Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review

Abstract

There has been a lot of hype surrounding the advantages to be gained from rapid prototyping processes in a number of fields, including medicine. Our literature review aims objectively to assess how effective patient-specific surgical guides manufactured using rapid prototyping are in a number of orthopaedic surgical applications. To this end, we carried out a systematic review to identify and analyse clinical and experimental literature studies in which rapid prototyping patient-specific surgical guides are used, focusing especially on those that entail quantifiable outcomes and, at the same time, providing details on the guides' design and type of manufacturing process. Here, it should be mentioned that in this field there are not yet medium- or long-term data, and no information on revisions. In the reviewed studies, the reported positive opinions on the use of rapid prototyping patient-specific surgical guides relate to the following main advantages: reduction in operating times, low costs and improvements in the accuracy of surgical interventions thanks to guides' personalisation. However, disadvantages and sources of errors which can cause patient-specific surgical guide failures are as well discussed by authors. Stereolithography is the main rapid prototyping process employed in these applications although fused deposition modelling or selective laser sintering processes can also satisfy the requirements of these applications in terms of material properties, manufacturing accuracy and construction time. Another of our findings was that individualised drill guides for spinal surgery are currently the favourite candidates for manufacture using rapid prototyping. Other emerging applications relate to complex orthopaedic surgery of the extremities: the forearm and foot. Several procedures such as osteotomies for radius malunions or tarsal coalition could become standard, thanks to the significant assistance provided by rapid prototyping patient-specific surgical guides in planning and performing such operations.

Web-based Collaborative Platform for Personalized Orthopaedic Applications

“…The answers to these questionnaires are sent to the engineer as reports. Based on the cases presented in the literature [12] and on the project team members' experience, structured and adaptive questionnaires are set for the main type of interventions in which patient individualized surgical guides can be used. These constitute heuristics for the rules based inference engine.…”

“…Literature analysis [12] served for defining the aforementioned list, but also the input and experience of orthopedic surgeons' from the research team was considered.…”

Novel Procedure for Designing and 3D Printing a Customized Surgical Template for Arthrodesis Surgery on the Sacrum

“…Screw placement in spinal segments is a frequently used procedure for posterior stabilization of the spine [1,2] via arthrodesis intervention [3]. The variability of pedicles' geometries and orientation, their small size, as well as the existence of nearby nerve roots and vascular structures can cause problems for screw placement.…”

“…Once the entry point is fixed, surgeons generally need to make adjustments or corrections to the direction of the screws. The incorrect positioning of the screws may lead to an increase in the overall duration of surgery, and, consequently, more harmful, real-time X-ray checks [1,2] and can cause operating failures and subsequent re-operations,. Computer-Aided Surgery (CAS) uses systems that provide real-time assistance to the surgeon during the operation.…”

Development and 3D Printing of an ABS Ergonomic Handle for Medical Use A case study

“…The use of Additive Manufacturing (or 3D Printing) in the medical field starts to become a common practice if one considers the increasing number of scientific papers [1][2][3], research projects and patents [4,5], as well as the number of applications developed by universities and/or specialized companies [3,6].…”