Additive manufacturing-based design approaches and challenges for orthopaedic bone screws: a state-of-the-art review

Agarwal, Raj; Gupta, Vishal; Singh, Jaskaran

doi:10.1007/s40430-021-03331-8

Cited by 45 publications

(24 citation statements)

References 109 publications

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“…[15,16] Bone screws provide support for fixation of bone plates and fragments but require high pullout strength along with reduced chances of screw loosening. [17] Wires and pins are mostly added along with other fixation devices for enhancement of bone stability because wires show minimum resistance to bending. Provision of space for placement of additional hardware with minimum damage to bone and soft tissues are key advantages of using wires and pins as internal fixation devices.…”

Section: Introductionmentioning

confidence: 99%

Current trends, applications, and challenges of coatings on additive manufacturing based biopolymers: A state of art review

2022

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Healing of bone fractures highly depends on the biocompatibility, stability in biological conditions, biodegradability, technical functionality, and shelf‐life of biomaterials. Metallic biomaterials offer excellent mechanical properties and biocompatibility. However, metallic bone implants result in stress shielding, release of toxic ions, excessive wear, and corrosion. Polymer materials are being explored for bone implants due to their light‐weight, biocompatibility, biodegradability, and absence of stress shielding. In the new era, additive manufacturing (AM) is being preferred due to its capability of fabricating customer specific implants with minimum material wastage. However, AM based polymer implants lack in mechanical strength and biological properties. Surface modification of polymeric substrates using coatings and incorporation of bioadditives have been regarded as alternatives for improvement of mechanical and biological properties. This review discusses about various coating techniques and gives an overview about coatings and bioadditives that can be used for enhancement of properties. From the review, it is evident that reinforcement of hydroxyapatite to polylactic acid resulted in prevention of crack growth during shape recovery cycles which can be used for self‐fitting implants. Coatings have been successful in enhancing hydrophilicity, mechanical properties, anti‐biofouling, antibacterial and anti‐coagulative properties, adhesion, proliferation, and differentiation of cells on the coated surface. This review also discusses the challenges that need to be overcome for progression in this field.

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Section: Introductionmentioning

confidence: 99%

Current trends, applications, and challenges of coatings on additive manufacturing based biopolymers: A state of art review

2022

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“…Three dimensional (3D) printing technology is currently employed in orthopedic surgery, dental surgery and cardiovascular surgeries for surgical planning, 3D scanning, virtual planning, patient-specific prosthetics and customized implants fabrication. [13][14][15][16][17][18][19] It can provide a porous lattice structure utilized in orthopedics for personalized implant design and porous screw fabrication. Korde et al [20] used 3D printing technology to fabricate honeycomb-patterned composites.…”

Section: Introductionmentioning

confidence: 99%

Post‐yielding fracture mechanics of 3D printed polymer‐based orthopedic cortical screws

et al. 2022

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The internal fixation of a fractured bone is generally achieved with bone screws during most orthopedic surgeries. Biodegradable screws have not received as much attention as they deserve. Biodegradable screws reduce the stress‐shielding effect, screw failure, complex, painful revision surgery for screw extraction. The vital focus of the present research is to fabricate cortical bone screws using polylactic acid (PLA) by fused deposition modeling technology. The PLA cortical screws were manufactured with different infill patterns (triangular, honeycomb, grid, and concentric), keeping other parameters constant using three‐dimensional printing. The mechanical behavior and fracture mechanism of different patterned cortical screws were observed based on compression testing and tensile testing of screws. Scanning electron microscopy (SEM) observed the surface topographical features, fracture behavior, and microstructure characterization of different patterned polymeric cortical screws were observed using SEM. Based on the SEM micrographs, mechanical characterization of compression and tensile testing shows the stress, fractures and fatigue cracks propagation at the bone screw interfaces by fractures copy. Moreover, it was observed that the fracture mechanism of ductile to brittle fracture was observed with variation in the infill pattern of the bone screw. The outcomes revealed that the cortical screw with honeycomb infill pattern has the highest compressive and tensile strength than other infill patterns. Honeycomb structured cortical screws have approximately 17% higher compressive strength and 30% higher tensile strength than the triangular patterned cortical screw due to higher bonding surface area at the intercalated layers.

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“…Bioabsorbable screws are magnetic resonance imaging (MRI) compatible, reduce the stress-shielding effect, degrade and absorb in the body so no revision surgery is required for removal of the implanted screw and also decreased the incidence of graft laceration (Chandra and Pandey, 2020). The biodegradable screws are made of synthetic polymers like poly(lactic-co-glycolic acid) (PLGA), poly(L-lactic acid) (PLLA), polycaprolactone (PCL), poly(lactic acid) (PLA) (Agarwal, Gupta, et al , 2022). Hydrolytic degradation of PLGA or PLLA releases acidic by-products that inhibit angiogenesis causing fluid effusion and foreign body reactions.…”

Section: Introductionmentioning

confidence: 99%

“…Additive manufacturing (AM) technology is rapidly used in various surgeries for surgical planning, patient-specific prosthetics (Agarwal, Gupta, et al , 2022), improving precise medical treatment through 3 D reconstruction (Agarwal, 2021), 3 D scanning (Ahangar et al , 2019) and digital processing of patient data (Marinescu and Popescu, 2020). In addition, this technology can provide complex structure and porous lattice structure that makes it used in orthopaedics for customized implant design and porous screw fabrication (Lee et al , 2020).…”

Section: Introductionmentioning

confidence: 99%

Mechanical and biological behaviour of additive manufactured biomimetic biodegradable orthopaedic cortical screws

Agarwal

Gupta

Singh

2022

RPJ

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Purpose The complications caused by metallic orthopaedic bone screws like stress-shielding effect, screw loosening, screw migration, higher density difference, painful reoperation and revision surgery for screw extraction can be overcome with the bioabsorbable bone screws. This study aims to use additive manufacturing (AM) technology to fabricate orthopaedic biodegradable cortical screws to reduce the bone-screw-related-complications. Design/methodology/approach The fused filament fabrication technology (FFFT)-based AM technique is used to fabricate orthopaedic cortical screws. The influence of various process parameters like infill pattern, infill percentage, layer height, wall thickness and different biological solutions were observed on the compressive strength and degradation behaviour of cortical screws. Findings The porous lattice structures in cortical screws using the rapid prototyping technique were found to be better as porous screws can enhance bone growth and accelerate the osseointegration process with sufficient mechanical strength. The compressive strength and degradation rate of the screw is highly dependent on process parameters used during the fabrication of the screw. The compressive strength of screw is inversely proportional to the degradation rate of the cortical screw. Research limitations/implications The present study is focused on cortical screws. Further different orthopaedic screws can be modified with the use of different rapid prototyping techniques. Originality/value The use of rapid prototyping techniques for patient-specific bone screw designs is scantly reported. This study uses FFFT-based AM technique to fabricate various infill patterns and porosity of cortical screws to enhance the design of orthopaedic cortical screws.

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Additive manufacturing-based design approaches and challenges for orthopaedic bone screws: a state-of-the-art review

Cited by 45 publications

References 109 publications

Current trends, applications, and challenges of coatings on additive manufacturing based biopolymers: A state of art review

Current trends, applications, and challenges of coatings on additive manufacturing based biopolymers: A state of art review

Post‐yielding fracture mechanics of 3D printed polymer‐based orthopedic cortical screws

Mechanical and biological behaviour of additive manufactured biomimetic biodegradable orthopaedic cortical screws

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