3D printing in shoulder surgery

Abstract

Three-dimensional (3D) printing is a novel modality with the potential to make a huge impact in the surgical field. The aim of this paper is to provide an overview on the current use of 3D printing in shoulder surgery. We have reviewed the use of this new method in 3 fields of shoulder surgery: shoulder arthroplasty, recurrent shoulder instability and orthopedic shoulder traumatology. In shoulder arthroplasty, several authors have shown that the use of the 3D printer improves the positioning of the glenoid component, even if longer clinical follow-up is needed to determine whether the cost of this system rationalizes the potential improved functional outcomes and decreases glenoid revision rates. In the treatment of anterior shoulder instability, the literature agrees on the fact that the use of the 3D printing can: enhance the dept and size of bony lesions, allowing a patient tailored surgical planning and potentially reducing operative times; allow the production of personalized implants to restore substantial bone loss; restore glenohumeral morphology and instability. In orthopedic trauma, the use of 3D printing can be helpful to increase the understanding of fracture patterns, facilitating a more personalized planning, and can be used for resident training and education. We can conclude the current literature regarding the use of 3D printed models in orthopedic surgery agrees finding objective improvements to preoperative planning and to the surgical procedure itself, by shortening the intraoperative time and by the possibility to develop custom-made, patient-specific surgical instruments, and it suggests that there are tangible benefits for its implementation.

Artroplastia parcial de ombro guiada por prototipagem tridimensional

“…Concluem que a técnica é benéfica e responsável pela redução do tempo cirúrgico, da perda sanguínea e de fluoroscopia demasiada. 13…”

“…The authors conclude that the technique is beneficial and can reduce surgical time, blood loss, and fluoroscopy use. 13…”

“…The authors conclude that the technique is beneficial and can reduce surgical time, blood loss, and fluoroscopy use. 13 The purpose of planning with a 3D-printed prototype in a young female patient with distorted anatomy was to perform all the steps quickly, accurately, and safely, and to increase prosthesis survival. However, an unforeseen extra step, a GT osteotomy, was required, potentially leading to implant choice issues and iatrogenic injuries, such as periprosthetic fractures and increased safety for the surgery team during the procedure.…”

“…Concluem que a técnica é benéfica e responsável pela redução do tempo cirúrgico, da perda sanguínea e de fluoroscopia demasiada. 13 O propósito do planejamento da impressão 3D em um caso com a anatomia distorcida em uma paciente jovem foi executar de maneira rápida, precisa e segura todos os passos, e proporcionar uma maior sobrevida à prótese. Entretanto, demonstrou-se a necessidade de um passo extra não previsto, uma osteotomia da GT, que potencialmente causaria imprevistos na escolha de implante, lesões iatrogénicas como fraturas periprotéticas e permitiu maior segurança da equipe de cirurgia durante o procedimento.…”

Three-dimensional technologies used for patient specific applications in orthopedics

“…Three-dimensional printing technology has been used successfully in preoperative planning of complex acetabular fractures [9], clavicle fractures [10], tibial fractures [11], pelvic surgery [12], trimalleolar and calcaneal fractures [13], elbow fractures [14], complicated proximal shoulder fractures [15], ankle fractures [16], rib fractures [17], long bone fractures [18], as well as in pre-contouring of fixation plates [19].…”