scholarly journals Computer Assisted Surgery and 3D Printing in Orthopaedic Oncology: A Lesson Learned by Cranio-Maxillo-Facial Surgery

2021 ◽  
Vol 11 (18) ◽  
pp. 8584
Author(s):  
Giuseppe Bianchi ◽  
Tommaso Frisoni ◽  
Benedetta Spazzoli ◽  
Alessandra Lucchese ◽  
Davide Donati
Keyword(s):  
3D Printing ◽  
Pelvic Surgery ◽  
Patient Specific ◽  
Computer Assisted ◽  
Mechanical Complication ◽  
Orthopaedic Oncology ◽  
Custom Made ◽  
Patient Specific Instruments ◽  
Primary Bone ◽  
Custom Made Prostheses

Primary bone sarcomas are rare tumors and surgical resection in combination with chemo and radiation therapy is the mainstay of treatment. Some specific anatomical sites still represent a reconstructive challenge due to their complex three-dimensional anatomy. In recent years, patient specific instruments along with 3D printing technology has come to represent innovative techniques in orthopaedic oncology. We retrospectively reviewed 23 patients affected by primary bone sarcoma treated with patient-specific instruments and 3D printing custom made prostheses. At follow up after approximately two years, the infection rate was 26%, mechanical complication rate 13%, and local recurrence rate 13% (with a five-years implant survival rate of 74%). Based on our experience, patient-specific instruments and 3D custom-made prostheses represents a reliable and safe technique for improving the accuracy of resection of primary bone tumour, with a particular use in pelvic surgery ameliorating functional results.

scholarly journals An Innovative and Cost-Advantage CAD Solution for Cubitus Varus Surgical Planning in Children

2021 ◽  
Vol 11 (9) ◽  
pp. 4057
Author(s):  
Leonardo Frizziero ◽  
Gian Maria Santi ◽  
Christian Leon-Cardenas ◽  
Giampiero Donnici ◽  
Alfredo Liverani ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Low Cost ◽  
Cost Effective ◽  
Varus Deformity ◽  
Patient Specific ◽  
Cubitus Varus ◽  
Surgical Guide ◽  
Traditional Procedure ◽  
Custom Made ◽  
Patient Specific Instruments

The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.

scholarly journals Accuracy of Coronal Plane Mechanical Alignment in a Customized, Individually Made Total Knee Replacement with Patient-Specific Instrumentation

2017 ◽  
Vol 31 (08) ◽  
pp. 792-796 ◽  
Author(s):  
Gary Levengood ◽  
Jack Dupee
Keyword(s):  
Mechanical Axis ◽  
Computer Assisted Surgery ◽  
Coronal Plane ◽  
Patient Specific ◽  
Computer Assisted ◽  
Consecutive Series ◽  
Mechanical Alignment ◽  
Patient Specific Instrumentation ◽  
Patient Specific Instruments ◽  
Total Knee

AbstractThe objective of this study was to evaluate the accuracy of a customized individually made total knee implant used in conjunction with patient-specific cutting guides in restoring coronal plane mechanical axis alignment using computer-assisted surgery (CAS). A consecutive series of 63 total knee arthroplasty (TKA) patients were prospectively measured with intraoperative CAS. The patient-specific instruments and implants were created utilizing a preoperative CT scan. CAS system was used for all patients, to determine mechanical alignment. Bone cuts were made using the patient-specific instruments. Both bone cuts and final coronal mechanical alignment were recorded utilizing the navigation system for the assessment.The patient-specific instruments and implants provided perfect neutral coronal mechanical alignment (0°) in 53 patients. The remaining 10 patients had a postoperative alignment within ± 2° of neutral. The average preoperative deformity was 5.57° versus 0.18° postoperatively (p < 0.0001). The mean correction angle was 5.68°. No patients had postoperative extension deficits as measured with CAS (7.50° pre-op for 40/63 patients). Customized, individually made total knee implant with patient-specific cutting jigs showed results that are comparable to those of CAS systems in this study. This technology restores the neutral coronal mechanical axis very accurately, while offering unique benefits such as improved implant fit and restoration of the patient's J-curves, which require further investigation.

scholarly journals A Cadaveric Comparative Study on the Surgical Accuracy of Freehand, Computer Navigation, and Patient-Specific Instruments in Joint-Preserving Bone Tumor Resections

Sarcoma ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Sarah E. Bosma ◽  
Kwok Chuen Wong ◽  
Laurent Paul ◽  
Jasper G. Gerbers ◽  
Paul C. Jutte
Keyword(s):  
Computer Navigation ◽  
Computer Assisted Surgery ◽  
Patient Specific ◽  
Computer Assisted ◽  
Oncologic Surgery ◽  
Engineering Software ◽  
Patient Specific Instrumentation ◽  
Quality Control Tool ◽  
Patient Specific Instruments ◽  
Intraoperative Quality Control

Orthopedic oncologic surgery requires preservation of a functioning limb at the essence of achieving safe margins. With most bone sarcomas arising from the metaphyseal region, in close proximity to joints, joint-salvage surgery can be challenging. Intraoperative guidance techniques like computer-assisted surgery (CAS) and patient-specific instrumentation (PSI) could assist in achieving higher surgical accuracy. This study investigates the surgical accuracy of freehand, CAS- and PSI-assisted joint-preserving tumor resections and tests whether integration of CAS with PSI (CAS + PSI) can further improve accuracy. CT scans of 16 simulated tumors around the knee in four human cadavers were performed and imported into engineering software (MIMICS) for 3D planning of multiplanar joint-preserving resections. The planned resections were transferred to the navigation system and/or used for PSI design. Location accuracy (LA), entry and exit points of all 56 planes, and resection time were measured by postprocedural CT. Both CAS + PSI- and PSI-assisted techniques could reproduce planned resections with a mean LA of less than 2 mm. There was no statistical difference in LA between CAS + PSI and PSI resections (p=0.92), but both CAS + PSI and PSI showed a significantly higher LA compared to CAS (p=0.042 and p=0.034, respectively). PSI-assisted resections were faster compared to CAS + PSI (p<0.001) and CAS (p<0.001). Adding CAS to PSI did improve the exit points, however not significantly. In conclusion, PSI showed the best overall surgical accuracy and is fastest and easy to use. CAS could be used as an intraoperative quality control tool for PSI, and integration of CAS with PSI is possible but did not improve surgical accuracy. Both CAS and PSI seem complementary in improving surgical accuracy and are not mutually exclusive. Image-based techniques like CAS and PSI are superior over freehand resection. Surgeons should choose the technique most suitable based on the patient and tumor specifics.

3D Bioprinted Cardiac Tissues and Devices for Tissue Maturation

2021 ◽  
pp. 1-14
Author(s):  
Veronika Sedlakova ◽  
Christopher McTiernan ◽  
David Cortes ◽  
Erik J. Suuronen ◽  
Emilio I. Alarcon
Keyword(s):  
3D Printing ◽  
Tissue Repair ◽  
Surgical Planning ◽  
Cardiac Tissue ◽  
Treatment Options ◽  
Cardiac Regeneration ◽  
Patient Specific ◽  
Cardiac Tissues ◽  
Cardiovascular Tissue ◽  
Custom Made

Cardiovascular diseases are the leading cause of mortality worldwide. Given the limited endogenous regenerative capabilities of cardiac tissue, patient-specific anatomy, challenges in treatment options, and shortage of donor tissues for transplantation, there is an urgent need for novel approaches in cardiac tissue repair. 3D bioprinting is a technology based on additive manufacturing which allows for the design of precisely controlled and spatially organized structures, which could possibly lead to solutions in cardiac tissue repair. In this review, we describe the basic morphological and physiological specifics of the heart and cardiac tissues and introduce the readers to the fundamental principles underlying 3D printing technology and some of the materials/approaches which have been used to date for cardiac repair. By summarizing recent progress in 3D printing of cardiac tissue and valves with respect to the key features of cardiovascular tissue (such as contractility, conductivity, and vascularization), we highlight how 3D printing can facilitate surgical planning and provide custom-fit implants and properties that match those from the native heart. Finally, we also discuss the suitability of this technology in the design and fabrication of custom-made devices intended for the maturation of the cardiac tissue, a process that has been shown to increase the viability of implants. Altogether this review shows that 3D printing and bioprinting are versatile and highly modulative technologies with wide applications in cardiac regeneration and beyond.

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 Pelvic Chondrosarcoma Treated by En Bloc Resection with Patient-Specific Osteotomy Guides and Reimplantation of the Extracorporeally Irradiated Bone as an Osseocartilaginous Structural Orthotopic Autograft: A Report of Two Cases with Description of the Surgical Technique

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Georgios Gkagkalis ◽  
Kevin Moerenhout ◽  
Hannes A. Rüdiger ◽  
Daniel A. Müller ◽  
Igor Letovanec ◽  
...  
Keyword(s):  
Computer Navigation ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Patient Specific ◽  
En Bloc ◽  
Primary Tumors ◽  
Complex Anatomy ◽  
Custom Made ◽  
Patient Specific Instruments ◽  
Modular Prostheses

Primary tumors of the pelvis are considered difficult to treat due to the complex anatomy and the proximity of important neurovascular structures. The surgical armamentarium for the treatment of these tumors has evolved with the help of cutting-edge technology from debilitating hemipelvectomies to solutions such as precise resections guided by patient-specific instruments or computer navigation and reconstruction by modular prostheses, 3D-printed custom-made implants, or orthotopic autograft reimplantation after extracorporeal irradiation. Different combinations of these techniques have been described in the literature with various rates of success. We present two cases of pelvic chondrosarcomas successfully treated by a combination of periacetabular resection with patient-specific osteotomy guides and orthotopic reimplantation of the extracorporeally irradiated autograft resulting in retention of the native hip.

Design, additive manufacture and clinical application of a patient-specific titanium implant to anatomically reconstruct a large chest wall defect

2021 ◽  
Vol 27 (2) ◽  
pp. 304-310
Author(s):  
Alba Gonzalez Alvarez ◽  
Peter Ll. Evans ◽  
Lawrence Dovgalski ◽  
Ira Goldsmith
Keyword(s):  
Chest Wall ◽  
Development Process ◽  
Patient Specific ◽  
Computer Assisted ◽  
Design Guideline ◽  
Wall Defect ◽  
Content Type ◽  
Chest Wall Defect ◽  
Paradoxical Movement ◽  
Custom Made

Purpose Chest wall reconstruction of large oncological defects following resection is challenging. Traditional management involves the use of different materials that surgeons creatively shape intraoperatively to restore the excised anatomy. This is time-consuming, difficult to mould into shape and causes some complications such as dislocation or paradoxical movement. This study aims to present the development and clinical implantation of a novel custom-made three-dimensional (3D) laser melting titanium alloy implant that reconstructs a large chest wall resection and maintains the integrity of the thoracic cage. Design/methodology/approach The whole development process of the novel implant is described: design specifications, computed tomography (CT) scan manipulation, 3D computer-assisted design (CAD), rapid prototyping, final manufacture and clinical implantation. A multidisciplinary collaboration in between engineers and surgeons guided the iterative design process. Findings The implant provided excellent aesthetical and functional results. The virtual planning and production of the implant prior to surgery reduced surgery time and uncertainty. It also improved safety and accuracy. The implant sited nicely on the patient anatomy after resection following the virtual plan. At six months following implantation, there were no implant-related complications of pain, infection, dislocation or paradoxical movement. This technique offered a fast lead-time for implant production, which is crucial for oncological treatment. Research limitations/implications More cases and a long-term follow-up are needed to confirm and quantify the benefits of this procedure; further research is also required to design a solution that better mimics the chest wall biomechanics while preventing implant complications. Originality/value The authors present a novel custom thoracic implant that provided a satisfactory reconstruction of a large chest wall defect, developed and implanted within three weeks to address a fast-growing chondrosarcoma. Furthermore, the authors describe its development process in detail as a design guideline, discussing potential improvements and critical design considerations so that this study can be replicated for future cases.

3D printing objects as knowledge artifacts for a do-it-yourself approach in clinical practice

2018 ◽  
Vol 52 (1) ◽  
pp. 163-186 ◽  
Author(s):  
Federico Cabitza ◽  
Angela Locoro ◽  
Aurelio Ravarini
Keyword(s):  
3D Printing ◽  
User Study ◽  
Medical Knowledge ◽  
Patient Specific ◽  
Free Text ◽  
Content Type ◽  
Knowledge Practices ◽  
Custom Made ◽  
Do It Yourself ◽  
The Impact

Purpose The purpose of this paper is to investigate the phenomenon of the digital do-it-yourself (DiDIY) in the medical domain. In particular, the main contribution of the paper is the analysis and discussion of a questionnaire-based user study focused on 3D printing (3DP) technology, which was conducted among clinicians of one of the most important research hospital group in Lombardy, Italy. Design/methodology/approach A general reflection on the notion of knowledge artifacts (KAs) and on the use of 3DP in medicine is followed by the research questions and by a more detailed analysis of the specialist literature on the usage of 3DP technology for diagnostic, training and surgical planning activities for clinicians and patients. The questionnaire-based user study design is then emerging from the conceptual framework for DiDIY in healthcare. To help focus on the main actors and assets composing the 3DP innovation roles in healthcare, the authors model: the DiDIY-er as the main initiator of the practice innovation; the available technology allowing the envisioning of new practices; the specific activities gaining benefits from the innovative techniques introduced; and the knowledge community continuously supporting and evolving knowledge practices. Findings The authors discuss the results of the user study in the light of the four main components of our DiDIY framework and on the notion of KA. There are differences between high expertise, or senior, medical doctors (MDs) and relatively lower expertise MDs, or younger MDs, regarding the willing to acquire 3DP competences; those who have seen other colleagues using 3DP are significantly more in favor of 3DP adoption in medical practices, and those who wish to acquire 3DP competence and do-by-themselves are significantly more interested in the making of custom-made patient-specific tools, such as cutting guides and templates; there are many recurrent themes regarding how 3DP usage and application may improve medical practice. In each of the free-text questions, there were comments regarding the impact of 3DP on medical knowledge practices, such as surgical rehearsal, surgery, pathology comprehension, patient-physician communication and teaching. Originality/value The 3DP adoption in healthcare is seen favorably and advocated by most of the respondents. In this domain, 3DP objects can be considered KAs legitimately. They can support knowledgeable practices, promote knowledge sharing and circulation in the healthcare community, as well as contribute to their improvement by the introduction of a new DiDIY mindset in the everyday work of MDs.

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 Morphometric Evaluation of Detailed Asymmetry for the Proximal Humerus in Korean Population

Symmetry ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 862
Author(s):  
Eunah Hong ◽  
Dai-Soon Kwak ◽  
In-Beom Kim
Keyword(s):  
Proximal Humerus ◽  
Contralateral Side ◽  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Instruments ◽  
Left And Right ◽  
Ct Data ◽  
Bilateral Differences ◽  
Computer Assisted Orthopedic Surgery ◽  
Morphometric Evaluation

Computer-assisted orthopedic surgery and patient-specific instruments are widely used in orthopedic fields that utilize contralateral side bone data as a template to restore the affected side bone. The essential precondition for these techniques is that the left and right bone features are similar. Although proximal humerus fracture accounts for 4% to 8% of all fractures, the bilateral asymmetry of the proximal humerus is not fully understood. The aim of this study is to investigate anthropometric differences of the bilateral proximal humerus. One hundred one pairs of Korean humerus CT data from 51 females and 50 males were selected for this research. To investigate bilateral shape differences, we divided the proximal humerus into three regions and the proximal humerus further into five sections in each region. The distance from the centroid to the cortical outline at every 10 degrees was measured in each section. Differences were detected in all regions of the left and right proximal humerus; however, males had a larger number of significant differences than females. Large bilateral differences were measured in the greater tubercle. Nevertheless, using contralateral data as a template for repairing an affected proximal humerus might be possible.

Sign in / Sign up

Export Citation Format

Share Document