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3D-Printed Custom-Made Instruments

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3D Printing in Bone Surgery

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Abstract

In the last few decades, the development of new technologies and of new materials has driven the medical innovation process.

Three-dimensional (3D) printing technology, available for decades in the industrial and mechanical fields, has been characterized by high operating costs in the past. Currently, its diffusion is so high that it has made 3D manufactures easily accessible to the consumer market. The reduction of production costs, together with cheaper and more efficient equipment, has made possible to apply this technology to the daily surgical practice.(Malik et al., J Surg Res. 199:512–22, 2015; AlAli et al., Eplasty 15:e37, 2015).

3D printing allows the passage from a three-dimensional computerized model to a real artifact, which is “printed” by special 3D printers. This process, called “additive,” is based on the progressive overlap of layers of varying thickness and materials, plastic polymers or metals, according to a precise scheme. The traditional production techniques involve, by contrast, the removal of excess material from a starting volume for the production of the final product. (Chua and Leong, 3D Printing and additive manufacturing: principles and applications. World Scientific Publishing Co, Singapore, 2014)

Orthopedics and traumatology, simultaneously with maxillofacial surgery, were the first medical fields to use 3D-printed technology building personalized models (Wong, Orthop Res Rev 8:57–66, 201; Aimar et al., J Healthc Eng 2019:5340616, 2019). Bone structures can be easily segmented from medical images. Moreover, the advent of selective laser sintering (SLS), which can process metal and ceramic powder, allowed the production of personalized instruments to be tailored to the specific geometry of each clinical case. The introduction of materials for 3D printers, which can be sterilized, also created the way for prototyping personalized surgical instrumentation.

Since the clinical applications of 3D printing continue to evolve, orthopedic surgeons should embrace the latest knowledge of the technology and incorporate it into their clinical practice for possible benefits to patients. There is a common experience with the need for tools that would assist the orthopedic surgeon in solving a single case.

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References

  1. Zheng YX, Yu DF, Zhao JG, et al. 3D Print out models vs. 3D-rendered images: which is better for preoperative planning? J Surg Educ. 2016;73:518–23.

    Article  Google Scholar 

  2. Bizzotto N, Sandri A, Regis D, et al. Three-dimensional print- ing of bone fractures: a new tangible realistic way for preoperative planning and education. Surg Innov. 2015;22:548–51.

    Article  Google Scholar 

  3. Radermacher K, et al. Computer-assisted orthopedic surgery with image-based individual templates. Clin Orthop Relat Res. 1998;354:28e38.

    Article  Google Scholar 

  4. Hafez MA, Chelule KL, Seedhom BB, Sherman KP. Computer-assisted total knee arthroplasty using patient-specific templating. Clin Orthop Relat Res. 2006;444:184–92.

    Article  CAS  Google Scholar 

  5. Ng VY, DeClaire JH, Berend KR, Gulick BC, Lombardi AV Jr. Improved accuracy of alignment with patient-specific positioning guides compared with manual instrumentation in TKA. Clin Orthop Relat Res. 2012;470(1):99–107.

    Article  Google Scholar 

  6. Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL. Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Relat Res. 2012;470(3):895–902.

    Article  Google Scholar 

  7. White D, Chelule KL, Seedhom BB. Accuracy of MRI vs CT imaging with particular reference to patient specific templates for total knee replacement surgery. Int J Med Robot. 2008;4(3):224–31.

    Article  CAS  Google Scholar 

  8. Kunz M, Rudan JF, Wood GC, Ellis RE. Registration stability of physical templates in hip surgery. Stud Health Technol Inform. 2011;163:283–9.

    PubMed  Google Scholar 

  9. Schkommodau E, Decker N, Klapper U, Birnbaum K, Staudte HW, Radermacher K. Pedicle screw implantation using the DISOS template system. In: Stiehl JB, Konermann WH, Haaker RG, editors. Navigation and robotics in Total joint and spine surgery. Berlin: Springer-Verlag; 2003. p. 501–5.

    Google Scholar 

  10. Thayaparan GK, Owbridge MG, Thompson RG, D’Urso PS. Designing patient-specific solutions using biomodelling and 3D-printing for revision lumbar spine surgery. Eur Spine J. 2018;28:18–24.

    Article  Google Scholar 

  11. Staudte HW, Schkommodau E, Portheine F, Radermacher K. Pelvic osteotomy with template navigation. In: Stiehl JB, Konermann WH, Haaker RG, editors. Navigation and robotics in total joint and spine surgery. Berlin: Springer-Verlag; 2003. p. 455–63.

    Google Scholar 

  12. Munier M, Donnez M, Ollivier M, Flecher X, Chabrand P, Argenson JN, Parratte S. Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? Pilot study. Orthop Traumatol Surg Res. 2017;103(2):245–50.

    Article  CAS  Google Scholar 

  13. Hoekstra H, Rosseels W, Sermon A, Nijs S. Corrective limb osteotomy using patient specific 3D-printed guides: a technical note. Injury. 2016;47(10):2375–80.

    Article  CAS  Google Scholar 

  14. Arnal-Burro J, Perez-Mananes R, Gallo-Del-Valle E, Igualada-Blazquez C, Cuervas-Mons M, Vaquero- Martin J. Three dimensional-printed patient-specific cutting guides for femoral varization osteotomy: do it yourself. Knee. 2017;24(6):1359–68.

    Article  Google Scholar 

  15. Ranalletta M, Bertona A, Rios JM, Rossi LA, Tanoira I, Maignon GD, Sancineto CF. Corrective osteotomy for malunion of proximal humerus using a custom-made surgical guide based on three-dimensional computer planning: case report. J Shoulder Elb Surg. 2017;26(11):e357–63.

    Article  Google Scholar 

  16. Bauer AS, Storelli DAR, Sibbel SE, McCarroll HR, Lattanza LL. Preoperative computer simulation and patient-specific guides are safe and effective to correct forearm deformity in children. J Pediatr Orthop. 2017;37(7):504–10.

    Article  Google Scholar 

  17. Vlachopoulos L, Schweizer A, Graf M, Nagy L, Furnstahl P. Three-dimensional post- operative accuracy of extra-articular forearm osteotomies using CT-scan based patient-specific surgical guides. BMC Musculoskelet Disord. 2015;16:336.

    Article  Google Scholar 

  18. Hirsiger S, Schweizer A, Miyake J, Nagy L, Furnstahl P. Corrective osteotomies of phalangeal and metacarpal Malunions using patient-specific guides: CT-based evaluation of the reduction accuracy. Hand. 2017;1(1558944717726135):1558944717726135.

    Google Scholar 

  19. Weigelt L, Furnstahl P, Hirsiger S, Vlachopoulos L, Espinosa N, Wirth SH. Three-dimensional correction of complex ankle deformities with computer-assisted planning and patient-specific surgical guides. J Foot Ankle Surg. 2017;56(6):1158–64.

    Article  Google Scholar 

  20. Schweizer A, Mauler F, Vlachopoulos L, Nagy L, Furnstahl P. Computer-assisted 3- dimensional reconstructions of scaphoid fractures and nonunions with and without the use of patient-specific guides: early clinical outcomes and postoperative assessments of reconstruction accuracy. J Hand Surg Am. 2016;41(1):59–69.

    Article  Google Scholar 

  21. Schweizer A, Furnstahl P, Nagy L. Three-dimensional correction of distal radius intra-articular malunions using patient-specific drill guides. J Hand Surg Am. 2013;38(12):2339–47.

    Article  Google Scholar 

  22. Sherman SL, Thyssen E, Nuelle CW. Osteochondral autologous transplantation. Clin Sports Med. 2017;36(3):489–500.

    Article  Google Scholar 

  23. Sebastyan S, Kunz M, Stewart AJ, Bardana DD. Image-guided techniques improve accuracy of mosaic arthroplasty. Int J Comput Assist Radiol Surg. 2016;11(2):261–9.

    Article  Google Scholar 

  24. Koh JL, Wirsing K, Lautenschlager E, Zhang LO. The effect of graft height mismatch on contact pressure following osteochondral grafting: a biomechanical study. Am J Sports Med. 2004;32(2):317–20.

    Article  Google Scholar 

  25. Aisen AM, Martel W, Braunstein EM, McMillin KI, Phillips WA, Kling TF. MRI and CT evaluation of primary bone and soft-tissue tumors. Am J Roentgenol. 1986;146:749–56.

    Article  CAS  Google Scholar 

  26. Luckas J, Daniel AM, Philipp F, Sandro FF, Lazaros V. Joint-preserving tumour resection around the knee with allograft reconstruction using three-dimensional preoperative planning and patient-specific instruments. Knee. 2019;26(3):787–93.

    Article  Google Scholar 

  27. Dobbe JG, Pré KJ, Kloen P, Blankevoort L, Streekstra GJ. Computer-assisted and patient-specific 3-D planning and evaluation of a single-cut rotational osteotomy for complex long-bone deformities. Med Biol Eng Comput. 2011;49(12):1363–70.

    Article  CAS  Google Scholar 

  28. Wong KC, Kumta SM, Sze KY, Wong CM. Use of patient-specific CAD/CAM surgical jig in extremity bone tumor resection and custom prosthetic reconstruction. Comput Aided Surg. 2012;17:1–10.

    Article  Google Scholar 

  29. Bellanova L, Paul L, Docquier PL. Surgical guides (patient-specific instruments) for pediatric tibial bone sarcoma resection and allograft reconstruction. Sarcoma. 2013;2013:1e7.

    Article  Google Scholar 

  30. Cartiaux O, Aurent P, Francq BG, Banse X, Docquier PL. Improved Accuracy with 3D Planning and Patient-Specific Instruments During Simulated Pelvic Bone Tumor Surgery. Annals of Biomedical Engineering. 2014;42(1):205–13.

    Article  Google Scholar 

  31. Lee N. The lancet technology: 3D printing for instruments, models, and organs? Lancet. 2016;388:1368.

    Article  Google Scholar 

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Authors and Affiliations

  1. Oncological Orthopaedics Department, IRCCS - Regina Elena National Cancer Institute, Rome, Italy

    Jacopo Baldi, Alessandro Grò, Umberto Orsini & Leonardo Favale

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  1. Jacopo Baldi
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  2. Alessandro Grò
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  3. Umberto Orsini
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  4. Leonardo Favale
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Editor information

Editors and Affiliations

  1. Department of Anatomical, Histological Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Rome, Italy

    Carmine Zoccali

  2. Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

    Pietro Ruggieri

  3. Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza, Brescia, Italy

    Francesco Benazzo

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Baldi, J., Grò, A., Orsini, U., Favale, L. (2022). 3D-Printed Custom-Made Instruments. In: Zoccali, C., Ruggieri, P., Benazzo, F. (eds) 3D Printing in Bone Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-91900-9_15

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  • DOI: https://doi.org/10.1007/978-3-030-91900-9_15

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