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      Three-dimensional printing in orthopaedic surgery: a scoping review

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          Abstract

          • Three-dimensional printing (3DP) has become more frequently used in surgical specialties in recent years. These uses include pre-operative planning, patient-specific instrumentation (PSI), and patient-specific implant production.

          • The purpose of this review was to understand the current uses of 3DP in orthopaedic surgery, the geographical and temporal trends of its use, and its impact on peri-operative outcomes

          • One-hundred and eight studies ( N = 2328) were included, published between 2012 and 2018, with over half based in China.

          • The most commonly used material was titanium.

          • Three-dimensional printing was most commonly reported in trauma ( N = 41) and oncology ( N = 22). Pre-operative planning was the most common use of 3DP ( N = 63), followed by final implants ( N = 32) and PSI ( N = 22).

          • Take-home message: Overall, 3DP is becoming more common in orthopaedic surgery, with wide range of uses, particularly in complex cases. 3DP may also confer some important peri-operative benefits.

          Cite this article: EFORT Open Rev 2020;5:430-441. DOI: 10.1302/2058-5241.5.190024

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          Tips for learners of evidence-based medicine: 3. Measures of observer variability (kappa statistic).

          T. McGinn (2004)
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            Three-Dimensional Printed PCL-Based Implantable Prototypes of Medical Devices for Controlled Drug Delivery.

            Ermei Mäkilä, Niklas Sandler, Jenny Holländer … (2016)
            The goal of the present study was to fabricate drug-containing T-shaped prototypes of intrauterine system (IUS) with the drug incorporated within the entire backbone of the medical device using 3-dimensional (3D) printing technique, based on fused deposition modeling (FDM™). Indomethacin was used as a model drug to prepare drug-loaded poly(ε-caprolactone)-based filaments with 3 different drug contents, namely 5%, 15%, and 30%, by hot-melt extrusion. The filaments were further used to 3D print IUS. The results showed that the morphology and drug solid-state properties of the filaments and 3D prototypes were dependent on the amount of drug loading. The drug release profiles from the printed devices were faster than from the corresponding filaments due to a lower degree of the drug crystallinity in IUS in addition to the differences in the external/internal structure and geometry between the products. Diffusion of the drug from the polymer was the predominant mechanism of drug release, whereas poly(ε-caprolactone) biodegradation had a minor effect. This study shows that 3D printing is an applicable method in the production of drug-containing IUS and can open new ways in the fabrication of controlled release implantable devices.
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              How slow is too slow? Correlation of operative time to complications: an analysis from the Tennessee Surgical Quality Collaborative.

              Oscar D Guillamondegui, Brian Daley, William Cecil … (2015)
              The Tennessee Surgical Quality Collaborative analyzes NSQIP data from 21 participating hospitals. The Tennessee Surgical Quality Collaborative has reduced surgical complications, but causative factors are unclear. We sought to correlate surgical duration with complications to reveal mitigating strategies.
              Article 0 comments Cited 65 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): EFORT Open Rev
                Journal ID (iso-abbrev): EFORT Open Rev
                Title: EFORT Open Reviews
                Publisher: British Editorial Society of Bone and Joint Surgery
                ISSN (Electronic): 2058-5241
                Publication date Collection: July 2020
                Publication date (Electronic): 1 August 2020
                Volume: 5
                Issue: 7
                Pages: 430-441
                Affiliations
                [1 ]Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
                [2 ]Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
                Author notes
                [*]Seper Ekhtiari, Division of Orthopaedic Surgery, McMaster University, 5N-237 Barton St E Hamilton, Ontario, L8L 2X2, Canada. Email: seper.ekhtiari@ 123456medportal.ca
                Author information
                https://orcid.org/0000-0002-4571-9655
                Article
                Publisher ID: 10.1302_2058-5241.5.190024
                DOI: 10.1302/2058-5241.5.190024
                PMC ID: 7407871
                PubMed ID: 32818070
                SO-VID: f3073300-5fe5-4ad2-834e-5760bb344db5
                Copyright © © 2020 The author(s)
                License:

                This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                History
                Categories
                Subject: Basic Science
                Subject: 9
                Subject: 3D printing
                Subject: additive manufacturing
                Subject: orthopaedic surgery
                Subject: patient-specific instrumentation

                Keywords: 3d printing,additive manufacturing,orthopaedic surgery,patient-specific instrumentation
                Data availability:
                Keywords: 3d printing, additive manufacturing, orthopaedic surgery, patient-specific instrumentation

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