Three-dimensional Printing in Orthopaedic Surgery: Current Applications and Future Developments

Wixted, Colleen; Peterson, Jonathan; Kadakia, Rishin J.; Adams, Samuel B.

doi:10.5435/jaaosglobal-d-20-00230

Cited by 52 publications

(27 citation statements)

References 73 publications

(41 reference statements)

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“…The growing popularity and expansion across industries providing 3D printing resources has substantially decreased costs, increased access, and led to multiple applications in orthopaedic trauma surgery [ 6 , 7 ]. Early results on the clinical application of 3D printing improved levels of understanding into complex fractures for both surgeons and patients and strengthened the informed consent process [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

Assink

Reininga

Duis

et al. 2021

Eur J Trauma Emerg Surg

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Purpose The aim of this systematic review was to provide an overview of current applications of 3D technologies in surgical management of tibial plateau fractures and to assess whether 3D-assisted surgery results in improved clinical outcome as compared to surgery based on conventional imaging modalities. Methods A literature search was performed in Pubmed and Embase for articles reporting on the use of 3D techniques in operative management of tibial plateau fractures. This systematic review was performed in concordance with the PRISMA-guidelines. Methodological quality and risk of bias was assessed according to the guidelines of the McMaster Critical Appraisal. Differences in terms of operation time, blood loss, fluoroscopy frequency, intra-operative revision rates and patient-reported outcomes between 3D-assisted and conventional surgery were assessed. Data were pooled using the inverse variance weighting method in RevMan. Results Twenty articles evaluating 948 patients treated with 3D-assisted surgery and 126 patients with conventional surgery were included. Five different concepts of 3D-assisted surgery were identified: ‘3D virtual visualization’, ‘3D printed hand-held fracture models’, ‘Pre-contouring of osteosynthesis plates’, ‘3D printed surgical guides’, and ‘Intra-operative 3D imaging’. 3D-assisted surgery resulted in reduced operation time (104.7 vs. 126.4 min; P < 0.01), less blood loss (241 ml vs. 306 ml; P < 0.01), decreased frequency of fluoroscopy (5.8 vs. 9.1 times; P < 0.01). No differences in functional outcome was found (Hospital for Special Surgery Knee-Rating Scale: 88.6 vs. 82.8; P = 0.23). Conclusions Five concepts of 3D-assisted surgical management of tibial plateau fractures emerged over the last decade. These include 3D virtual fracture visualization, 3D-printed hand-held fracture models for surgical planning, 3D-printed models for pre-contouring of osteosynthesis plates, 3D-printed surgical guides, and intra-operative 3D imaging. 3D-assisted surgery may have a positive effect on operation time, blood loss, and fluoroscopy frequency.

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Section: Introductionmentioning

confidence: 99%

Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

Assink

Reininga

Duis

et al. 2021

Eur J Trauma Emerg Surg

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“…[10,13,24] Both polymers and metals are being 3D printed and used for various orthopedic applications. [7,8,13,25,26] Metallic porous scaffolds are advantageous for structural support and load-bearing applications due to their high strength and fatigue resistance, which is especially beneficial for bone reconstruction applications. [13] Polymeric scaffolds are more compatible with softer tissues and can be biodegradable, allowing a theoretical return to all-natural tissues.…”

Section: Resultsmentioning

confidence: 99%

High‐Strength Composites Based on 3D Printed Porous Scaffolds Infused with a Bioresorbable Mineral–Organic Bone Adhesive

et al. 2022

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Bioresorbable bone adhesives are attractive materials for applications where bone repair, regeneration, or reconstruction is involved. They can potentially augment or replace metal fixation while allowing to avoid follow‐up procedures upon bone healing. Combining such bone adhesives with other clinically relevant materials could significantly improve the mechanical and biological properties of the resulting composite due to the strong adhesive interactions between the adhesive and the material. Herein, an efficient strategy is presented to create biomedically relevant biphasic scaffolds through filling 3D printed gyroid polymer or metal structures with a bioresorbable mineral‐organic bone adhesive. Due to the high interfacial adhesion of the bone adhesive and both polymers and metals, the biphasic scaffolds are efficiently stabilized by the bone adhesive, leading to a significant increase in the compressive strength and modulus. The 3D printed composite scaffolds infused with the bone adhesive possess improved mechanical properties and bioactivity while providing adhesion to bone facilitated by the bone adhesive regions and could potentially considerably improve clinical outcomes in orthopedic applications.

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“…Доказом збільшуваної уваги до 3D-друку є підвищення кількості публікацій із цієї тематики, які ілюструють дослідження, виконані в Китаї, США, Великій Британії, та їхньої цитованості в різних базах даних (Pubmed, Cochrane, SCOPUS, Web of Scince). Автори опублікованого аналізу дійшли оптимістичного висновку щодо перспектив використання цього методу в ортопедії та травматології [10]. Тому ми вважали за доцільне провести аналіз можливостей застосування методу 3D-візуалізації, зокрема 3D-друку, у лікуванні пацієнтів із наслідками травм кінцівок.…”

Section: вступunclassified

“…Отримані нами результати узгоджуються з досвідом зарубіжних колег щодо доцільності та можливості використання тривимірного друку в ортопедичній хірургії. Ця технологія забезпечує гнучкість у процесі проєктування хірургічного втручання на скелеті та дозволяє ефективно впроваджувати як готові, так і персоналізовані лікарські вироби, які краще відповідають потребам пацієнтів, ніж традиційні виробничі процеси [10]. Методом 3D-друку виготовляють не лише анатомічні моделі, а й нестандартні індивідуальні імплантати, інструменти та протези [9].…”

Section: результати та їх обговоренняunclassified

3D-print in the planning of surgical treatment in the case of extraarticular deformity of lower limbs

Romanenko¹,

Prozorovskiy²,

Doluda³

2021

OTP

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An adequate planning of the curative measures is an important factor providing good functional results in the treatment of consequences of long bones injuries, in particular, malunions (post traumatic deformities). 3D-modeling in the preoperative planing gives an opportunity to assess both deformity itself and joint status. Visualization of injured segment with three-dimensional model manufactured using 3D-print in actual size (1:1 scale) provides additional capacities. Objective. To analyze the capacity provided by the usage of three-dimensional models of damaged segments in scale 1:1 while the planning of corrective surgery. Methods. Practicability of the usage of 3D-models, that was worked out on the base of CT-scanning, was studied in the treatment of 52 patients with different post traumatic extraarticular deformities of femur and tibia, after the fractures with intraarticular extension. Clinical results were evaluated using SF-36 and AOFAS scales. Results. Calculation for 3D-modeling was performed mostly virtually using standard computer programs with 3D-reconstruction, but 3D-print technology was used for 5 patients with the most severe and sophisticated deformities of the lower extremities. Changes in functional outcomes, according to SF-36 and AOFAS, for the patients undergone opera- tive treatment, were positive at 12 month of follow-up. Foreign colleagues expose analogous results of the investigations and suggest that the modeling with 3D-print provides mostly more safe, reliable and standardized clinical decisions for every particular patient. Conclusions. Preoperative usage of 3D-print on the stage of preoperative planing allows the surgeons to simulate different stages of operative intervention on the physical model, thus, help him to realize possible technical problems, choose adequate fixation device and proper instrumentation. It facilitates the shortening of surgery time, elimination of possible complications rate and achievement, in sum, good functional results in the treatment of this kind of patients.

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Three-dimensional Printing in Orthopaedic Surgery: Current Applications and Future Developments

Cited by 52 publications

References 73 publications

Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

High‐Strength Composites Based on 3D Printed Porous Scaffolds Infused with a Bioresorbable Mineral–Organic Bone Adhesive

3D-print in the planning of surgical treatment in the case of extraarticular deformity of lower limbs

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