Analysis of principles inspiring design of three-dimensional-printed custom-made prostheses in two referral centres

2020 ◽  
Vol 44 (5) ◽  
pp. 829-837 ◽  
Author(s):  
Andrea Angelini ◽  
Daniel Kotrych ◽  
Giulia Trovarelli ◽  
Andrzej Szafrański ◽  
Andrzej Bohatyrewicz ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Custom Made ◽  
Custom Made Prostheses

Custom, rapid prototype thumb prosthesis for partial-hand amputation: A case report

2017 ◽  
Vol 42 (2) ◽  
pp. 187-190 ◽  
Author(s):  
Ashley Quinn Swartz ◽  
Kristi Turner ◽  
Laura Miller ◽  
Todd Kuiken
Keyword(s):  
Three Dimensional ◽  
Rapid Prototype ◽  
Dominant Hand ◽  
Rapid Prototype Technology ◽  
Three Dimensional Printing ◽  
Custom Made ◽  
Unique Approach ◽  
Hand Amputation ◽  
Acceptance Rates ◽  
Custom Made Prostheses

Background: Due to advancements in three-dimensional printing, custom-made prostheses are becoming more viable options for persons with difficult cases of prosthetic management. The purpose of this article was to develop a custom voluntary-closing, body-powered thumb mechanism for a partial-hand amputee who had amputations of the index finger and thumb on the left, non-dominant hand. Case description and methods: The prosthesis model was manufactured using rapid prototype technology and was developed to provide greater force and functionality, and to decrease overall size compared to traditional hand prostheses. Findings and outcomes: Following device iterations and occupational therapy sessions, the patient achieved higher functionality in performing daily tasks such as cooking and cleaning, and in completing the Box and Blocks test, though some limitations still precluded full acceptance of the device. Conclusion: This case study represents a unique approach in the development of custom-made devices that may increase prostheses acceptance rates among partial-hand amputees. Clinical relevance Many partial-hand amputees report experiencing trouble in finding a device that fits their needs. This study highlights the potential of using rapid prototyping technology to design a prosthesis that meets a user’s specific desires.

scholarly journals A 3D-CT Analysis of Femoral Symmetry—Surgical Implications

2020 ◽  
Vol 9 (11) ◽  
pp. 3546 ◽  
Author(s):  
Joan Ferràs-Tarragó ◽  
Vicente Sanchis-Alfonso ◽  
Cristina Ramírez-Fuentes ◽  
Alejandro Roselló-Añón ◽  
Francisco Baixauli-García
Keyword(s):  
Surgical Planning ◽  
Three Dimensional ◽  
Mirror Image ◽  
Element Analysis ◽  
Custom Made ◽  
Specific Parameter ◽  
Ct Analysis ◽  
Healthy Side ◽  
The Mean ◽  
Custom Made Prostheses

Background: Mirroring the image of the affected side is a widely used technique for surgical planning in orthopedic surgery, especially for fractures and custom-made prostheses. Our objective is to evaluate the three-dimensional symmetry of the femurs using finite element analysis and manual alignment. Methods: Using the computed tomography of 15 patients without lower limb pathology, 30 3D biomodels of their femurs were obtained. The error obtained through image manipulation was calculated and broken down into a rendering error and a manual overlay error. The Hausdorff–Besicovitch method was applied to obtain the total asymmetry. The manipulation error was theb subtracted from it to obtain the intrapersonal asymmetry. Results: The mean intrapersonal asymmetry was 0.93 mm. It was obtained by subtracting the error derived from rendering and alignment of 0.59 mm (SD 0.17 mm) from the overall mean error of 1.52 mm (SD 1.45). Conclusions: Intrapersonal femoral asymmetry is low enough to use the mirror image of the healthy side as a reference for three-dimensional surgical planning. This type of planning is especially useful in deformity surgery when the objective of the surgery is not to restore only one specific parameter but to obtain a general functional morphology when a healthy contralateral femur is available.

scholarly journals Recurrent contracted sockets treated with personalized, three-dimensionally printed conformers and buccal grafts

2021 ◽  
pp. 112067212110000
Author(s):  
Annabel LW Groot ◽  
Jelmer S Remmers ◽  
Roel JHM Kloos ◽  
Peerooz Saeed ◽  
Dyonne T Hartong
Keyword(s):  
Three Dimensional ◽  
Case Series ◽  
Secondary Outcome ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Ocular Prosthesis ◽  
Buccal Mucosal Graft ◽  
Custom Made ◽  
3D Printed

Purpose: Recurrent contracted sockets are complex situations where previous surgeries have failed, disabling the wear of an ocular prosthesis. A combined method of surgery and long-term fixation using custom-made, three-dimensional (3D) printed conformers is evaluated. Methods: Retrospective case series of nine patients with recurrent excessive socket contraction and inability to wear a prosthesis, caused by chemical burns ( n = 3), fireworks ( n = 3), trauma ( n = 2) and enucleation and radiotherapy at childhood due to optic nerve glioma ( n = 1) with three average previous socket surgeries (range 2–6). Treatment consisted of a buccal mucosal graft and personalized 3D-printed conformer designed to be fixated to the periosteum and tarsal plates for minimal 2 months. Primary outcome was the retention of an ocular prosthesis. Secondary outcome was the need for additional surgeries. Results: Outcomes were measured at final follow-up between 7 and 36 months postoperatively (mean 20 months). Eight cases were able to wear an ocular prosthesis after 2 months. Three cases initially treated for only the upper or only the lower fornix needed subsequent surgery for the opposite fornix for functional reasons. Two cases had later surgery for cosmetic improvement of upper eyelid position. Despite pre-existing lid abnormalities (scar, entropion, lash deficiency), cosmetic outcome was judged highly acceptable in six cases because of symmetric contour and volume, and reasonably acceptable in the remaining two. Conclusions: Buccal mucosal transplant fixated with a personalized 3D-designed conformer enables retention of a well-fitted ocular prosthesis in previously failed socket surgeries. Initial treatment of both upper and lower fornices is recommended to avoid subsequent surgeries for functional reasons.

Limb-salvage reconstruction following resection of pelvic bone sarcomas involving the acetabulum

2021 ◽  
Vol 103-B (4) ◽  
pp. 795-803
Author(s):  
Tomohiro Fujiwara ◽  
Manuel Ricardo Medellin Rincon ◽  
Andrea Sambri ◽  
Yusuke Tsuda ◽  
Rhys Clark ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Major Complication ◽  
Ice Cream ◽  
Pelvic Bone ◽  
Limb Salvage Surgery ◽  
Consecutive Series ◽  
Major Complications ◽  
Custom Made ◽  
The Mean ◽  
Custom Made Prostheses

Aims Limb salvage for pelvic sarcomas involving the acetabulum is a major surgical challenge. There remains no consensus about what is the optimum type of reconstruction after resection of the tumour. The aim of this study was to evaluate the surgical outcomes in these patients according to the methods of periacetabular reconstruction. Methods The study involved a consecutive series of 122 patients with a periacetabular bone sarcoma who underwent limb-salvage surgery involving a custom-made prosthesis in 65 (53%), an ice-cream cone prosthesis in 21 (17%), an extracorporeal irradiated autograft in 18 (15%), and nonskeletal reconstruction in 18 (15%). Results The rates of major complications necessitating further surgery were 62%, 24%, 56%, and 17% for custom-made prostheses, ice-cream cone prostheses, irradiated autografts and nonskeletal reconstructions, respectively (p = 0.001). The ten-year cumulative incidence of failure of the reconstruction was 19%, 9%, 33%, and 0%, respectively. The major cause of failure was deep infection (11%), followed by local recurrence (6%). The mean functional Musculoskeletal Tumour Society (MSTS) scores were 59%, 74%, 64%, and 72%, respectively. The scores were significantly lower in patients with major complications than in those without complications (mean 52% (SD 20%) vs 74% (SD 19%); p < 0.001). For periacetabular resections involving the ilium, the mean score was the highest with custom-made prostheses (82% (SD 10%)) in patients without any major complication; however, nonskeletal reconstruction resulted in the highest mean scores (78% (SD 12%)) in patients who had major complications. For periacetabular resections not involving the ilium, significantly higher mean scores were obtained with ice-cream cone prostheses (79% (SD 17%); p = 0.031). Conclusion Functional outcome following periacetabular reconstruction is closely associated with the occurrence of complications requiring further surgery. For tumours treated with periacetabular and iliac resection, skeletal reconstruction may result in the best outcomes in the absence of complications, whereas nonskeletal reconstruction is a reasonable option if the risk of complications is high. For tumours requiring periacetabular resection without the ilium, reconstruction using an ice-cream cone prosthesis supported by antibiotic-laden cement is a reliable option. Cite this article: Bone Joint J 2021;103-B(4):795–803.

Development of Thin Metal Film Deposition Process for the Intravascular Catheter

1999 ◽  
Author(s):  
Seok Chung ◽  
Jun Keun Chang ◽  
Dong Chul Han
Keyword(s):  
Metal Film ◽  
Three Dimensional ◽  
Deposition Process ◽  
Medical Application ◽  
Thin Metal Film ◽  
Film Deposition ◽  
Thin Metal ◽  
Mems Devices ◽  
Sensors And Actuators ◽  
Custom Made

Abstract To make some MF.MS devices such as sensors and actuators be useful in the medical application, it is required to integrate this devices with power or sensor lines and to keep the hole devices biocompatible. Integrating micro machined sensors and actuators with conventional copper lines is incompatible because the thin copper lines are not easy to handle in the mass production. To achieve the compatibility of wiring method between MEMS devices, we developed the thin metal film deposition process that coats micropattered thin copper films on the non silicon-wafer substrate. The process was developed with the custom-made three-dimensional thin film sputter/evaporation system. The system consists of process chamber, two branch chambers, substrate holder unit and linear/rotary motion feedthrough. Thin metal film was deposited on the biocompatible polymer, polyurethane (PellethaneR) and silicone, catheter that is 2 mm in diameter and 1,000 mm in length. We deposited Cr/Cu and Ti/Cu layer and made a comparative study of the deposition processes, sputtering and evaporation. The temperature of both the processes were maintained below 100°C, for the catheter not melting during the processes. To use the films as signal lines connect the signal source to the actuator on the catheter tip, we machined the films into desired patterns with the eximer laser. In this paper, we developed the thin metal film deposition system and processes for the biopolymeric substrate used in the medical MEMS devices.

scholarly journals Early Outcomes of Patient-Specific Modular Cones for Substitution of Methaphysial and Diaphysial Bone Defects in Revision Knee Arthroplasty

2019 ◽  
Vol 25 (2) ◽  
pp. 9-18 ◽  
Author(s):  
A. A. Cherny ◽  
A. N. Kovalenko ◽  
S. S. Bilyk ◽  
A. O. Denisov ◽  
A. V. Kazemirskiy ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Scoring Systems ◽  
Bone Defects ◽  
Patient Specific ◽  
Implant Fixation ◽  
Diaphyseal Bone ◽  
Custom Made ◽  
The Stability ◽  
Valid Solution

The aim of this study was the assessment of early outcomes of patient-specific three-dimensional titanium cones with specified porosity parameters to compensate for extensive metaphysical-diaphyseal bone defects in RTKA.Materials and Methods. Since 2017 till 2019 30 patient-specific titanium cones (12 femoral and 18 tibial) implanted during 26 RTKAS. Clinical outcomes evaluated using KSS, WOMAC and fjS-12 scoring systems on average 10 (2–18) months after surgery. At the same time the stability of implant fixation analyzed using frontal, lateral and axial knee roentgenograms.Results. During all procedures there were no technical difficulties in positioning and implantation of custom-made titanium cones. At the time of preparation of the publication, none of the patients had indications for further surgical intervention, as well as intra- and postoperative complications. Six months after surgery all scores improved significantly: KSS from 23 (2–42, SD 19.96) to 66.5 (62–78, SD 7.68), WOMAC from 59 (56–96, SD 28.31) to 32.25 (19–46, SD 11.76), the index FJS-12 was 29.16 points (0–68.75, SD 30.19). The average scores continued to improve up to 18 months: KSS — 97.5 (88–108, SD 9.14), WOMAC — 16.5 (9–24, SD 6.45), FJS-12 — 45.85 (25–75, SD 22.03). No radiolucent lines were noticed during this period of observation.Conclusion. The original additive technology of designing and producing patient-specific titanium cones for compensation of extensive metaphyseal-diaphyseal bone defects in RTKA is a valid solution at least in the short term. A longer follow-up period is required to assess its medium-and long-term reliability compared to existing alternative surgical solutions.

scholarly journals Surgical benefit of mandibular morphometric analysis: A new tool to standardize mandibular reconstruction

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0240558
Author(s):  
Alice Prevost ◽  
Franck Delanoe ◽  
Zoé Cavallier ◽  
Samuel Muller ◽  
Raphael Lopez ◽  
...  
Keyword(s):  
Morphometric Analysis ◽  
Descriptive Analysis ◽  
Donor Site ◽  
Three Dimensional ◽  
Free Flaps ◽  
Reference Points ◽  
Mandibular Reconstruction ◽  
Gonial Angle ◽  
Custom Made ◽  
Cutting Guides

Purpose The gold-standard for reconstruction of large mandibular defects is the use of free flaps of vascularized autologous bone with the fibula as the preferred donor site. The use of "custom cutting guides" for this indication is becoming increasingly prevalent. But cost of the procedure averages around 2,500 dollars per patient excluding treatment and entails selection criteria. We think it is possible to standardize mandibular reconstructions from an anatomical mean. The objective of this study was to perform a mandibular morphometric analysis in order to obtain a set of "mean" measurements, which can be used by all surgeons interested in mandibular reconstruction. Methods We performed a morphometric analysis consisting of three-dimensional mandibular reconstructions of 30 men and 30 women. Several reference points were set and defined to evaluate specific lengths and angles of interest. We conducted an intra and inter-sexual descriptive analysis of measurements obtained. Results We did not identify any major intra-sexual differences within each group. The gonial angle is more open in women and the measurements characterizing the basilar contour are more prominent in men. We did not identify any differences in alveolar region parameters. Conclusion The results of this study constitute a morphological tool for surgeons, from bone graft to free flap. These results also confirm us that the use of «custom cutting guides» for mandibular reconstruction may be excessive. It is pertinent to examine the value of "custom made" mandibular reconstructions since the differences observed are of the order of millimeters.

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