Three-Dimensional Printed Knee Implants: Insights into Surgeons’ Points of View (original) (raw)
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Techniques in Orthopaedics, 2016
Three-dimensional printing and modeling has evolved significantly since first introduced in the 1980s. In the last 5 years, this revolution in technology has become far more accessible and affordable, and is already mainstream in many areas of medicine. Nowhere is this more apparent than in orthopedics, and many surgeons already incorporate aspects of 3D modeling and virtual procedures in their routine clinical practice. However, this technology promises to become even more prevalent as creative applications continue to be developed, and further innovations are certain to come. There are important public policy aspects to consider, both economic and regulatory. Regulatory issues are currently still under development, but will need to take into account sterilization, quality assurance, and product liability. The mechanical integrity of 3D-printed implants is influenced by the unique characteristics of the print process, including the energy density of the laser, the resolution of the print, and the orientation of the print on the build platform. Introduction of expensive new technology should only be done after careful consideration of the costs associated, the potential benefits, and the value that can be derived. The value in 3D modeling and printing can be considered relative to the initial costs, the experience of a 3D modeling unit, the complexity of a particular case, and the clinical expertise of the surgeons involved. There is significant potential value derived from modeling most displaced intraarticular fractures, once a 3D modeling unit is established and proficient. However, the greatest value comes from modeling the most highly complex cases. When the pathology is most abnormal, 3D modeling/printing can be a valuable clinical adjunct for even the most expert and experienced surgeons. Although currently hospital-based 3D modeling/printing units are uncommon, they will soon become far more common. For surgeons in developing nations, 3D printing may currently be prohibitively expensive, but 3D modeling is relatively inexpensive and therefore far more accessible. As 3D printer prices continue to fall, the ability to rapidly manufacture prototypes and patient-specific models will inevitably spread through these regions as well. However, the future for 3D-printed medical models, devices, and implants will be limited unless we are able to document their clinical superiority and confirm their value with respect to patient outcomes. Level of Evidence: Level V-expert opinion.
Application of 3D printing in orthopaedic surgery. A new affordable horizon for cost-conscious care
JPMA. The Journal of the Pakistan Medical Association, 2019
Application of three-dimensional (3D) printing facilities in orthopaedic surgery is getting popular in resourceconstrained countries. It is cost- and resource-efficient to assist in planning and increasing orthopaedic procedures efficienc y. Furthermore, it improves educational training and provides cheaper prosthesis and creation of customised implants for special cases. Moreover, 3D models of computed tomography (CT) and magnetic resonance imaging (MRI) data play a helpful rule for a more hands-on approach for the surgeon. Likeevidence-based medicine practice, researchers are exploring new areas of patient-specific instrumentation in the surgical field, searching for favourable and costeffective results. Three-dimensional printing has shown promising results for quick and cost-effective solutions in several fields. Many fields of application are dependent on various uses of 3D printing, but it has yet to be used widely in medicine and orthopaedics. The current literature review wa...
Cureus, 2023
Total knee arthroplasty (TKA) is currently one of the most common orthopedic surgeries due to the everincreasing average life expectancy. The constant need for effective and accurate techniques was contributed to the development of three-dimensional (3D) printing in that field, especially for patient-specific instrumentation (PSI) and custom-made implants fabrication. PSI may offer numerous benefits, such as resection accuracy, mechanical axis alignment, cost-effectiveness, and time economy. Nonetheless, the results of existing studies are controversial. For this purpose, a review article of the published articles was conducted to summarize the role of 3D-printed PSI in TKA.
3D Printing Applications in Orthopaedic Surgery: Clinical Experience and Opportunities
Applied Sciences
Background: Three-dimensional (3D) printing is a technology capable of creating solid objects based on the reproduction of computerised images. This technology offers revolutionary impacts on surgical practice, especially in prosthetic and traumatological surgery. Methods: 20 patients with proximal humeral fractures were divided into two groups, one of which involved the processing of a 3D model. The model made it possible to plan the positioning and dimensions of the implants. The results were then compared with those obtained according to the usual procedures. We also reported the irreparable case of a custom revision implants acetabular bone loss treated with a 3D-printed, custom-made implant. Results: In the processed 3D proximal humeral fracture series, in the face of time and costs expenses, surgical and X-ray times were shorter than in the control group. On the other hand, there were no differences in terms of blood loss. The patient who underwent acetabular re-prosthetic sur...
3D Printing in Arthroplasty: A Systematic Review
Journal of Orthopedics and Joint Surgery
SyStematic review material, liquid-like plastic/polymers, or metals are used by the printer to assemble the model. 3D printing incorporates adding or removing material layers to form the desired shape, which allows porous and solid sections to combine to offer optimal strength and performance. 3D printing application in arthroplasty includes detailed preoperative planning, including the manufacturing of patient-specific templates and cutting guide generation of customized implants. It also increases the accurate guidance to perform desired bone cuts in the arthroplasty. Various studies have been done to validate the outcome of this technology in arthroplasty procedures of different joints in the body.
3D PRINTING TECHNOLOGY SOFTWARE IN ORTHOPEDIC THERAPIES
Three-dimensional printing technology, commonly known as practical or functional prototypes, is a one-of-a-kind method for developing three-dimensional conceptions utilizing computer-aided design. One Pakistani doctor devised it fifty years ago, and was first employed in industrialization. Only within recent decades, with advancements in industrial technology also materials, has 3D printing was employed in a few medicinal professions just like dentistry, maxillofacial operations, also neurosurgery. 3D printing has similarly become gradually general in orthopedics, particularly for treatment planning, surgical guidance, individualized implants, and customized prostheses. Personalized surgical therapy might be readily and accurately designed using 3D printing, lowering frequency response and complications associated. And for its specific qualities, 3D printing could bring the physician to accuracy medicine while also providing cases having both the greatest cure outcomes at the lowest possible cost.
3D printing and unicompartmental knee arthroplasty
EFORT open reviews, 2018
In suitable patients, unicompartmental knee arthroplasty (UKA) offers a number of advantages compared with total knee arthroplasty. However, the procedure is technically demanding, with a small tolerance for error. Assistive technology has the potential to improve the accuracy of implant positioning.This review paper describes the concept of detailed UKA planning in 3D, and the 3D printing technology that enables a plan to be delivered intraoperatively using patient-specific instrumentation (PSI).The varying guide designs that enable accurate registration are discussed and described. The system accuracy is reported.Future studies need to ascertain whether accuracy for low-volume surgeons can be delivered in the operating theatre using PSI, and reflected in improved patient reported outcome measures, and lower revision rates. Cite this article: 2018;3 DOI: 10.1302/2058-5241.3.180001.
BMC Musculoskeletal Disorders, 2021
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 h...
3D printing in orthopaedic surgery: a scoping review of randomized controlled trials
Bone & Joint Research
Aims The use of 3D printing has become increasingly popular and has been widely used in orthopaedic surgery. There has been a trend towards an increasing number of publications in this field, but existing literature incorporates limited high-quality studies, and there is a lack of reports on outcomes. The aim of this study was to perform a scoping review with Level I evidence on the application and effectiveness of 3D printing. Methods A literature search was performed in PubMed, Embase, and Web of Science databases. The keywords used for the search criteria were ((3d print*) OR (rapid prototyp*) OR (additive manufactur*)) AND (orthopaedic). The inclusion criteria were: 1) use of 3D printing in orthopaedics, 2) randomized controlled trials, and 3) studies with participants/patients. Risk of bias was assessed with Cochrane Collaboration Tool and PEDro Score. Pooled analysis was performed. Results Overall, 21 studies were included in our study with a pooled total of 932 participants. ...