Purpose -The last decade has seen major advances in rapid prototyping (RP), with it becoming a multi-disciplinary technology, crossing various research fields, and connecting continents. Process and material advancements open up new applications and manufacturing (through RP) is serving non-traditional industries. RP technology is used to support rapid product development (RPD). The purpose of this paper is to describe how the Integrated Product Development research group of the Central University of Technology, Free State, South Africa is applying various CAD/CAM/RP technologies to support a medical team from the Grootte Schuur and Vincent Palotti hospitals in Cape Town, to save limbs -as a last resort at a stage where conventional medical techniques or practices may not apply any longer. Design/methodology/approach -The paper uses action research to justify the proposal of a new method to use CAD/CAM/RP related technologies to substitute lost/damaged bone regions through the use of CT to CAD to.STL manipulation. Findings -A case study where RP related technologies were used to support medical product development for a patient with severe injuries from a road accident is discussed. Originality/value -The paper considers current available technologies, and discusses new advancements in direct metal freeform fabrication, and its potential to revolutionise the medical industry.

Background: The reconstruction of complex pelvic trauma or developmental bone abnormalities is challenging as it involves in-depth understanding of a complex three-dimensional structure. Advances in medical imaging and rapid prototyping allow for detailed pre-operative planning and manufacture of planning models, custom jigs and prostheses to make this type of surgery manageable with good results. Methods:We report the reconstruction of a hip and proximal femur using planning models, jigs and custom prostheses produced by rapid prototyping methods. These tools helped to solve a complex problem and produced a good functional result for the patient. Results:In this case report the patient underwent the reconstruction of her right hip joint. She was unable to mobilise well independently prior to the surgery. The surgery provided her with a stable and functional hip joint. This allows her to mobilise independently with an external prosthesis. One year down the line she has a Fair MSTS score (14 of 30). Conclusion:Advances in medical imagining and rapid prototyping have produced planning and operative tools with which surgeons are able to solve complex problems safely and with good result. This technology has widespread use not only in orthopaedics but other surgical disciplines, and with increasing availability and improved cost effectiveness will be used more frequently in the future. Level of evidence: Level V (case report)

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Background: The management of osteoid osteoma (OO) and other small primary benign lesions of bone has evolved over the past 50 years from open surgery with wide resection margins to less invasive surgical techniques such as image-guided intralesional excision and percutaneous radiofrequency ablation. We aim to evaluate the outcomes of patients treated with computerised tomography (CTguided) intralesional excision and bone grafting of small benign lesions of bone. Method: A retrospective folder review of patients treated in a large academic hospital in Cape Town, South Africa, between March 2012 and May 2016 was performed. Patient demographics, details of presentation, clinical information and outcome following treatment were analysed descriptively. Pre-operative diagnosis based on radiological examination was compared with histological diagnosis. Result: Eleven patients (five male) with a median age of 16 years (range 5-33) were included. Pain was the most common presenting feature. A histological diagnosis of OO was confirmed in five of nine patients with a suspected diagnosis of OO pre-operatively. Of the four patients whose diagnosis changed after the procedure, the diagnoses included a benign spindle cell lesion, a benign fibrous histiocytoma, subacute osteitis and an osteochondral defect with geode cyst formation. Of the two patients where OO was not suspected pre-operatively, chondroblastoma was confirmed in one while a benign spindle cell lesion was reported in the other. Overall histological yield was thus 100%. There were no complications or repeat procedures at a median follow-up of 42 months (range 30-52 months). Conclusion: CT-guided intralesional curettage is a safe and minimally invasive technique. This is especially useful in less accessible regions of the skeleton as it provides a means of accurately locating the lesion with minimal risk of complications and morbidity to the patient. We consider this to be the optimal method of treatment in our setting as it provides high success rates, few complications and a histological diagnosis without the need for any additional and expensive equipment.