From Patient to Procedure: The Process of Creating a Custom 3D-Printed Medical Device for Foot and Ankle Pathology

Abstract

Three-dimensional (3D) printing technology has advanced greatly over the past decade and is being used extensively throughout the field of medicine. Several orthopaedic surgery specialties have demonstrated that 3D printing technology can improve patient care and physician education. Foot and ankle pathology can be complex as the 3D anatomy can be challenging to appreciate. Deformity can occur in several planes simultaneously and bone defects either from previous surgery or trauma can further complicate surgical correction. Three-dimensional printing technology provides an avenue to tackle the challenges associated with complex foot and ankle pathology. A basic understanding of how these implants are designed and made is important for surgeons as this technology is becoming more widespread and the clinical applications continue to grow within foot and ankle surgery. Levels of Evidence: Level V

Outcomes of Surgical Reconstruction Using Custom 3D-Printed Porous Titanium Implants for Critical-Sized Bone Defects of the Foot and Ankle

“…Advances in additive manufacturing now allow surgeons and engineers to collaborate potentially advanced patient care by 3D printing high-strength, anatomic, and porous implants designed to meet the needs of each patient. 19,22,29 This study provides data on the largest known cohort of patients receiving custom 3D-printed titanium implants for distal tibia, ankle, and hindfoot CSDs in a foot and ankle surgeon's practice. Previously, our group reported on a smaller, 15-patient cohort, demonstrating successful overall outcomes.…”

“…In each case, the 3D implant was created as previously described. 19 Briefly, a CT scan was obtained of the involved extremity and sent to the device manufacturer (either 4WEB Medical or Restor3D). Next, a team of engineers worked with the surgeon to design the implant based on the size and shape of the CSD and any additional surgical instrumentation (cutting guides, sizers) needed.…”

Development and evaluation of a facile mesh-to-surface tool for customised wheelchair cushions

“…Any process that requires an STL model to be parametrically edited after a scan, such as upper and lower limb prosthetic design or moulds for custom dental devices, could take the building blocks of the Grasshopper tool created and tested in this paper and restructure them to suit the needs of the product. Devices in the medical industry are already benefiting from moving to 3D printing as a manufacturing method [14,15]. To make custom 3D printed products more widely available to patients, creating and supplying software tools that ease the pain of device design without majorly increasing costs or design difficulty is key.…”

Use of 3D-Printed Implants in Complex Foot and Ankle Reconstruction

“…The process of creating a custom 3D-printed implant has been described in detail. [14][15][16] In brief, the first step is to obtain a recent CT scan of the involved extremity. The CT scan is sent to the implant manufacturer and undergoes the process of segmentation to define the relevant anatomy.…”