scholarly journals 3D printing of patient-specific implants for osteochondral defects: workflow for an MRI-guided zonal design

2021 ◽  
Author(s):  
David Kilian ◽  
Philipp Sembdner ◽  
Henriette Bretschneider ◽  
Tilman Ahlfeld ◽  
Lydia Mika ◽  
...  
Keyword(s):  
Additive Manufacturing ◽  
Implant Design ◽  
Patient Specific ◽  
Osteochondral Defects ◽  
Technological Gap ◽  
Patient Specific Implants ◽  
Cad Cam ◽  
Magnetic Resonance Imaging Mri ◽  
Common Clinical Practice ◽  
Geometric Compatibility

Abstract Magnetic resonance imaging (MRI) is a common clinical practice to visualize defects and to distinguish different tissue types and pathologies in the human body. So far, MRI data have not been used to model and generate a patient-specific design of multilayered tissue substitutes in the case of interfacial defects. For orthopedic cases that require highly individual surgical treatment, implant fabrication by additive manufacturing holds great potential. Extrusion-based techniques like 3D plotting allow the spatially defined application of several materials, as well as implementation of bioprinting strategies. With the example of a typical multi-zonal osteochondral defect in an osteochondritis dissecans (OCD) patient, this study aimed to close the technological gap between MRI analysis and the additive manufacturing process of an implant based on different biomaterial inks. A workflow was developed which covers the processing steps of MRI-based defect identification, segmentation, modeling, implant design adjustment, and implant generation. A model implant was fabricated based on two biomaterial inks with clinically relevant properties that would allow for bioprinting, the direct embedding of a patient’s own cells in the printing process. As demonstrated by the geometric compatibility of the designed and fabricated model implant in a stereolithography (SLA) model of lesioned femoral condyles, a novel versatile CAD/CAM workflow was successfully established that opens up new perspectives for the treatment of multi-zonal (osteochondral) defects. Graphic abstract

scholarly journals Additive manufacturing in medical sciences: past, present and the future

2018 ◽  
Vol 5 (1) ◽  
pp. 201
Author(s):  
Lakshya P. Rathore ◽  
Naina Verma
Keyword(s):  
Tissue Engineering ◽  
Additive Manufacturing ◽  
Biological Tissue ◽  
Patient Specific ◽  
Basic Fact ◽  
Medical Sciences ◽  
Novel Technique ◽  
Patient Specific Implants ◽  
Tissue Replacement ◽  
The Future

Additive manufacturing (AM) is a novel technique that despite having been around for more than 35 years, has been underutilized. Its great advantage lies in the basic fact that it is incredibly customizable. Since its use was recognized in various fields of medicine like orthopaedics, otorhinolaryngology, ophthalmology etc, it has proved to be one of the most promising developments in most of them. Customizable orthotics, prosthetics and patient specific implants and tracheal splints are few of its advantages. And in the future too, the combination of tissue engineering with AM is believed to produce an immense change in biological tissue replacement.

scholarly journals Imaging, Virtual Planning, Design, and Production of Patient-Specific Implants and Clinical Validation in Craniomaxillofacial Surgery

2012 ◽  
Vol 5 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Per Dérand ◽  
Lars-Erik Rännar ◽  
Jan-M Hirsch
Keyword(s):  
Additive Manufacturing ◽  
Treatment Plan ◽  
Maxillofacial Surgery ◽  
Bone Substitutes ◽  
Patient Specific ◽  
Virtual Design ◽  
Patient Specific Implants ◽  
Cutting Guide ◽  
Ablative Surgery ◽  
Cutting Guides

The purpose of this article was to describe the workflow from imaging, via virtual design, to manufacturing of patient-specific titanium reconstruction plates, cutting guide and mesh, and its utility in connection with surgical treatment of acquired bone defects in the mandible using additive manufacturing by electron beam melting (EBM). Based on computed tomography scans, polygon skulls were created. Following that virtual treatment plans entailing free microvascular transfer of fibula flaps using patient-specific reconstruction plates, mesh, and cutting guides were designed. The design was based on the specification of a Compact UniLOCK 2.4 Large (Synthes®, Switzerland). The obtained polygon plates were bent virtually round the reconstructed mandibles. Next, the resections of the mandibles were planned virtually. A cutting guide was outlined to facilitate resection, as well as plates and titanium mesh for insertion of bone or bone substitutes. Polygon plates and meshes were converted to stereolithography format and used in the software Magics for preparation of input files for the successive step, additive manufacturing. EBM was used to manufacture the customized implants in a biocompatible titanium grade, Ti6Al4V ELI. The implants and the cutting guide were cleaned and sterilized, then transferred to the operating theater, and applied during surgery. Commercially available software programs are sufficient in order to virtually plan for production of patient-specific implants. Furthermore, EBM-produced implants are fully usable under clinical conditions in reconstruction of acquired defects in the mandible. A good compliance between the treatment plan and the fit was demonstrated during operation. Within the constraints of this article, the authors describe a workflow for production of patient-specific implants, using EBM manufacturing. Titanium cutting guides, reconstruction plates for fixation of microvascular transfer of osteomyocutaneous bone grafts, and mesh to replace resected bone that can function as a carrier for bone or bone substitutes were designed and tested during reconstructive maxillofacial surgery. A clinically fit, well within the requirements for what is needed and obtained using traditional free hand bending of commercially available devices, or even higher precision, was demonstrated in ablative surgery in four patients.

scholarly journals Applications of 3D Planning, Plastic Materials and Additive Manufacturing in Functional Rehabilitations in the Head and Neck Surgery

2018 ◽  
Vol 55 (3) ◽  
pp. 431-433
Author(s):  
Gheorghe Muhlfay ◽  
Zoltan Fabian ◽  
Radu Neagoe ◽  
Karin Ursula Horvath
Keyword(s):  
Additive Manufacturing ◽  
Surgical Planning ◽  
Standard Of Care ◽  
Neck Surgery ◽  
Patient Specific ◽  
Patient Specific Implants ◽  
Planning Software ◽  
Plastic Materials ◽  
Potential Benefits ◽  
Manufacturing Technologies

The developments in the biocompatible materials and additive manufacturing technologies gave birth to new possibilities in reconstructive surgery. In addition to revolutionizing the diagnostic possibilities, the modern medical imaging has led to the development of surgical planning software. Using these state-of-the-art technologies, a new standard of care is rising with the spread of patient specific implants. Our view in studying and using these materials and technologies goes beyond their biocompatibility, focusing on the functional and esthetic impact of these restorations. Our aim is to show their potential benefits and pitfalls presenting a couple of posttraumatic and oncological application possibilities, focusing on the new presurgical planning, choice of materials and manufacturing technologies.

scholarly journals An Approach to Developing Customized Total Knee Replacement Implants

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Xinyu Li ◽  
Changjiang Wang ◽  
Yuan Guo ◽  
Weiyi Chen
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Biomechanical Analysis ◽  
Implant Design ◽  
Patient Specific ◽  
3 Dimensional ◽  
Total Knee ◽  
Ct Data ◽  
Magnetic Resonance Imaging Mri ◽  
End Stage

Total knee replacement (TKR) has been performed for patients with end-stage knee joint arthritis to relieve pain and gain functions. Most knee replacement patients can gain satisfactory knee functions; however, the range of motion of the implanted knee is variable. There are many designs of TKR implants; it has been suggested by some researchers that customized implants could offer a better option for patients. Currently, the 3-dimensional knee model of a patient can be created from magnetic resonance imaging (MRI) or computed tomography (CT) data using image processing techniques. The knee models can be used for patient-specific implant design, biomechanical analysis, and creating bone cutting guide blocks. Researchers have developed patient-specific musculoskeletal lower limb model with total knee replacement, and the models can be used to predict muscle forces, joint forces on knee condyles, and wear of tibial polyethylene insert. These available techniques make it feasible to create customized implants for individual patients. Methods and a workflow of creating a customized total knee replacement implant for improving TKR kinematics and functions are discussed and presented in this paper.

scholarly journals Topology and FEA modeling and optimization of a patient-specific zygoma implant

2021 ◽  
Author(s):  
Abhijit Cholkar ◽  
David Kinahan ◽  
Dermot Brabazon
Keyword(s):  
Additive Manufacturing ◽  
Optimum Design ◽  
Optimization Technique ◽  
Operating Time ◽  
Topological Optimization ◽  
Implant Design ◽  
Patient Specific ◽  
Stainless Steel 316L ◽  
Element Analysis ◽  
Suitable Material

Additive manufacturing has proven to be a very beneficial production technology in the medical and healthcare industries. While existing for over four decades, recent work has seen great improvements in the quality of products; particularly in medical devices such as implants. Improved customization reduced operating time and increased cost-effectiveness associated with Metal AM for these products offers a new value proposition.  This paper investigates and evaluates modelling methods for the zygoma bone (human jawbone) and explores the most suitable material and optimum design for this critical biomedical implant. This paper proposes an innovative and efficient pre-process methodology that includes modelling, design validation, topological optimization, and numerical analysis. The method includes the generation of the model using reverse engineering of CT scan data and a topology optimization technique which makes the implant lightweight without causing excessive stress concentration. Static structural Finite Element Analysis was conducted to test three different biocompatible materials (Ti6Al4V, stainless steel 316L and CoCr alloys) which are commonly available for metal additive manufacturing. The stresses and conditions in the analysis were that of the human mastication process and all the implant design were tested with the three material types. The Taguchi method was used to determine the optimum design which was found to result in the highest mass reduction of 25% with Ti6Al4V as the implant material.

scholarly journals Application of 3D Printing Technology in Orthopedic Medical Implant -Spinal surgery as an example

2019 ◽  
Vol 5 (2) ◽  
pp. 3
Author(s):  
Rong Feng Zhang ◽  
Peng Yun Wang ◽  
Ming Yang ◽  
Xuebo Dong ◽  
Xue Liu ◽  
...  
Keyword(s):  
Additive Manufacturing ◽  
Spinal Surgery ◽  
Surgical Planning ◽  
Operating Time ◽  
Manufacturing Technology ◽  
Patient Specific ◽  
Additive Manufacturing Technology ◽  
Patient Specific Implants ◽  
Surgical Guides ◽  
Communication Aid

Additive manufacturing has been used in complex spinal surgical planning since the 1990s and is now increasingly utilized to produce surgical guides, templates, and more recently customized implants. Surgeons report beneficial impacts using additively manufactured biomodels as pre-operative planning aids as it generally provides a better representation of the patient’s anatomy than on-screen viewing of computed tomography (CT) or magnetic resonance imaging (MRI). Furthermore, it has proven to be very beneficial in surgical training and in explaining complex deformity and surgical plans to patients/ parents. This paper reviews the historical perspective, current use, and future directions in using additive manufacturing in complex spinal surgery cases. This review reflects the authors’ opinion of where the field is moving in light of the current literature. Despite the reported benefits of additive manufacturing for surgical planning in recent years, it remains a high niche market. This review raises the question as to why the use of this technology has not progressed more rapidly despite the reported advantages – decreased operating time, decreased radiation exposure to patients intraoperatively, improved overall surgical outcomes, pre-operative implant selection, as well as being an excellent communication aid for all medical and surgical team members. Increasingly, the greatest benefits of additive manufacturing technology in spinal surgery are customdesigned drill guides, templates for pedicle screw placement, and customized patient-specific implants. In view of these applications, additive manufacturing technology could potentially revolutionize health care in the near future.

scholarly journals Randomized Clinical Trial of the Accuracy of Patient-Specific Implants versus CAD/CAM Splints in Orthognathic Surgery

2021 ◽  
Vol 148 (5) ◽  
pp. 1101-1110
Author(s):  
Biao Li ◽  
Hongpu Wei ◽  
Tengfei Jiang ◽  
Yifeng Qian ◽  
Tianjia Zhang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Orthognathic Surgery ◽  
Patient Specific ◽  
Patient Specific Implants ◽  
Cad Cam

Load Transfer Along the Bone-Dental Implant Interface

2009 ◽  
Author(s):  
Samira Faegh ◽  
Sinan Müftü
Keyword(s):  
Dental Implants ◽  
Load Transfer ◽  
Surface Characteristics ◽  
Systematic Investigation ◽  
Long Term Results ◽  
Implant Design ◽  
Patient Specific ◽  
Success Rates ◽  
Bone Implant ◽  
Patient Specific Implants

Endosseous dental implants are used as prosthetic treatment alternatives for treating partial edentulism [1]. Excellent long term results and high success rates have been achieved using dental implants during the past decades. Further improvements in implant protocols will include immediate loading, patient specific implants, applications for patients with extreme bone loss and extreme biting habits such as bruxism. The implant designs available in the market vary in size, shape, materials and surface characteristics [2], and address some of these concerns. An important factor in the implant design is the load transfer from the implant to bone during occlusal loading.[2,3] Load transfer starts along the bone-implant interface, and is affected by the loading type, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface [4]. While many studies using the finite element method (FEM) have been carried out [2–5], a systematic investigation of the load transfer at the bone implant interface, and the effects of various parameters that make the implant contour is lacking. The goal of this paper is to investigate one aspect of this multivariable problem, namely the effect of external implant threads on the load transfer along the bone-implant interface.

Sign in / Sign up

Export Citation Format

Share Document