Electrospinning has been widely accepted for several decades by the tissue engineering and regenerative medicine community as a technique for nanofiber production. Owing to the inherent flexibility of the electrospinning process, a number of techniques can be easily implemented to control fiber deposition (i.e. electric/magnetic field manipulation, use of alternating current, or air-based fiber focusing) and/or porosity (i.e. air impedance, sacrificial porogen/sacrificial fiber incorporation, cryo-electrospinning, or alternative techniques). The purpose of this review is to highlight some of the recent work using these techniques to create electrospun scaffolds appropriate for mimicking the structure of the native extracellular matrix, and to enhance the applicability of advanced electrospinning techniques in the field of tissue engineering.
The use of 3-dimensional (3D) printing in orthopedics is developing rapidly and impacting the areas of preoperative planning, surgical guides, and simulation. As this technology continues to improve, the greatest impact of 3D printing may be in low- and middle-income countries where surgical items are in short supply. This study investigated sterility of 3D-printed ankle fracture fixation plates and cortical screws. The hypothesis was that the process of heated extrusion in fused deposition modeling printing would create sterile prints in a timely fashion that would not require postproduction sterilization. A free computer-assisted design program was used to design the implant models. One control group and 8 study groups were printed. Print construct, orientation, size, and postproduction sterilization differed among the groups. Sterility was assessed using thioglycollate broth cultures at 24 hours, 48 hours, and 7 days. Positive growth was speciated for aerobic and anaerobic bacteria. Print time and failed prints were recorded. Control samples were 100% positive for bacterial growth. All test samples remained sterile at all time points (100%). Speciation of control samples was obtained, and Staphylococcus was the most common species. Print times varied; however, no print time exceeded 6.75 minutes. Eighteen prints (17%) failed in the printing process. These findings demonstrate an intrinsic sterilization process associated with fused deposition modeling 3D printing and indicate the feasibility of 3D-printed surgical implants and equipment for orthopedic applications. With future research, 3D-printed implants may be a treatment modality to assist orthopedic surgeons in low- and middle-income countries. [ Orthopedics . 2020; 43(1): 46–51.]
A radial tear of the meniscus can lead to significant loss of meniscus function, resulting in deleterious cartilage changes. Repair of radial meniscus tears has several challenges, including suture pull-out, which can reduce healing success. We present an arthroscopic repair technique in a complete radial lateral meniscus tear using vertical reinforced bars (rebar) of suture tapes to reduce suture pull-out and approximate the radial tear.
Aim: 3D printing is a growing technology with promising applications in orthopedic surgery. However, the utilization of 3D-printed surgical implants has not been fully explored. Materials & methods: One-third tubular plates and cortical screws were printed via fused deposition modeling using four materials: acrylonitrile butadiene styrene, carbon fiber-reinforced polylactic acid, polycarbonate and polyether ether ketone. Plates were analyzed with three-point bending and torque testing, and screws underwent torque, shear and pullout testing. Results: Two-factor Analysis of Variance (ANOVA) demonstrated several significant differences between mechanical profiles for different materials and between designs. Conclusion: The results demonstrate that desktop 3D printers can print biocompatible materials to replicate surgical implant designs at a low cost. However, current materials and structures do not approximate the properties of stainless-steel implants.
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