Three‐dimensional printing in orthopaedic surgery: review of current and future applications

Abstract

Objectives: Three dimensional (3D) printing technology has many current and future applications in orthopaedics. The objectives of this article are to review published literature regarding applications of 3D technology in orthopaedic surgery with a focus on knee surgery. Methods: A narrative review of the applications of 3D printing technology in orthopaedic practice was achieved by a search of computerised databases, internet and reviewing references of identified publications. Results: There is current widespread use of 3D printing technology in orthopaedics. 3D technology can be used in education, preoperative planning and custom manufacturing. Custom manufacturing applications include surgical guides, prosthetics and implants. Many future applications exist including biological applications. 3D printed models of anatomy have assisted in the education of patients, students, trainees and surgeons. 3D printed models also assist with surgical planning of complex injuries or unusual anatomy. 3D printed surgical guides may simplify surgery, make surgery precise and reduce operative time. Computer models based on MRI or CT scans are utilised to plan surgery and placement of implants. Complex osteotomies can be performed using 3D printed surgical guides. This can be particularly useful around the knee. A 3D printed guide allows pre osteotomy drill holes for the plate fixation and provides an osteotomy guide to allow precise osteotomy. 3D printed surgical guides for knee replacement are widely available. 3D printing has allowed the emergence of custom implants. Custom implants that are patient specific have been particularly used for complex revision arthroplasty or for very difficult cases with altered anatomy. Future applications are likely to include biological 3D printing of cartilage and bone scaffolds. Conclusion:3D printing in orthopaedic surgery has and will continue to change orthopaedic practice. Its role is to provide safe, reproducible, reliable models with reduced operative time and improves patient outcomes compared to traditional surgical techniques. Long term follow up of the techniques is still required.

3D Printing of Surgical Instruments for Children: Testing the Novel Concept

“…The main applications of 3D printing in the field of surgery include manufacturing of anatomic models based on patient imaging studies, instrument, device, implant production and regenerative medicine (1)(2)(3)(4)(5)(6)(7).…”

Patient Education for Endoscopic Sinus Surgery: Preliminary Experience Using 3D-Printed Clinical Imaging Data

“…These materials can be mixed at customizable ratios from each extruder head, at specific spatial coordinates, to yield novel composite models. While the use of 3D printing has been reported in the areas of oncology [8], craniofacial reconstruction [9], orthopedics [10], and organ models [11,12,13], there has been relatively little work reported in the rhinology/otolaryngology space [14]. Here we report the use of PolyJet technology to create an anatomical replica of patient sinus passages, with soft tissue and bone structure represented with malleable and hard polymeric materials, respectively.…”

Three‐dimensional printing in orthopaedic preoperative planning improves intraoperative metrics: a systematic review

“…3D printing technology can also be unreliable, with desktop fused deposition modelling printing in particular. The dimensional accuracy and resolution of the final 3D model are also reliant on the quality and resolution of the original image data . High‐resolution imaging is required to be able to fully assess the 3D anatomy.…”

“…The introduction of three‐dimensional (3D) modelling and printing to medicine has seen a proliferation of new and exciting uses. Surgical applications have seen the most growth, ranging from education of patients and trainee surgeons to custom implantable devices …”

“…Novel methods have been investigated with the aim of improving this process. Surgical planning using 3D printed models has been an early application of the technology . Its use in the preoperative analysis of relevant surgical anatomy and relations as well as its utility in the creation of patient‐specific instrumentation for on‐table use has been documented …”