximal humeral fracture series, in the face of time and costs expenses, surgical and X-ray times were shorter than in the control group. On the other hand, there were no differences in terms of blood loss. The patient who underwent acetabular re-prosthetic surgery in a 3B Paprosky bone loss was managed and solved with a 3D-printed, custom-made implant and reported excellent outcomes at a 1 year follow-up. Conclusion: Three-dimensional printing made it possible to create better pre-operative planning in traumatology in order to optimise surgical procedures and outcomes. It also made it possible to deal with large losses of bone stock in prosthetic revision surgery, even when reconstruction may have appeared impossible with traditional implants.

Three-dimensional printed models can reduce costs and surgical time for complex proximal humeral fractures: preoperative planning, patient satisfaction, and improved resident skills

“…In general, the interpretation of imaging data is now actually a process of integrating 2D and 3D images, but in complex fractures of the proximal humerus, with difficult-to-understand spatial structures, the analysis and complete determination of the fracture pathological anatomy are more difficult [ 8 , 11 , 26 ]. The occurrence of iatrogenic complications is not only associated with surgical skill and mastery of theoretical knowledge, but also related to preoperative diagnosis and surgical planning [ 1 ]. This is especially true for junior surgeons and trainees, where hands-on practical experience goes a long way in successfully performing high-demand surgeries [ 27 , 28 ].…”

“…Utilizing a well-defined methodology to create a 1:1 scale 3D-printed model using polytactic acid (PLA) plastic filament [ 1 ], two full-touch anatomical models were created for each patient in group A: a “fracture model” and a “reduction model.” Our academic institution owns the printer, which is made freely available for research purposes. The “fracture model” served as a static representation of the fracture, in which artificial “3D bridges” were included to stabilize and maintain the precise and current positions of the bone fragments.…”

“…Anatomical three-dimensional (3D) printers are a type of technology that can duplicate solid objects using digital scans from informatics. These samples are utilized in medical research to examine anatomical deformities that have a significant impact on surgical practice [ 1 – 4 ].…”

“…In the trauma field, a 3D-printed anatomical model may offer a direct and interactive image of the characteristics of a fracture, assisting orthopedic surgeons in better operational planning [ 1 ]. Additionally, this technology can be used to simulate surgical procedures, such as fracture reduction and hardware selection to get the best fixation, just as has been done for some anatomical areas, including acetabulum, wrist, tibia, and calcaneus [ 5 – 7 ].…”

The Clinical Efficacy of Contouring Periarticular Plates on a 3D Printed Bone Model

“…Technical advances have considerably improved medical treatment practices, and 3D printing (3DP) techniques have been applied to the field of orthopedics [7][8][9][10][11][12]. Recently, several studies have shown that 3DP, the rapid prototyping technology, can be used for efficient preoperative plate contouring as per the exact surface of the individualized 3DP bone model [13][14][15][16].…”