Additive manufacturing in orthopaedics: Clinical implications (original) (raw)
Related papers
Rapid Prototyping Journal, 2012
Purpose-The purpose of this paper is to present an improved methodology for design of custom-made hip prostheses, through integration of advanced image processing, computer aided design (CAD) and additive manufacturing (AM) technologies. Design/methodology/approach-The proposed methodology for design of custom-made hip prostheses is based on an independent design criterion for each of the intra-medullary and extra-medullary portions of the prosthesis. The intra-medullar part of the prosthesis is designed using a more accurate and detailed description of the 3D geometry of the femoral intra-medullary cavity, including the septum calcar ridge, so that an improved fill and fit performance is achieved. The extra-medullary portion of the prosthesis is designed based on the anatomical features of the femoral neck, in order to restore the original biomechanical characteristics of the hip joint. The whole design procedure is implemented in a systematic framework to provide a fast, repeatable and non-subjective response which can be further evaluated and modified in a preplanning simulation environment. Findings-The efficacy of the proposed methodology for design of custom-made hip prostheses was evaluated in a case study on a hip dysplasia patient. The cortical bone was distinguished from cancellous in CT images using a thresholding procedure. In particular the septum calcar ridge could be recognized and was incorporated in the design to improve the primary stability of the prosthesis. The lateral and frontal views of the prosthesis, with the patient's images at the background, indicated a close geometrical match with the cortical bone of femoral shaft, and a good compatibility with the anatomy of the proximal femur. Also examination of the cross sections of the prosthesis and the patient's intra-medullary canal at five critical levels revealed close geometrical match in distal stem but less conformity in proximal areas due to preserving the septum calcar ridge. The detailed analysis of the fitting deviation between the prosthesis and point cloud data of the patient's femoral intra-medullary canal, indicated a rest fitting deviation of 0.04 to 0.11 mm in stem. However, relatively large areas of interference fit of 20.04 mm were also found which are considered to be safe and not contributing to the formation of bone cracks. The geometrical analysis of the extra-medullary portion of the prosthesis indicated an anteversion angle of 12.5 degrees and a neck-shaft angle of 131, which are both in the acceptable range. Finally, a time and cost effective investment casting technique, based on AM technology, was used for fabrication of the prosthesis. Originality/value-The proposed design methodology helps to improve the fixation stability of the custom made total hip prostheses and restore the original biomechanical characteristics of the joint. The fabrication procedure, based on AM technology, enables the production of the customized hip prosthesis more accurately, quickly and economically.
Additive manufacturing applications in orthopaedics: A review
Journal of Clinical Orthopaedics and Trauma, 2018
The applications of Additive Manufacturing (AM) have increased extensively in the area of orthopaedics. The AM applications are for making anatomic models, surgical instruments & tool design, splints, implants and prosthesis. A brief review of various research articles shows that patient-specific orthopaedic procedures provide multiple applications areas and provide directions for future developments. The purpose of this paper is to identify the best possible usage of additive manufacturing applications in orthopaedics field. It also presents the steps used to prepare a 3D printed model by using this technology and details applications in the field of orthopaedics. AM gives a flexible solution in orthopaedics area, where customised implants can be formed as per the required shape and size and can help substitution with customised products. A 3D model created by this technology gain an accurate perception of patient's anatomy which is used to perform mock surgeries and is helpful for highly complex surgical pathologies. It makes surgeon's job accessible and increases the success rate of the operation. AM provides a perfect fit implant for the specific patient by unlimited geometric freedom. Various scanning technologies capture the status of bone defects, and printing of the model is done with the help of this technology. It gives an exact generation of a physical model which is also helpful for medical education, surgical planning and training. This technology can help to solve present-day challenges as data of every patient is different from another.
Recently, as the result of development in modern imaging, computerized three dimensional data processing and advanced engineering techniques, a prosthesis that match the skeletal anatomy can be accurately designed using computer aided design (CAD) where the physical model of prosthesis or skull replica can be produced through rapid prototyping (RP), rapid tooling (RT), and computer aided manufacturing (CAM) technology. This paper aims to describe CAD, CAM, RP systems and technologies for design and fabrication of custom-made hip prostheses. A novel methodology based on RP technology is applied to design and manufacture a custom-made hip prostheses. Results show that the RP models provide an accurate and useful tool for preoperative, surgical simulation and fabrication of such prostheses. Concerning the disadvantages such as time and cost for the hip prostheses design and need for surgical robot to perform the bone resection and preparing proper femoral canal, RP technologies fabricate the custom-made prostheses quickly, accurately and economically.
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.
Current status and challenges of Additive manufacturing in orthopaedics: An overview
Journal of Clinical Orthopaedics and Trauma, 2018
Additive manufacturing is a rapidly emerging technology which is being successfully implemented in the various field of medicine as well as in orthopaedics, where it has applications in reducing cartilage defects and treatments of bones. The technology helps through systematic collection of information about the shape of the "defects" and precise fabrication of complex 3D constructs such as cartilage, heart valve, trachea, myocardial bone tissue and blood vessels. In this paper, a large number of the relevant research papers on the additive manufacturing and its application in medical specifically orthopaedics are identified through Scopus had been studied using Bibliometric analysis and application analysis is undertaken. The bibliometric analysis shows that there is an increasing trend in the research reports on additive manufacturing applications in the field of orthopaedics. Discussions are on using technological advancement like scanning techniques and various challenges of the orthopaedic being met by additive manufacturing technology. For patient-specific orthopaedic applications, these techniques incorporate clinical practice and use for effective planning. 3D printed models printed by this technology are accepted for orthopaedic surgery such as revision of lumbar discectomy, pelvic surgery and large scapular osteochondroma. The applications of additive manufacturing in orthopaedics will experience a rapid translation in future. An orthopaedic surgeon can convert need/idea into a reality by using computeraided design (CAD) software, analysis software to facilitate the manufacturing. Thus, AM provides a comprehensive opportunity to manufacture orthopaedic implantable medical devices.
Orthopaedics and Additive Manufacturing: The Start of a New Era
Pakistan Journal of Medical Sciences, 2022
The aim of this article is to report the recent surge in use of additive manufacturing (AM) or three-dimensional printing (3DP) services in healthcare, especially the field of orthopaedics. Pakistan’s healthcare infrastructure has been slow in adapting and implementing this new technology which is an integral part of the industry 4.0. Various sources including Pubmed, ScienceDirect, Google Scholar and Google were utilised from June to august 2021 to extract articles and information on advantages of AM in orthopaedics. Furthermore, its possible acquisition by a hospital, educational or an industrial setup is also highlighted in this review. doi: https://doi.org/10.12669/pjms.38.3.5182 How to cite this:Gandapur HK, Amin MS. Orthopaedics and Additive Manufacturing: The Start of a New Era. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5182 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativ...
Current Stem Cell Research & Therapy
Orthopaedic surgery lends itself well to advances in technology. An area of interest and ongoing research is that of the production of scaffolds for use in trauma and elective surgery. 3D printing provides unprecedented accuracy in terms of micro-and macro-structure and geometry for scaffold production. It can also be utilised to construct scaffolds of a variety of different materials and more recently has allowed for the construction of bio-implants which recapitulate bone and cartilage tissue. This review seeks to look at the various methods of 3DP, the materials used, elements of functionality and design, as well as modifications to increase the biomechanics and bioactivity of 3DP scaffolds.
The Application of Additive Manufacturing in Developing 3D Printed Prostethics and Orthotic Devices
2020
This paper covers the advanced Additive Manufacturing (AM) techniques used to fabricate prostethic and orthotic devices. It reviews the available literature and summarizes the advances in medicine, computing and engineering that have led to the development of currently available prostheses. Some of the open-source bionic hands and other available prosthesis are shown, as well as the technologies and materials which are used to manufacture the parts. Since prototyping, combined with the possibility for easy maintenance and repair, is very attractive for prosthesis design, as a conclusion we summarize and discuss some of the key areas that could lead to improvements in bionic limb functionality and use.
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...