Use of three-dimensional printing in preoperative planning in orthopaedic trauma surgery: A systematic review and meta-analysis

Morgan, Catrin; Khatri, Chetan; Hanna, Sammy A.; Ashrafian, Hutan; Sarraf, Khaled M

doi:10.5312/wjo.v11.i1.57

Cited by 60 publications

(66 citation statements)

References 43 publications

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“…The utility of 3D printed biomodels for preoperative planning has been of great interest in recent years [35]. In our study, 87.32% of the required products were 3D printed biomodels used not only for surgical planning but also for communication or research.…”

Section: Discussionmentioning

confidence: 81%

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from “do it yourself” to “point of care manufacturing”

Calvo-Haro

Pascau

Mediavilla-Santos

et al. 2021

BMC Musculoskelet Disord

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Background 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and to identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine. Methods Observational, descriptive, retrospective and monocentric study of a total of 623 additive manufacturing processes carried out in a Department of Orthopedic Surgery and Traumatology from November 2015 to March 2020. Variables such as product type, utility, time or materials for manufacture were analyzed. Results The areas of expertise that have performed more processes are Traumatology, Reconstructive and Orthopedic Oncology. Pre-operative planning is their primary use. Working and 3D printing hours, as well as the amount of 3D printing material used, vary according to the type of product or material delivered to perform the process. The most commonly used 3D printing material for manufacturing is polylactic acid, although biocompatible resin has been used to produce surgical guides. In addition, the hospital has worked on the co-design of customized implants with manufacturing companies. Conclusions The integration of 3D printing in a Department of Orthopedic Surgery and Traumatology allows identifying the conceptual evolution from “Do-It-Yourself” to “POC manufacturing”.

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Section: Discussionmentioning

confidence: 81%

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from “do it yourself” to “point of care manufacturing”

Calvo-Haro

Pascau

Mediavilla-Santos

et al. 2021

BMC Musculoskelet Disord

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“… 37 This is consistent with literature in the adult population. 9 , 47 , 48 Improvements in angular correction 29 and range of motion were also demonstrated. 29 , 30 …”

Section: Discussionmentioning

confidence: 84%

The effect of three-dimensional (3D) printing on quantitative and qualitative outcomes in paediatric orthopaedic osteotomies: a systematic review

2021

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Three-dimensional (3D) printing technology is increasingly being utilized in various surgical specialities. In paediatric orthopaedics it has been applied in the pre-operative and intra-operative stages, allowing complex deformities to be replicated and patient-specific instrumentation to be used. This systematic review analyses the literature on the effect of 3D printing on paediatric orthopaedic osteotomy outcomes. A systematic review of several databases was conducted according to PRISMA guidelines. Studies evaluating the use of 3D printing technology in orthopaedic osteotomy procedures in children (aged ≤ 16 years) were included. Spinal and bone tumour surgery were excluded. Data extracted included demographics, disease pathology, target bone, type of technology, imaging modality used, qualitative/quantitative outcomes and follow-up. Articles were further categorized as either ‘pre-operative’ or ‘intra-operative’ applications of the technology. Twenty-two articles fitting the inclusion criteria were included. The reported studies included 212 patients. There were five articles of level of evidence 3 and 17 level 4. A large variety of outcomes were reported with the most commonly used being operating time, fluoroscopic exposure and intra-operative blood loss. A significant difference in operative time, fluoroscopic exposure, blood loss and angular correction was found in the ‘intra-operative’ application group. No significant difference was found in the ‘pre-operative’ category. Despite a relatively low evidence base pool of studies, our aggregate data demonstrate a benefit of 3D printing technology in various deformity correction applications, especially when used in the ‘intra-operative’ setting. Further research including paediatric-specific core outcomes is required to determine the potential benefit of this novel addition. Cite this article: EFORT Open Rev 2021;6:130-138. DOI: 10.1302/2058-5241.6.200092

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“…In the last years, preoperative planning using clinical CT scans, 3D printing, or virtual reality, as well as intraoperative navigation and 3D printed templates has become increasingly more routine, especially in complex cases [19][20][21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans

Wähnert

Frank

Ueberberg

et al. 2021

Sci Rep

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Sufficient implant anchoring in osteoporotic bone is one major challenge in trauma and orthopedic surgery. In these cases, preoperative planning of osteosynthesis is becoming increasingly important. This study presents the development and first biomechanical validation of a bone-implant-anchorage score based on clinical routine quantitative computer tomography (qCT) scans. 10 pairs of fresh frozen femora (mean age 77.4 years) underwent clinical qCT scans after placing 3 referential screws (for matching with the second scan). Afterwards, three 4.5 mm cortical screws (DePuy Synthes, Zuchwil, Switzerland) were placed in each distal femur in the dia-metaphyseal transition followed by the second CT scan. The femur was segmented using thresholding and its outer shape was visualized as a surface model. A 3D model of the cortex screw in STL format was used to model the screw surface precisely. For each femur, the 3 cortex screw models were exactly positioned at the locations previously determined using the second CT scan. The BMD value was calculated at the center of each triangle as an interpolation from the measured values at the three vertices (triangle corners) in the CT. Scores are based on the sum of all the triangles’ areas multiplied by their BMD values. Four different scores were calculated. A screw pull-out test was performed until loss of resistance. A quadratic model adequately describes the relation between all the scores and pull-out values. The square of the best score explains just fewer than 70% of the total variance of the pull-out values and the standardized residual which were approximately normally distributed. In addition, there was a significant correlation between this score and the peak pull-out force (p < 0.001). The coefficient of determination was 0.82. The presented score has the potential to improve preoperative planning by adding the mechanical to the anatomical dimension when planning screw placement.

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Use of three-dimensional printing in preoperative planning in orthopaedic trauma surgery: A systematic review and meta-analysis

Cited by 60 publications

References 43 publications

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from “do it yourself” to “point of care manufacturing”

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from “do it yourself” to “point of care manufacturing”

The effect of three-dimensional (3D) printing on quantitative and qualitative outcomes in paediatric orthopaedic osteotomies: a systematic review

Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans

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