3D Printing In Orthopaedics

The 3D printing technology is penetrating the healthcare field at an astonishing rate. Although there is still a long way to go to realize organ printing and despite the constantly existing ethical and technical changes.

Orthopedic implants are artificial devices incorporated into joints and bones to restore normal functions. They are widely used for patients suffering from bone damage caused by injury or disease, such as osteoarthritis, which causes pain and stiffness in joints. Due to the limits of traditional engineering methods, the shapes of orthopedic implants used conventionally in regular way are usually geometric patterns and, as a result, cannot attach to bones firmly without additional cement, screws or fixing plates. But 3-D printing can virtually produce implants in any shape, as long as the computer that controls the printer has a digital model to follow. Also, through tiny pores made in the new implants, bones are able to grow into the implants, securing the implant. Researchers have also used a 3D printer to create a bone-like material that could be used to create customized scaffolds to stimulate the growth of replacement bone tissue this would allow customized scaffolds to be produced for new bone to grow on in orthopedic procedures and to deliver medicine for treating osteoporosis.So in all this aspect, 3-D printed implants are more efficient & reliable than traditional ones.

3D-Printed Bone Models

Based on imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), the 3D images of the bones can be re-constructed; then, the prototypes of the bones can be obtained using the layered manufacturing technique (LMT) for teaching, presentation, and surgical design. Based on the symmetry of the human anatomy, or by using the human anatomy data in database, we can also reverse or mimic the 3D images of the bones at the missing parts, so as to assist the conventional mechanical processing to manufacture bone prostheses that can be implanted into human body. These two rapid prototyping manufacturing (RPM) techniques have been quite mature and commonly applied in surgery design.

3D printed Patient-Specific Guides

Even the best planners can face unexpected challenges when putting a pre-operative plan into action in the operating room. 3D-printed, patient-specific guides to remove many of the hurdles involved in making your surgical plan a reality. These surgical tools help reduce the need for intra-operative decision-making, such as determining the best angle or depth for osteotomies or drilling. The guides are built to fit the unique shape of your patient’s anatomy and can help reduce the complexity of the surgery by enhancing predictability.

Patient specific guides

 

 

Correction of Deformities is a challenging aspect where exact osteotomy and placement of screws are of uttmost importance which decides the final outcome.

Some of the Examples where Patient specific Guides are useful.

Radius and ulna deformities

 

Distal Humerus Deformities

Proximal Humerus deformities

Osteotomies Around The Knee

 

Partial and Total knee Replacement

3D Printing Of Orthopaedic Implants

Development of metallic implants and personalized prostheses is the most important and most valuable direction when applying the 3D printing in the field of orthopedics. This is determined by the materials, equipment, and manufacturing capabilities available for 3D printing. The commonly used metal materials including Ti6Al4V, cobalt-chromium alloy, and stainless steel can be used for 3D printing and manufacturing. The preciseness and efficiency of high-energy 3D printing equipment such as electron beam and laser beam can meet the requirements for manufacturing small parts or achieving high-scale production. Under the computer-aided design, the 3D printing can rapidly manufacture shaped implants; meanwhile, it can also produce size-controllable micro-pore structures. These micro-pore structures can lower the elastic modulus of metal materials and decrease the stress shielding at the solid parts of the implants and can promote the integration between metal and bones at the surface of the implants.

 

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Due to their innate biological inertness, the metal materials can not be easily integrated with the host bones. Currently, one of the hot research topics is the modification in the nature of the porous surfaces of the 3D printing-formed metals. The aims of these studies are to promote the osseointegration efficiency of the porous surfaces of the metals; or, they may be used as stent materials to be loaded with other functional materials and drugs (e.g., producing anti-bacterial surfaces).

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3D Printed implants in Tumor Surgery

With advances in 3D printed implants bone mets are no more a contraindication to surgery. Complex and Extensive resections of bones can be performed and customized 3D printed implants assist in reconstruction.

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Customized 3D Printed Braces for Scoliosis Treatment

 

In 2015 the Rock Hill, South Carolina-based company, 3D Systems, unveiled their bespoke back braces which were entirely 3D printed and used to correct the curvature of the spine caused by severe scoliosis. Because the braces could be completely customized based on the shape of the patient’s body as well as their corrective needs, they were both more efficient and more comfortable for the patient to wear.

The braces currently used in the medical field are clunky, uncomfortable, large and do not allow for the circulation of air. Considering that the braces are supposed to be worn for the majority of the day, these issues often lead children to find way to remove them. Embarrassment is often a reason that kids take their braces off, as they protrude out of clothing, and oftentimes other children poke fun at these abnormalities. 3D printing, however, can overcome almost all of the shortcomings of current corrective braces

Unlike traditional braces, the Bespoke™ brace is flexible, as well as thin, making it easy to hide under a child’s shirt, and comfortable to wear all day long.  The customization, via 3D printing, continues to leave its mark on the medical community.

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3D Printed Customized Orthopedic Wrist Braces

 

The existing wrist braces and casts on the market have many problems including but not limited to bulkiness, discomfort, odor, and resulting muscle atrophy for the patient. While there have been advancements in the materials used for bracing, the method of bracing itself is an area prime for improvement. The HEALX prototypes for wrist-related injuries target immobilization points. Because they are developed based on scans of the specific patient’s injured limb, HEALX is able to design a customized bracing system that can provide the user feedback on the healing process. The brace itself is less invasive, waterproof, and enables x-rays to be taken of the injury while the patient is wearing the brace. HEALX uses 3D scan data from the injured limb and, in conjunction with their own software, uses that data to develop a customized wrist brace.

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Future of 3 D printing : Cartilage printing

Chondral and osteochondral lesions represent one of the most challenging and frustrating scenarios for the orthopedic surgeon and for the patient. The lack of therapeutic strategies capable to reconstitute the function and structure of hyaline cartilage and to halt the progression toward osteoarthritis has brought clinicians and scientists together, to investigate the potential role of tissue engineering as a viable alternative to current treatment modalities. In particular, the role of bioprinting is emerging as an innovative technology that allows for the creation of organized 3D tissue constructs via a “layer-by-layer” deposition process. This process also has the capability to combine cells and biomaterials in an ordered and predetermined way.

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3D Printed customized Casts

Cortex Cast

 

 

 

 

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