Will 3D printing take away surgical planning from doctors?

Artificial intelligence-based orthopaedic perpetual design

Background and aims

Integrating Artificial Intelligence (AI) methodologies in orthopaedic surgeries is becoming increasingly important as it optimises implant designs and treatment procedures. This research article introduces an innovative approach using an AI-driven algorithm, focusing on the humerus bone anatomy. The primary focus of this work is to determine implant dimensions tailored to individual patients.

Methodology

We have utilised Python's DICOM library, which extracts rich information from medical images obtained through CT and MRI scans. The algorithm generates precise three-dimensional reconstructions of the bone, enabling a comprehensive understanding of its morphology.

Results

Using algorithms that reconstructed 3D bone models to propose optimal implant geometries that adhere to patients' unique anatomical intricacies and cater to their functional requirements. Integrating AI techniques promotes enhanced implant designs that facilitate enhanced integration with the host bone, promoting improved patient outcomes.

Conclusion

A notable breakthrough in this research is the ability of the algorithm to predict implant physical dimensions based on CT and MRI data. The algorithm can infer implant specifications that align with patient-specific bone characteristics by training the AI model on a diverse dataset. This approach could revolutionise orthopaedic surgery, reducing patient waiting times and the duration of medical interventions.

A virtual reality simulation of a novel way to illuminate the surgical field - A feasibility study on the use of automated lighting systems in the operating theatre

Introduction

Surgical lighting systems have to be re-adjusted manually during surgery by the medical personnel. While some authors suggest that interaction with a surgical lighting system in the operating room might be a distractor, others support the idea that manual interaction with the surgical lighting system is a hygiene problem as pathogens might be present on the handle. In any case, it seems desirable to develop a novel approach to surgical lighting that minimizes the need for manual interaction during a surgical procedure.

Methodes

We investigated the effect of manual interaction with a classical surgical lighting system and simulated a proposed novel design of a surgical lighting system in a virtual reality environment with respect to performance accuracy as well as cognitive load (measured by electroencephalographical recordings).

Results

We found that manual interaction with the surgical lights has no effect on the quality of performance, yet for the price of a higher mental effort, possibly leading to faster fatigue of the medical personnel in the long run.

Discussion

Our proposed novel surgical lighting system negates the need for manual interaction and leads to a performance quality comparable to the classical lighting system, yet with less mental load for the surgical personnel.

Technology and orthopaedic surgeons

Modern and innovative technologies are rapidly penetrating the clinical practices of Orthopaedic Surgeons. The ones that have proved successful for clinical use are Additive Manufacturing/3D printing, Artificial Intelligence, Robotics, Smart sensors, and Orthobiologics. Industry 5.0 revolution has helped provide personalised treatment by integrating machines and human beings. In this special issue, we present a collection of excellent articles on these technologies.

Functionally graded additive manufacturing for orthopedic applications

Background

Additive Manufacturing due to its benefits in developing parts with complex geometries and shapes, has evolved as an alternate manufacturing process to develop implants with desired properties. The structure of human bones being anisotropic in nature is biologically functionally graded i,e. The structure possesses different properties in different directions. Therefore, various orthopedic implants such as knee, hip and other bone plates, if functionally graded can perform better. In this context, the development of functionally graded (FG) parts for orthopedic application with tailored anisotropic properties has become easier through the use of additive manufacturing (AM).

Objectives

and Rationale: The current paper aims to study the various aspects of additively manufactured FG parts for orthopedic applications. It presents the details of various orthopedic implants such as knee, hip and other bone plates in a structured manner. A systematic literature review is conducted to study the various material and functional aspects of functionally graded parts for orthopedic applications. A section is also dedicated to discuss the mechanical properties of functionally graded parts.

Conclusion

The literature revealed that additive manufacturing can provide lot of opportunities for development of functionally graded orthopedic implants with improved properties and durability. Further, the effect of various FG parameters on the mechanical behavior of these implants needs to be studied in detail. Also, with the advent of various AM technologies, the functional grading can be achieved by various means e.g. density, porosity, microstructure, composition, etc. By varying the AM parameters. However, the current limitations of cost and material biocompatibility prevent the widespread exploitation of AM technologies for various orthopedic applications.

Additive Manufacturing in Orthopedics: A Review

Additive manufacturing is an advanced manufacturing manner that seems like the industrial revolution. It has the inborn benefit of producing complex formations, which are distinct from traditional machining technology. Its manufacturing strategy is flexible, including a wide range of materials, and its manufacturing cycle is short. Additive manufacturing techniques are progressively used in bone research and orthopedic operation as more innovative materials are developed. This Review lists the recent research results, analyzes the strengths and weaknesses of diverse three-dimensional printing strategies in orthopedics, and sums up the use of varying 3D printing strategies in surgical guides, surgical implants, surgical predictive models, and bone tissue engineering. Moreover, various postprocessing methods for additive manufacturing for orthopedics are described.

Virtual preoperative planning and 3D printing are valuable for the management of complex orthopaedic trauma

PURPOSE

The technology of 3D printing (3DP) exists for quite some time, but it is still not utilized to its full potential in the field of orthopaedics and traumatology, such as underestimating its worth in virtual preoperative planning (VPP) and designing various models, templates, and jigs. It can be a significant tool in the reduction of surgical morbidity and better surgical outcome avoiding various associated complications.

METHODS

An observational study was done including 91 cases of complex trauma presented in our institution requiring operative fixation. Virtual preoperative planning and 3DP were used in the management of these fractures. Surgeons managing these cases were given a set of questionnaire and responses were recorded and assessed as a quantitative data.

RESULTS

In all the 91 cases, where VPP and 3DP were used, the surgeons were satisfied with the outcome which they got intraoperatively and postoperatively. Surgical time was reduced, with a better outcome. Three dimensional models of complex fracture were helpful in understanding the anatomy and sketching out the plans for optimum reduction and fixation. The average score of the questionnaire was 4.5, out of a maximum of 6, suggesting a positive role of 3DP in orthopaedics.

CONCLUSION

3DP is useful in complex trauma management by accurate reduction and placement of implants, reduction of surgical time and with a better outcome. Although there is an initial learning curve to understand and execute the VPP and 3DP, these become easier with practice and experience.