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 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.

Use of Three-dimensional Printing and Patient-matched Implant in Total Hip Arthroplasty – a Case Study

2019 ◽  
Vol 21 (3) ◽  
pp. 207-216 ◽  
Author(s):  
Piotr Sypień ◽  
Paweł Łęgosz ◽  
Paweł Małdyk
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Revision Arthroplasty ◽  
Patient Specific ◽  
Oral Antibiotic ◽  
Precise Position ◽  
Total Hip ◽  
Custom Made ◽  
History Of

We present a case report of a 70-year-old female patient with a history of right hip dysplasia and total hip arthroplasty complicated by chronic periprosthetic hipction. Failure of oral antibiotic treatment was an indication for implant removal. A computed tomography scan performed during qualification for reimplantation revealed massive bone defects in the pelvis. A three-dimensional printed patient-specific anatomical model of the pelvis helped to determine the precise position and cup size in preoperative planning and prepare a patient-matched acetabulum. The custom-made endoprosthesis was implanted during revision arthroplasty.

scholarly journals The Bordetella Bps Polysaccharide Is Critical for Biofilm Development in the Mouse Respiratory Tract

2007 ◽  
Vol 189 (22) ◽  
pp. 8270-8276 ◽  
Author(s):  
Gina Parise Sloan ◽  
Cheraton F. Love ◽  
Neelima Sukumar ◽  
Meenu Mishra ◽  
Rajendar Deora
Keyword(s):  
Whooping Cough ◽  
Three Dimensional ◽  
Respiratory Pathogens ◽  
Adolescents And Adults ◽  
The Stability ◽  
Inert Surfaces ◽  
Biofilm Development

ABSTRACT Bordetellae are respiratory pathogens that infect both humans and animals. Bordetella bronchiseptica establishes asymptomatic and long-term to life-long infections of animal nasopharynges. While the human pathogen Bordetella pertussis is the etiological agent of the acute disease whooping cough in infants and young children, it is now being increasingly isolated from the nasopharynges of vaccinated adolescents and adults who sometimes show milder symptoms, such as prolonged cough illness. Although it has been shown that Bordetella can form biofilms in vitro, nothing is known about its biofilm mode of existence in mammalian hosts. Using indirect immunofluorescence and scanning electron microscopy, we examined nasal tissues from mice infected with B. bronchiseptica. Our results demonstrate that a wild-type strain formed robust biofilms that were adherent to the nasal epithelium and displayed architectural attributes characteristic of a number of bacterial biofilms formed on inert surfaces. We have previously shown that the Bordetella Bps polysaccharide encoded by the bpsABCD locus is critical for the stability and maintenance of three-dimensional structures of biofilms. We show here that Bps is essential for the formation of efficient nasal biofilms and is required for the colonization of the nose. Our results document a biofilm lifestyle for Bordetella in mammalian respiratory tracts and highlight the essential role of the Bps polysaccharide in this process and in persistence of the nares.

scholarly journals Modern Applications of 3D Printing: The Case of an Artificial Ear Splint Model

2021 ◽  
Vol 4 (3) ◽  
pp. 54
Author(s):  
Athanasios Argyropoulos ◽  
Pantelis N. Botsaris
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Shape Preservation ◽  
Patient Specific ◽  
Fused Deposition Modelling ◽  
Comprehensive Overview ◽  
Protruding Ears ◽  
Fused Deposition ◽  
Custom Made ◽  
Wide Range

Three-dimensional (3D) printing is a leading manufacturing technique in the medical field. The constantly improving quality of 3D printers has revolutionized the approach to new challenges in medicine for a wide range of applications including otoplasty, medical devices, and tissue engineering. The aim of this study is to provide a comprehensive overview of an artificial ear splint model applied to the human auricle for the treatment of stick-out protruding ears. The deformity of stick-out protruding ears remains a significant challenge, where the complex and distinctive shape preservation are key factors. To address this challenge, we have developed a protocol that involves photogrammetry techniques, reverse engineering technologies, a smart prototype design, and 3D printing processes. Specifically, we fabricated a 3D printed ear splint model via fused deposition modelling (FDM) technology by testing two materials, a thermoplastic polyester elastomer material (Z-Flex) and polycaprolactone (PCL 100). Our strategy affords a custom-made and patient-specific artificial ear aligner with mechanical properties that ensures sufficient preservation of the auricular shape by applying a force on the helix and antihelix and enables the ears to pin back to the head.

scholarly journals Investigation into factors affecting the mechanical behaviours of a patient-specific vertebral body replacement

2018 ◽  
Vol 232 (4) ◽  
pp. 378-387 ◽  
Author(s):  
Ling Wang ◽  
Jianfeng Kang ◽  
Lei Shi ◽  
Jun Fu ◽  
Dichen Li ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Bone Growth ◽  
Three Dimensional ◽  
Peak Stress ◽  
Fusion Rate ◽  
Vertebral Body Replacement ◽  
Patient Specific ◽  
Geometrical Parameters ◽  
Element Analysis

Most vertebral body implants that are currently designed and produced in batches have difficulty meeting the patient-specific demands. Moreover, several complications, including a low fusion rate, subsidence occurrence, and rod displacement, are associated with these implants. This study aims to investigate the effects of patient-specific geometric and clinical parameters on the biomechanics of a vertebral body replacement. A three-dimensional patient-specific vertebral body replacement model was established as the basic model for parametric studies, including the anatomic design of the endplates, tilting angle, thickness, and dislocation of the vertebral body implant. A finite element analysis was applied to determine the stress distribution of the vertebral body implant when under various loading conditions. The model with an anatomical interfacing design generates 75% less stress concentration compared to a flat design; the peak stress of the model with a tilted angle closely matching the replaced vertebra segment is decreased by 30%; and the thickness close to the cortical bone can offer better bone growth capability and long-term stability. Patient-specific geometrical parameters were found to significantly affect the biomechanics of a vertebral body replacement, and therefore, a design customized especially for the endplates is necessary for better stability and long-term longevity of the prostheses. Regardless of such progress, how to balance the stability of a vertebral body implant and the safety of the peripheral nervous system remains a clinical challenge.

Reconstruction of craniofacial bone defects with three-dimensional custom-made implants. A five year experience

2009 ◽  
Vol 38 (5) ◽  
pp. 500 ◽  
Author(s):  
H. Rotaru ◽  
G. Bǎciuţ ◽  
H. Stan ◽  
R. Schumacher ◽  
H.F. Zeilhofer ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Bone Defects ◽  
Craniofacial Bone ◽  
Custom Made

Quality of Reamed Surface Using Serrated Blades as Compared to a Conventional Acetabular Reamer

2013 ◽  
Author(s):  
Annie Levasseur ◽  
Jérémie Ménard ◽  
Victor Songmené ◽  
Julio Fernandes ◽  
Yvan Petit
Keyword(s):  
Experimental Testing ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Numerical Control ◽  
Long Term Stability ◽  
Surface Irregularities ◽  
The Stability ◽  
Acetabular Implant

Background: Hip arthroplasty requires the preparation of the acetabular cavity to allow a proper contact between the bone and the implant. It is essential to allow osseointegration and long-term stability of the implant. The aim of this study was to conduct experimental testing to evaluate the quality of reamed surfaces using a serrated blade acetabular reamer as compared to a conventional rasp reamer. Method of Approach: Reaming tests were performed on a computerized numerical control tools machine at a rotational speed of 250 rpm and 3 different penetration speeds: 0.20 mm/s, 0.55 mm/s and 0.90 mm/s. For each reamer, a complete semi-hemispherical hole was perforated in 7 polyurethane samples. The reamed surfaces were digitized with a three-dimensional high resolution (40 μm) self-positioning laser scanner to carry out a quantitative analysis of the surface quality. Results: Results demonstrated that the cutting edge and the penetration speed influence the quality of the reamed surface. The serrated blade was found to reduce surface irregularities (ranging between 0.19 mm to 0.21 mm for the conventional rasp and between 0.07 mm and 0.12 mm for the serrated blades), and to reduce inaccuracies on the reamed cavity diameter (0.13 mm ± 0.05mm for the rasps and 0.06 mm ± 0.03mm for the serrated blade). Conclusions: The use of such tool by the surgeon may influence the stability of the acetabular implant and reduce the risks of revision surgery.

scholarly journals 3D printing in shoulder surgery

2020 ◽  
Author(s):  
Vincenzo Campana ◽  
Valentina Cardona ◽  
Valeria Vismara ◽  
Andrea Stefano Monteleone ◽  
Piero Piazza ◽  
...  
Keyword(s):  
3D Printing ◽  
Shoulder Instability ◽  
Shoulder Arthroplasty ◽  
Three Dimensional ◽  
Shoulder Surgery ◽  
Surgical Instruments ◽  
Patient Specific ◽  
Anterior Shoulder Instability ◽  
Glenoid Component ◽  
Custom Made

Three-dimensional (3D) printing is a novel modality with the potential to make a huge impact in the surgical field. The aim of this paper is to provide an overview on the current use of 3D printing in shoulder surgery. We have reviewed the use of this new method in 3 fields of shoulder surgery: shoulder arthroplasty, recurrent shoulder instability and orthopedic shoulder traumatology. In shoulder arthroplasty, several authors have shown that the use of the 3D printer improves the positioning of the glenoid component, even if longer clinical follow-up is needed to determine whether the cost of this system rationalizes the potential improved functional outcomes and decreases glenoid revision rates. In the treatment of anterior shoulder instability, the literature agrees on the fact that the use of the 3D printing can: enhance the dept and size of bony lesions, allowing a patient tailored surgical planning and potentially reducing operative times; allow the production of personalized implants to restore substantial bone loss; restore glenohumeral morphology and instability. In orthopedic trauma, the use of 3D printing can be helpful to increase the understanding of fracture patterns, facilitating a more personalized planning, and can be used for resident training and education. We can conclude the current literature regarding the use of 3D printed models in orthopedic surgery agrees finding objective improvements to preoperative planning and to the surgical procedure itself, by shortening the intraoperative time and by the possibility to develop custom-made, patient-specific surgical instruments, and it suggests that there are tangible benefits for its implementation.

scholarly journals Accuracy of an automated three-dimensional technique for the computation of femoral angles in dogs

2019 ◽  
Vol 185 (14) ◽  
pp. 443-443 ◽  
Author(s):  
Federico Longo ◽  
Gianpaolo Savio ◽  
Barbara Contiero ◽  
Roberto Meneghello ◽  
Gianmaria Concheri ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Patient Specific ◽  
3D Scanner ◽  
Measurement Variability ◽  
Reliable Technique ◽  
Gold Standard Method ◽  
Femoral Torsion ◽  
Custom Made

Aims: The purpose of the study was to evaluate the accuracy of a three-dimensional (3D) automated technique (computer-aided design (aCAD)) for the measurement of three canine femoral angles: anatomical lateral distal femoral angle (aLDFA), femoral neck angle (FNA) and femoral torsion angle.Methods:Twenty-eight femurs equally divided intotwo groups (normal and abnormal) were obtained from 14 dogs of different conformations (dolicomorphic and chondrodystrophicCT scans and 3D scanner acquisitions were used to create stereolithographic (STL) files , which were run in a CAD platform. Two blinded observers separately performed the measurements using the STL obtained from CT scans (CT aCAD) and 3D scanner (3D aCAD), which was considered the gold standard method. C orrelation coefficients were used to investigate the strength of the relationship between the two measurements.Results: A ccuracy of the aCAD computation was good, being always above the threshold of R2 of greater than 80 per cent for all three angles assessed in both groups. a LDFA and FNA were the most accurate angles (accuracy >90 per cent).Conclusions: The proposed 3D aCAD protocol can be considered a reliable technique to assess femoral angle measurements in canine femur. The developed algorithm automatically calculates the femoral angles in 3D, thus considering the subjective intrinsic femur morphology. The main benefit relies on a fast user-independent computation, which avoids user-related measurement variability. The accuracy of 3D details may be helpful for patellar luxation and femoral bone deformity correction, as well as for the design of patient- specific, custom-made hip prosthesis implants.

scholarly journals Reconstruction options and outcomes for acetabular bone loss in revision hip arthroplasty

2020 ◽  
Author(s):  
Fabio Mancino ◽  
Giorgio Cacciola ◽  
Davide De Marco ◽  
Alexander Greenberg ◽  
Carlo Perisano ◽  
...  
Keyword(s):  
Bone Loss ◽  
Hip Arthroplasty ◽  
Bone Defects ◽  
Acetabular Reconstruction ◽  
Metal Mesh ◽  
Acetabular Bone ◽  
Acetabular Bone Loss ◽  
Custom Made ◽  
Long Term Studies

Revision total hip arthroplasty in the setting of acetabular bone loss is a challenging procedure and requires a solid understanding of current acetabular reconstruction options. Despite major developments in the field of revision hip surgery in recent decades, reconstruction of acetabular defects remains a major problem in order to achieve primary stability and durable fixation without sacrificing additional bone stock. Although there are several ways to classify acetabular bone defects, the Paprosky classification system is the most commonly used to describe the defects and guide treatment strategy. An understanding of the bone defects associated with detailed pre-operative assessment and planning are essential elements in order to achieve satisfactory outcomes. Multiple acetabular reconstructive options are currently available including impaction bone grafting with metal mesh, reinforcement rings and antiprotrusio cage, structural allografts, cementless hemispherical cups, extra-large “jumbo cups”, oblong cups, modular porous metal augments, cup-cage constructs, custom- made triflange cups, and acetabular distraction. To date, debate continues as to which technique is most effective due to the lack of long-term studies of modern reconstruction systems. Further long-term studies are necessary to assess the longevity of the different implants. The purpose of this study was to review the current literature and provide a comprehensive understanding of the available reconstruction options with their clinical outcomes.

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