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Alzubaidi L, Al-Dulaimi K, Salhi A, Alammar Z, Fadhel MA, Albahri AS, Alamoodi AH, Albahri OS, Hasan AF, Bai J, Gilliland L, Peng J, Branni M, Shuker T, Cutbush K, Santamaría J, Moreira C, Ouyang C, Duan Y, Manoufali M, Jomaa M, Gupta A, Abbosh A, Gu Y. Comprehensive review of deep learning in orthopaedics: Applications, challenges, trustworthiness, and fusion. Artif Intell Med 2024; 155:102935. [PMID: 39079201 DOI: 10.1016/j.artmed.2024.102935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 03/18/2024] [Accepted: 07/22/2024] [Indexed: 08/24/2024]
Abstract
Deep learning (DL) in orthopaedics has gained significant attention in recent years. Previous studies have shown that DL can be applied to a wide variety of orthopaedic tasks, including fracture detection, bone tumour diagnosis, implant recognition, and evaluation of osteoarthritis severity. The utilisation of DL is expected to increase, owing to its ability to present accurate diagnoses more efficiently than traditional methods in many scenarios. This reduces the time and cost of diagnosis for patients and orthopaedic surgeons. To our knowledge, no exclusive study has comprehensively reviewed all aspects of DL currently used in orthopaedic practice. This review addresses this knowledge gap using articles from Science Direct, Scopus, IEEE Xplore, and Web of Science between 2017 and 2023. The authors begin with the motivation for using DL in orthopaedics, including its ability to enhance diagnosis and treatment planning. The review then covers various applications of DL in orthopaedics, including fracture detection, detection of supraspinatus tears using MRI, osteoarthritis, prediction of types of arthroplasty implants, bone age assessment, and detection of joint-specific soft tissue disease. We also examine the challenges for implementing DL in orthopaedics, including the scarcity of data to train DL and the lack of interpretability, as well as possible solutions to these common pitfalls. Our work highlights the requirements to achieve trustworthiness in the outcomes generated by DL, including the need for accuracy, explainability, and fairness in the DL models. We pay particular attention to fusion techniques as one of the ways to increase trustworthiness, which have also been used to address the common multimodality in orthopaedics. Finally, we have reviewed the approval requirements set forth by the US Food and Drug Administration to enable the use of DL applications. As such, we aim to have this review function as a guide for researchers to develop a reliable DL application for orthopaedic tasks from scratch for use in the market.
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Affiliation(s)
- Laith Alzubaidi
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia.
| | - Khamael Al-Dulaimi
- Computer Science Department, College of Science, Al-Nahrain University, Baghdad, Baghdad 10011, Iraq; School of Electrical Engineering and Robotics, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Asma Salhi
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Zaenab Alammar
- School of Computer Science, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Mohammed A Fadhel
- Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - A S Albahri
- Technical College, Imam Ja'afar Al-Sadiq University, Baghdad, Iraq
| | - A H Alamoodi
- Institute of Informatics and Computing in Energy, Universiti Tenaga Nasional, Kajang 43000, Malaysia
| | - O S Albahri
- Australian Technical and Management College, Melbourne, Australia
| | - Amjad F Hasan
- Faculty of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO 65211, USA
| | - Jinshuai Bai
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Luke Gilliland
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Jing Peng
- Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Marco Branni
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Tristan Shuker
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; St Andrew's War Memorial Hospital, Brisbane, QLD 4000, Australia
| | - Kenneth Cutbush
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; St Andrew's War Memorial Hospital, Brisbane, QLD 4000, Australia
| | - Jose Santamaría
- Department of Computer Science, University of Jaén, Jaén 23071, Spain
| | - Catarina Moreira
- Data Science Institute, University of Technology Sydney, Australia
| | - Chun Ouyang
- School of Information Systems, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Ye Duan
- School of Computing, Clemson University, Clemson, 29631, SC, USA
| | - Mohamed Manoufali
- CSIRO, Kensington, WA 6151, Australia; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Mohammad Jomaa
- QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; St Andrew's War Memorial Hospital, Brisbane, QLD 4000, Australia
| | - Ashish Gupta
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia; Research and Development department, Akunah Med Technology Pty Ltd Co, Brisbane, QLD 4120, Australia
| | - Amin Abbosh
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Yuantong Gu
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology, Brisbane, QLD 4000, Australia; QUASR/ARC Industrial Transformation Training Centre-Joint Biomechanics, Queensland University of Technology, Brisbane, QLD 4000, Australia
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Chen F, Huang C, Ling C, Zhou J, Wang Y, Zhang P, Jiang X, Xu X, Jian J, Li J, Wang L, Yao Q. 3D PRINTING IN COMPLEX TIBIAL FRACTURE CLASSIFICATION & PLANNING. ACTA ORTOPEDICA BRASILEIRA 2024; 32:e269705. [PMID: 39119246 PMCID: PMC11308553 DOI: 10.1590/1413-785220243203e269705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2024] [Indexed: 08/10/2024]
Abstract
Objective Tibial plateau fractures are common intra-articular fractures that pose classification and treatment challenges for orthopedic surgeons. Objective This study examines the value of 3D printing for classifying and planning surgery for complex tibial plateau fractures. Methods We reviewed 54 complex tibial plateau fractures treated at our hospital from January 2017 to January 2019. Patients underwent preoperative spiral CT scans, with DICOM data processed using Mimics software. 3D printing technology created accurate 1:1 scale models of the fractures. These models helped subdivide the fractures into seven types based on the tibial plateau's geometric planes. Surgical approaches and simulated operations, including fracture reduction and plate placement, were planned using these models. Results The 3D models accurately depicted the direction and extent of fracture displacement and plateau collapse. They facilitated the preoperative planning, allowing for precise reconstruction strategies and matching intraoperative details with the pre-printed models. Post-surgery, the anatomical structure of the tibial plateau was significantly improved in all 54 cases. Conclusion 3D printing effectively aids in the classification and preoperative planning of complex tibial plateau fractures, enhancing surgical outcomes and anatomical restoration. Level of Evidence IV, Prospective Study.
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Affiliation(s)
- Fuyang Chen
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Chenyu Huang
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
- Univerisity of California, Department of Biomedical Engineering, Irvine, USA
| | - Chen Ling
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Jinming Zhou
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Yufeng Wang
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Po Zhang
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Xiao Jiang
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Xiaoming Xu
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Jian Jian
- Department of Orthopaedic Surgery, Pukou Hospital, Pukou branch of Jiangsu Province Hospital, Nanjing, China
| | - Jiayi Li
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Liming Wang
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
| | - Qingqiang Yao
- Nanjing Medical University, Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing, China
- Nanjing Medical University, Institute of digital medicine, Nanjing, China
- Nanjing Medical University, Institute of Digital Medicine, Key Lab of Additive Manufacturing Technology, Nanjing, China
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Flaxman TE, Cooke CM, Miguel OX, Sheikh A, McInnes M, Duigenan S, Singh SS. The Value of Using Patient-Specific 3D-Printed Anatomical Models in Surgical Planning for Patients With Complex Multifibroid Uteri. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102435. [PMID: 38458270 DOI: 10.1016/j.jogc.2024.102435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES To compare surgeon responses regarding their surgical plan before and after receiving a patient-specific three-dimensional (3D)-printed model of a patient's multifibroid uterus created from their magnetic resonance imaging. METHODS 3D-printed models were derived from standard-of-care pelvic magnetic resonance images of patients scheduled for surgical intervention for multifibroid uterus. Relevant anatomical structures were printed using a combination of transparent and opaque resin types. 3D models were used for 7 surgical cases (5 myomectomies, 2 hysterectomies). A staff surgeon and 1 or 2 surgical fellow(s) were present for each case. Surgeons completed a questionnaire before and after receiving the model documenting surgical approach, perceived difficulty, and confidence in surgical plan. A postoperative questionnaire was used to assess surgeon experience using 3D models. RESULTS Two staff surgeons and 3 clinical fellows participated in this study. A total of 15 surgeon responses were collected across the 7 cases. After viewing the models, an increase in perceived surgical difficulty and confidence in surgical plan was reported in 12/15 and 7/15 responses, respectively. Anticipated surgical time had a mean ± SD absolute change of 44.0 ± 47.9 minutes and anticipated blood loss had an absolute change of 100 ± 103.5 cc. 2 of 15 responses report a change in pre-surgical approach. Intra-operative model reference was reported to change the dissection route in 8/15 surgeon responses. On average, surgeons rated their experience using 3D models 8.6/10 for pre-surgical planning and 8.1/10 for intra-operative reference. CONCLUSIONS Patient-specific 3D anatomical models may be a useful tool to increase a surgeon's understanding of complex gynaecologic anatomy and to improve their surgical plan. Future work is needed to evaluate the impact of 3D models on surgical outcomes in gynaecology.
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Affiliation(s)
- Teresa E Flaxman
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON
| | - Carly M Cooke
- University of Ottawa, Faculty of Medicine, Department of Obstetrics and Gynecology, Ottawa, ON
| | - Olivier X Miguel
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON
| | - Adnan Sheikh
- University of British Columbia, Faculty of Medicine, Department of Radiology, Vancouver, BC
| | - Matthew McInnes
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON; The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON
| | - Shauna Duigenan
- University of Ottawa, Faculty of Medicine, Department of Radiology, Radiation Oncology and Medical Physics, Ottawa, ON; The Ottawa Hospital, Department of Medical Imaging, Ottawa, ON
| | - Sukhbir Sony Singh
- Ottawa Hospital Research Institute, Department of Clinical Epidemiology, Ottawa, ON; University of Ottawa, Faculty of Medicine, Department of Obstetrics and Gynecology, Ottawa, ON; The Ottawa Hospital, Department of Obstetrics, Gynecology and Newborn Care, Ottawa, ON.
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Jain M, Sharma V, Sood C, Shyam A. Impact of 3D printing on Orthopedic Surgery in India: Has the Technology Really Arrived! J Orthop Case Rep 2024; 14:1-3. [PMID: 38911002 PMCID: PMC11189093 DOI: 10.13107/jocr.2024.v14.i06.4480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/20/2024] [Indexed: 06/25/2024] Open
Abstract
Surgical innovations have driven advancements in patient care, leading to improved surgical results and decreased patient morbidity. The integration of new technical advancements in orthopedic surgery is linked to the clinical advantages, ethical challenges, financial factors, and its broader influence on the global health-care sector [1]. 3D printing in orthopedic surgery is a developing technique that is rapidly gaining recognition and positively impacting patient results. The widespread influence and usefulness of 3D printing in orthopedics have been confirmed through reports detailing its application in complex trauma, complex hip revision surgeries, and various other areas such as complex spine deformity for pedicle screw trajectory guides, 3D printed implants, and bio-scaffolds [2-5]. The amount of scientific literature on the use of 3D printing in orthopedics has significantly increased in the past decade, both internationally and in India [6]. However, it has this quickly rising trend in the field of orthopedic surgery “really arrived in India.”
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Affiliation(s)
- Mantu Jain
- Department of Orthopaedics, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India
| | - Vyom Sharma
- Department of Orthopaedics, Military Hospital Khadki and AFMC, Pune, Maharashtra, India
| | - Chetan Sood
- Department of Orthopaedics, Base Hospital Guwahati, Guwahati, Assam, India
| | - Ashok Shyam
- Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India
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Kahsai EA, O'Connor B, Khoo KJ, Ogunleye TD, Telfer S, Hagen MS. Improving Patient Understanding of Femoroacetabular Impingement Syndrome With Three-Dimensional Models. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202405000-00006. [PMID: 38722846 PMCID: PMC11081616 DOI: 10.5435/jaaosglobal-d-24-00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION Three-dimensional (3D) printed models may help patients understand complex anatomic pathologies such as femoroacetabular impingement syndrome (FAIS). We aimed to assess patient understanding and satisfaction when using 3D printed models compared with standard imaging modalities for discussion of FAIS diagnosis and surgical plan. METHODS A consecutive series of 76 new patients with FAIS (37 patients in the 3D model cohort and 39 in the control cohort) from a single surgeon's clinic were educated using imaging and representative 3D printed models of FAI or imaging without models (control). Patients received a voluntary post-visit questionnaire that evaluated their understanding of the diagnosis, surgical plan, and visit satisfaction. RESULTS Patients in the 3D model cohort reported a significantly higher mean understanding of FAIS (90.0 ± 11.5 versus 79.8 ± 14.9 out of 100; P = 0.001) and surgery (89.5 ± 11.6 versus 81.0 ± 14.5; P = 0.01) compared with the control cohort. Both groups reported high levels of satisfaction with the visit. CONCLUSION In this study, the use of 3D printed models in clinic visits with patients with FAIS improved patients' perceived understanding of diagnosis and surgical treatment.
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Affiliation(s)
- Ermyas A. Kahsai
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Bailey O'Connor
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Kevin J. Khoo
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Temi D. Ogunleye
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Scott Telfer
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Mia S. Hagen
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
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Li X, Su J, Han J, Li H, Yao W, Ding R, Zhang C. Coronavirus disease-2019 and orthopedics: A bibliometric analysis of the literature. Medicine (Baltimore) 2024; 103:e37714. [PMID: 38608113 PMCID: PMC11018195 DOI: 10.1097/md.0000000000037714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/04/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The coronavirus disease-2019 (COVID-19) pandemic has had a dramatic impact on global health, with orthopedics among the most affected specialties. An increasing number of COVID-19-related orthopedic studies have been published. The purpose of this study was to analyze the orthopedic literature published during the COVID-19 pandemic to guide future research. METHODS The Scopus database was searched for relevant literature published between 2020 and 2022. The keywords used in the retrieval process were ("COVID-19" OR "Coronavirus" OR "2019-nCoV" OR "SARS-CoV-2" OR "Betacoronavirus" OR "novel coronavirus 2019" OR "novel coronavirus" OR "coronavirus-19" OR "COVID 19" OR "nCOV" OR "COVID-2019" OR "COVID 2019") and ("orthopedic" OR "orthopedics" OR "orthopedic" OR "orthopedical" OR "orthopedical" OR "orthopedics"). Spreadsheet software (Excel, Microsoft Corp., Redmond, WA) was used to analyze the top 10 cited authors, countries, journals, and articles. The top 5 publication types were also analyzed. VOSviewer (Center for Science and Technology Studies, Leiden, Netherlands) was used to network and visualize the literature. RESULTS A total of 1619 publications relevant to COVID-19 and orthopedics were reviewed. Among these publications, the most active country, author, and publication type included the United States, Vaishya R, and original articles, respectively. The most frequently used keywords were human, coronavirus disease-2019, pandemic, and orthopedics. The Journal of Bone and Joint Surgery American Volume was the most cited journal, whereas the greatest number of articles was published in the Journal of Clinical Orthopedics and Trauma. CONCLUSIONS This study provides a perspective on the development of orthopedic publications during the COVID-19 pandemic and evidence for researchers worldwide to strengthen global cooperation in fighting the epidemic.
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Affiliation(s)
- Xiaobo Li
- Department of Orthopedics, General Hospital of Central Theater Command of PLA, Wuhan, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jixian Su
- Department of Orthopedics, General Hospital of Central Theater Command of PLA, Wuhan, China
- Clinical Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Jing Han
- Department of Orthopedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Hanlin Li
- Department of Orthopedics, General Hospital of Central Theater Command of PLA, Wuhan, China
- Clinical Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Wenhao Yao
- Department of Orthopedics, General Hospital of Central Theater Command of PLA, Wuhan, China
- Clinical Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Ran Ding
- Department of Orthopedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Chen Zhang
- Department of Orthopedics, General Hospital of Central Theater Command of PLA, Wuhan, China
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Akhtar MN, Haleem A, Javaid M, Mathur S, Vaish A, Vaishya R. Artificial intelligence-based orthopaedic perpetual design. J Clin Orthop Trauma 2024; 49:102356. [PMID: 38361509 PMCID: PMC10865397 DOI: 10.1016/j.jcot.2024.102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/17/2024] Open
Abstract
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.
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Affiliation(s)
- Md Nahid Akhtar
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Sonu Mathur
- Department of Mechanical Engineering GJUS &T Hisar Haryana, India
| | - Abhishek Vaish
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, New Delhi, India
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, New Delhi, India
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Martínez Quiñones JV, Orduna Martínez J, Pinilla Arias D, Bernal Lecina M, Consolini Rossi F, Arregui Calvo R. Systematic review of the utility and limits of 3D printing in spine surgery. NEUROCIRUGIA (ENGLISH EDITION) 2024; 35:30-40. [PMID: 37473871 DOI: 10.1016/j.neucie.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/18/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The main objective of this study has been to demonstrate why additive printing allows to make complex surgical pathological processes that affect the spine more visible and understandable, increasing precision, safety and reliability of the surgical procedure. METHODS A systematic review of the articles published in the last 10 years on 3D printing-assisted spinal surgery was carried out, in accordance with PRISMA 2020 declaration. Keywords "3D printing" and "spine surgery" were searched in Pubmed, Embase, Cochrane Database of Systematic Reviews, Google Scholar and Opengrey databases, which was completed with a manual search through the list of bibliographic references of the articles that were selected following the defined inclusion and exclusion criteria. RESULTS From the analysis of the 38 selected studies, it results that 3D printing is useful in surgical planning, medical teaching, doctor-patient relationship, design of navigation templates and spinal implants, and research, optimizing the surgical process by focusing on the patient, offering magnificent support during the surgical procedure. CONCLUSIONS The use of three-dimensional printing biomodels allows: making complex surgical pathological processes that affect the spine more visible and understandable; increase the accuracy, precision and safety of the surgical procedure, and open up the possibility of implementing personalized treatments, mainly in tumor surgery.
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Ackermann J, Hoch A, Snedeker JG, Zingg PO, Esfandiari H, Fürnstahl P. Automatic 3D Postoperative Evaluation of Complex Orthopaedic Interventions. J Imaging 2023; 9:180. [PMID: 37754944 PMCID: PMC10532700 DOI: 10.3390/jimaging9090180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/28/2023] Open
Abstract
In clinical practice, image-based postoperative evaluation is still performed without state-of-the-art computer methods, as these are not sufficiently automated. In this study we propose a fully automatic 3D postoperative outcome quantification method for the relevant steps of orthopaedic interventions on the example of Periacetabular Osteotomy of Ganz (PAO). A typical orthopaedic intervention involves cutting bone, anatomy manipulation and repositioning as well as implant placement. Our method includes a segmentation based deep learning approach for detection and quantification of the cuts. Furthermore, anatomy repositioning was quantified through a multi-step registration method, which entailed a coarse alignment of the pre- and postoperative CT images followed by a fine fragment alignment of the repositioned anatomy. Implant (i.e., screw) position was identified by 3D Hough transform for line detection combined with fast voxel traversal based on ray tracing. The feasibility of our approach was investigated on 27 interventions and compared against manually performed 3D outcome evaluations. The results show that our method can accurately assess the quality and accuracy of the surgery. Our evaluation of the fragment repositioning showed a cumulative error for the coarse and fine alignment of 2.1 mm. Our evaluation of screw placement accuracy resulted in a distance error of 1.32 mm for screw head location and an angular deviation of 1.1° for screw axis. As a next step we will explore generalisation capabilities by applying the method to different interventions.
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Affiliation(s)
- Joëlle Ackermann
- Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
- Laboratory for Orthopaedic Biomechanics, ETH Zurich, 8093 Zurich, Switzerland
| | - Armando Hoch
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Jess Gerrit Snedeker
- Laboratory for Orthopaedic Biomechanics, ETH Zurich, 8093 Zurich, Switzerland
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Patrick Oliver Zingg
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Hooman Esfandiari
- Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Philipp Fürnstahl
- Research in Orthopedic Computer Science, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
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Rani P, Yadav V, Pandey P, Yadav K. Recent patent-based review on the role of three-dimensional printing technology in pharmaceutical and biomedical applications. Pharm Pat Anal 2023; 12:159-175. [PMID: 37882734 DOI: 10.4155/ppa-2023-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Three-dimensional printing (3DP) is emerging as an innovative manufacturing technology for biomedical and pharmaceutical applications, since the US FDA approval of Spritam as a 3D-printed drug. In the present review, we have highlighted the potential benefits of 3DP technology in healthcare, such as the ability to create patient-specific medical devices and implants, as well as the possibility of on-demand production of drugs and personalized dosage forms. We have further discussed future research to optimize 3DP processes and materials for pharmaceutical and biomedical applications. Cohesively, we have put forward the current state of active patents and applications related to 3DP technology in the healthcare and pharmaceutical industries including hearing aids, prostheses, medical devices and drug-delivery systems.
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Affiliation(s)
- Palak Rani
- Chandigarh College of Pharmacy, Chandigarh Group of Colleges, Mohali, 140307, Punjab, India
| | - Vikas Yadav
- Department of Translational Medicine, Clinical Research Centre, Skane University Hospital, Lund University, Malmö SE-20213, Sweden
| | - Parijat Pandey
- Department of Pharmaceutical Sciences, Gurugram University, Gurugram, 122018, Haryana, India
| | - Kiran Yadav
- Chandigarh College of Pharmacy, Chandigarh Group of Colleges, Mohali, 140307, Punjab, India
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11
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Mendonça CJA, Gasoto SC, Belo IM, Setti JAP, Soni JF, Júnior BS. Application of 3D Printing Technology in the Treatment of Hoffa's Fracture Nonunion. Rev Bras Ortop 2023; 58:303-312. [PMID: 37252303 PMCID: PMC10212646 DOI: 10.1055/s-0042-1750760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/28/2022] [Indexed: 11/06/2022] Open
Abstract
Objective To evaluate a proposed three-dimensional (3D) printing process of a biomodel developed with the aid of fused deposition modeling (FDM) technology based on computed tomography (CT) scans of an individual with nonunion of a coronal femoral condyle fracture (Hoffa's fracture). Materials and Methods Thus, we used CT scans, which enable the evaluation of the 3D volumetric reconstruction of the anatomical model, as well as of the architecture and bone geometry of sites with complex anatomy, such as the joints. In addition, it enables the development of the virtual surgical planning (VSP) in a computer-aided design (CAD) software. This technology makes it possible to print full-scale anatomical models that can be used in surgical simulations for training and in the choice of the best placement of the implant according to the VSP. In the radiographic evaluation of the osteosynthesis of the Hoffa's fracture nonunion, we assessed the position of the implant in the 3D-printed anatomical model and in the patient's knee. Results The 3D-printed anatomical model showed geometric and morphological characteristics similar to those of the actual bone. The position of the implants in relation to the nonunion line and anatomical landmarks showed great accuracy in the comparison of the patient's knee with the 3D-printed anatomical model. Conclusion The use of the virtual anatomical model and the 3D-printed anatomical model with the additive manufacturing (AM) technology proved to be effective and useful in planning and performing the surgical treatment of Hoffa's fracture nonunion. Thus, it showed great accuracy in the reproducibility of the virtual surgical planning and the 3D-printed anatomical model.
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Affiliation(s)
- Celso Júnio Aguiar Mendonça
- Unidade do Sistema Musculoesquelético, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brasil
- Programa de Pós-Graduação em Engenharia Elétrica e Informática Industrial, Universidade Tecnológica Federal do Paraná, Curitiba, Paraná, Brasil
| | - Sidney Carlos Gasoto
- Programa de Pós-Graduação em Engenharia Elétrica e Informática Industrial, Universidade Tecnológica Federal do Paraná, Curitiba, Paraná, Brasil
| | - Ivan Moura Belo
- Programa de Pós-Graduação em Engenharia Biomédica, Universidade Tecnológica Federal do Paraná, Curitiba, Paraná, Brasil
| | - João Antônio Palma Setti
- Programa de Pós-Graduação em Engenharia Biomédica, Universidade Tecnológica Federal do Paraná, Curitiba, Paraná, Brasil
| | - Jamil Faissal Soni
- Unidade do Sistema Musculoesquelético, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brasil
- Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brasil
| | - Bertoldo Schneider Júnior
- Programa de Pós-Graduação em Engenharia Elétrica e Informática Industrial, Universidade Tecnológica Federal do Paraná, Curitiba, Paraná, Brasil
- Programa de Pós-Graduação em Engenharia Biomédica, Universidade Tecnológica Federal do Paraná, Curitiba, Paraná, Brasil
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12
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Xu SSD, Yeh TT, Chen JE, Li YT. Significantly reducing the presurgical preparation time for anterior pelvic fracture surgery by faster creating patient-specific curved plates. J Orthop Surg Res 2023; 18:265. [PMID: 37005637 PMCID: PMC10067232 DOI: 10.1186/s13018-023-03749-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND To shorten the preoperative preparation time, reconstruction plates were designed using the computed tomography (CT)-based three-dimensional (3D) medical imaging surgical planning software OOOPDS. In addition, 3D printing was used to generate curved plates for anterior pelvic fracture surgeries. METHODS This study analyzed two groups with the same 21 patients who underwent surgery for traumatic anterior pelvic ring fractures. In Group 1, the direct reconstruction plates were preoperatively contoured according to the anatomical 3D-printed pelvic model. In Group 2, the fixation plates were contoured according to the 3D printed plate templates, which were created based on the simulated plate templates by the OOOPDS software. The processing time, including the 3D printing time for the pelvic models in Group 1, the 3D printing time for the fixation plate templates in Group 2, and the pre-contouring time for the plates in both groups, was recorded. RESULTS The mean time of pre-contouring for the curved reconstruction plates in Group 2 was significantly less than in Group 1 (-55 min; P < 0.01). The mean time of 3D printing for the 3D plate template model in Group 2 was significantly less than that for the 3D pelvic model in Group 1 (-869 min; P < 0.01). Experimental results showed that the printing time for the plate pre-contouring and the 3D plate templates could be effectively reduced by approximately 93% and 90%, respectively. CONCLUSION This method can shorten the preoperative preparation time significantly.
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Grants
- Grant TSGH-NTUST-109-04 National Taiwan University of Science and Technology
- Grant TSGH-NTUST-109-04 National Taiwan University of Science and Technology
- Grants MOST 109-2221-E-011-074, MOST 110-2221-E-011-121, and MOST 111-2221-E-011-146-MY2. The Ministry of Science and Technology (MOST), Taiwan
- Grants TSGH-D-110105, TSGH-B-110008, MND-MAB-110-016, TSGH-NTUST-109-04, TSGH-A-109004, TSGH-B-109007, TSGH-C108-001, MAB-108-034, MND-MAB-C-11109-111035, and TSGH-C107-001. The Tri-Service General Hospital, Taiwan
- Grants TSGH-D-110105, TSGH-B-110008, MND-MAB-110-016, TSGH-NTUST-109-04, TSGH-A-109004, TSGH-B-109007, TSGH-C108-001, MAB-108-034, MND-MAB-C-11109-111035, and TSGH-C107-001. The Tri-Service General Hospital, Taiwan
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Affiliation(s)
- Sendren Sheng-Dong Xu
- Graduate Institute of Automation and Control, National Taiwan University of Science and Technology, No. 43, Keelung Rd., Sec. 4, Da'an Dist., Taipei City, 106335, Taiwan
- Advanced Manufacturing Research Center, National Taiwan University of Science and Technology, No. 43, Keelung Rd., Sec. 4, Da'an Dist., Taipei City, 106335, Taiwan
| | - Tsu-Te Yeh
- Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Chenggong Rd., Sec. 2, Neihu Dist., Taipei City, 114202, Taiwan.
- Medical 3D Printing Center, Tri-Service General Hospital, National Defense Medical Center, No. 325, Chenggong Rd., Sec. 2, Neihu Dist., Taipei City, 114202, Taiwan.
| | - Jia-En Chen
- Graduate Institute of Automation and Control, National Taiwan University of Science and Technology, No. 43, Keelung Rd., Sec. 4, Da'an Dist., Taipei City, 106335, Taiwan
- Medical 3D Printing Center, Tri-Service General Hospital, National Defense Medical Center, No. 325, Chenggong Rd., Sec. 2, Neihu Dist., Taipei City, 114202, Taiwan
- Department of Biomedical Engineering, National Defense Medical Center, No. 325, Chenggong Rd., Sec. 2, Neihu Dist., Taipei City, 114202, Taiwan
| | - Yuan-Ta Li
- Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Chenggong Rd., Sec. 2, Neihu Dist., Taipei City, 114202, Taiwan
- Department of Surgery, Tri-Service General Hospital Penghu Branch, No. 90, Qianliao, Magong City, Penghu County, 880026, Taiwan
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13
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Aiba H, Spazzoli B, Tsukamoto S, Mavrogenis AF, Hermann T, Kimura H, Murakami H, Donati DM, Errani C. Current Concepts in the Resection of Bone Tumors Using a Patient-Specific Three-Dimensional Printed Cutting Guide. Curr Oncol 2023; 30:3859-3870. [PMID: 37185405 PMCID: PMC10136997 DOI: 10.3390/curroncol30040292] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/01/2023] Open
Abstract
Orthopedic oncology has begun to use three-dimensional-printing technology, which is expected to improve the accuracy of osteotomies, ensure a safe margin, and facilitate precise surgery. However, several difficulties should be considered. Cadaver and clinical studies have reported more accurate osteotomies for bone-tumor resection using patient-specific cutting guides, especially in challenging areas such as the sacrum and pelvis, compared to manual osteotomies. Patient-specific cutting guides can help surgeons achieve resection with negative margins and reduce blood loss and operating time. Furthermore, this patient-specific cutting guide could be combined with more precise reconstruction using patient-specific implants or massive bone allografts. This review provides an overview of the basic technologies used in the production of patient-specific cutting guides and discusses their current status, advantages, and limitations. Moreover, we summarize cadaveric and clinical studies on the use of these guides in orthopedic oncology.
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Affiliation(s)
- Hisaki Aiba
- Department of Orthopedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
- Department of Orthopedic Surgery, Nagoya City University, Nagoya 467-8601, Aichi, Japan
| | - Benedetta Spazzoli
- Department of Orthopedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
| | - Shinji Tsukamoto
- Department of Orthopedic Surgery, Nara Medical University, Kashihara 634-8521, Nara, Japan
| | - Andreas F Mavrogenis
- First Department of Orthopedics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Tomas Hermann
- Department of Orthopedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
- Department of Tumors, HTC Hospital, Traumagologico Concepcion, 1580 San Martin, Concepcion 4030000, Chile
| | - Hiroaki Kimura
- Department of Orthopedic Surgery, Nagoya City University, Nagoya 467-8601, Aichi, Japan
| | - Hideki Murakami
- Department of Orthopedic Surgery, Nagoya City University, Nagoya 467-8601, Aichi, Japan
| | - Davide Maria Donati
- Department of Orthopedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
| | - Costantino Errani
- Department of Orthopedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy
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14
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Bodansky DMS, Sandow MJ, Volk I, Luria S, Verstreken F, Horwitz MD. Insights and trends review: the role of three-dimensional technology in upper extremity surgery. J Hand Surg Eur Vol 2023; 48:383-395. [PMID: 36748271 DOI: 10.1177/17531934221150498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The use of three-dimensional (3-D) technology in upper extremity surgery has the potential to revolutionize the way that hand and upper limb procedures are planned and performed. 3-D technology can assist in the diagnosis and treatment of conditions, allowing virtual preoperative planning and surgical templating. 3-D printing can allow the production of patient-specific jigs, instruments and implants, allowing surgeons to plan and perform complex procedures with greater precision and accuracy. Previously, cost has been a barrier to the use of 3-D technology, which is now falling rapidly. This review article will discuss the current status of 3-D technology and printing, including its applications, ethics and challenges in hand and upper limb surgery. We have provided case examples to outline how clinicians can incorporate 3-D technology in their clinical practice for congenital deformities, management of acute fracture and malunion and arthroplasty.
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Affiliation(s)
- David M S Bodansky
- Department of Plastic Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK
| | | | - Ido Volk
- Hadassah Medical Organisation, Jerusalem, Israel
| | - Shai Luria
- Hadassah Medical Organisation, Jerusalem, Israel
| | | | - Maxim D Horwitz
- Department of Plastic Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK
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15
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Tredan DAM, Mobbs RJ, Maharaj M, Parr WCH. Combining Virtual Surgical Planning and Patient-Specific 3D-Printing as a Solution to Complex Spinal Revision Surgery. J Pers Med 2022; 13:jpm13010019. [PMID: 36675680 PMCID: PMC9866145 DOI: 10.3390/jpm13010019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/03/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
With the advent of three-dimensional printing, rapid growth in the field and application in spinal and orthopedic surgery has been seen. This technology is now being applied in creating patient-specific implants, as it offers benefits over the generic alternative, with growing literature supporting this. This report details a unique application of virtual surgical planning and manufacture of a personalized implant in a case of cervical disc replacement failure with severe osteolysis and resultant hypermobility. Where this degree of degenerative bone loss would often necessitate a vertebrectomy to be performed, this case highlights the considerable customizability of 3D-printed patient-specific implants to contour to the bony defects, allowing for a smaller and safer operation, with the achievement of stability as early as 3 months after the procedure, by the presence of osseointegration. With increasing developments in virtual planning technology and 3D printing ability, the future of complex spinal revision surgery may adopt these technologies as it affords the patient a faster, safer, and less invasive and destructive procedure.
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Affiliation(s)
- David A. M. Tredan
- NeuroSpine Surgery Research Group (NSURG), Sydney, NSW 2031, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia
- Correspondence: ; Tel.: +61-(0)2-9382-2222
| | - Ralph J. Mobbs
- NeuroSpine Surgery Research Group (NSURG), Sydney, NSW 2031, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, University of New South Wales, Randwick, NSW 2031, Australia
- 3DMorphic Pty. Ltd., Matraville, NSW 2036, Australia
| | - Monish Maharaj
- NeuroSpine Surgery Research Group (NSURG), Sydney, NSW 2031, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia
| | - William C. H. Parr
- NeuroSpine Surgery Research Group (NSURG), Sydney, NSW 2031, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
- Surgical and Orthopaedic Research Laboratories (SORL), Prince of Wales Clinical School, University of New South Wales, Randwick, NSW 2031, Australia
- 3DMorphic Pty. Ltd., Matraville, NSW 2036, Australia
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16
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Abstract
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.
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Affiliation(s)
- Raju Vaishya
- Department of Orthopaedics & Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi, 110076, India
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17
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Semba JA, Mieloch AA, Tomaszewska E, Cywoniuk P, Rybka JD. Formulation and evaluation of a bioink composed of alginate, gelatin, and nanocellulose for meniscal tissue engineering. Int J Bioprint 2022; 9:621. [PMID: 36844246 PMCID: PMC9947383 DOI: 10.18063/ijb.v9i1.621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
1The necessity to preserve meniscal function prompts the research and development of novel treatment options, like three-dimensional (3D) bioprinting. However, bioinks for meniscal 3D bioprinting have not been extensively explored. Therefore, in this study, a bioink composed of alginate, gelatin, and carboxymethylated cellulose nanocrystal (CCNC) was formulated and evaluated. Firstly, bioinks with varying concentrations of the aforementioned components were subjected to rheological analysis (amplitude sweep test, temperature sweep test, and rotation). The optimal bioink formulation of 4.0% gelatin, 0.75% alginate, and 1.4% CCNC dissolved in 4.6% D-mannitol was further used for printing accuracy analysis, followed by 3D bioprinting with normal human knee articular chondrocytes (NHAC-kn). The encapsulated cells' viability was > 98%, and collagen II expression was stimulated by the bioink. The formulated bioink is printable, stable under cell culture conditions, biocompatible, and able to maintain the native phenotype of chondrocytes. Aside from meniscal tissue bioprinting, it is believed that this bioink could serve as a basis for the development of bioinks for various tissues.
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Affiliation(s)
- Julia Anna Semba
- Center for Advanced Technology, Adam Mickiewicz University, Poznan, Poland,Faculty of Biology, Adam Mickiewicz University, Poznan, Poland
| | - Adam Aron Mieloch
- Center for Advanced Technology, Adam Mickiewicz University, Poznan, Poland
| | - Ewa Tomaszewska
- Faculty of Mechanical Engineering, Poznan University of Technology, Poznan, Poland
| | - Piotr Cywoniuk
- Center for Advanced Technology, Adam Mickiewicz University, Poznan, Poland
| | - Jakub Dalibor Rybka
- Center for Advanced Technology, Adam Mickiewicz University, Poznan, Poland,Corresponding author: Jakub Dalibor Rybka ()
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18
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Van Deventer SJ, Hiansen JQ, Kim C, Mashari A, Zywiel MG. Precontouring Plates for MIS Bilateral Femur Osteosynthesis Using a Patient-Specific 3D Printed Model: A Case Report. JBJS Case Connect 2022; 12:01709767-202209000-00011. [PMID: 35852167 DOI: 10.2106/jbjs.cc.22.00097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 27-year-old woman with increasing bilateral thigh pain and underlying diagnosis of dysosteosclerosis was diagnosed with bilateral impending pathological femur fractures. Both femurs exhibited abnormal morphology with bowing, thickened cortices, and narrow intramedullary canals. We planned minimally invasive prophylactic plate osteosynthesis. Computed tomography scans of both femora were obtained and used to generate 3-dimensional (3D) printed models. Osteosynthesis plates were precontoured to fit the 3D models and sterilized, and prophylactic fixation was performed using a minimally invasive submuscular technique. CONCLUSION 3D printed models aided in precontouring fixation plates in a case with challenging bony anatomy, enabling minimally invasive surgery.
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Affiliation(s)
- Stephanus Johannes Van Deventer
- Schroeder Arthritis Institute, Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Joshua Qua Hiansen
- Lynn and Arnold Irwin Advanced Perioperative Imaging Lab, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Christopher Kim
- Schroeder Arthritis Institute, Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Azad Mashari
- Lynn and Arnold Irwin Advanced Perioperative Imaging Lab, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Michael G Zywiel
- Schroeder Arthritis Institute, Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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19
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Mittwede PN. CORR Insights®: Are 3D-printed Models of Tibial Plateau Fractures a Useful Addition to Understanding Fractures for Junior Surgeons? Clin Orthop Relat Res 2022; 480:1178-1180. [PMID: 35254328 PMCID: PMC9263491 DOI: 10.1097/corr.0000000000002170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 02/18/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Peter N Mittwede
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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20
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Krettek C. 3D-Druck in der Unfallchirurgie. Unfallchirurg 2022; 125:339-341. [DOI: 10.1007/s00113-022-01179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
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21
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Quan J. Visualization and Analysis Model of Industrial Economy Status and Development Based on Knowledge Graph and Deep Neural Network. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:7008093. [PMID: 35528336 PMCID: PMC9071965 DOI: 10.1155/2022/7008093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
Abstract
This paper adopts knowledge mapping combined with a deep neural network algorithm to conduct in-depth research and analysis on the current situation and development of the industrial economy and designs a visual analysis model of economic development based on knowledge mapping combined with a deep neural network algorithm. Cultivate the concept of coordinated development and legal system of the subject, improve the awareness of network security and integrity self-discipline of the subject, improve the level of network hardware equipment manufacturing, improve the level of network platform construction, build a network security technology prevention system, improve the repair system of network information alienation, set up a specialized agency setting for the coordinated development of network ecology and industrial economy, and increase the capital investment in network infrastructure and network information technology research and development. A framework of breadth and depth recommendation ranking based on a knowledge graph is proposed and implemented. This paper provides a visual analysis method to sort and classify multivariate data. The method first determines users' preferences through their interactive operations, calculates the weights of each attribute according to the users' preference model, then uses the obtained attribute weight sets to sort the whole data set, and finally completes the category classification according to the sorting results and the users' markings on some data. The visual display allows users to intuitively perform data sorting and classification operations and quickly understand the characteristics and category features of the data. The framework achieves modeling and integration of knowledge graph neighborhood information from breadth dimension and depth dimension to realize personalized recommendation sorting and improves the F1 metrics by 8.59%, 14.36%, and 15.22% on the public datasets Amazon-book, Yelp2018, and ILast-FM compared with the previous optimal model.
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Affiliation(s)
- Jing Quan
- Xi'an Peihua University, Xi'an, Shannxi 710125, China
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22
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Zhao Y, Wang Z, Zhao J, Hussain M, Wang M. Additive Manufacturing in Orthopedics: A Review. ACS Biomater Sci Eng 2022; 8:1367-1380. [PMID: 35266709 DOI: 10.1021/acsbiomaterials.1c01072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Yingchao Zhao
- Xiangya School of Medicine, Central South University, No.172 Yinpenling Street, Tongzipo Road, Changsha 410013, China
| | - Zhen Wang
- Xiangya School of Medicine, Central South University, No.172 Yinpenling Street, Tongzipo Road, Changsha 410013, China
| | - Jingzhou Zhao
- Department of Chemical & Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
| | - Mubashir Hussain
- Postdoctoral Innovation Practice, Shenzhen Polytechnic, No.4089 Shahe West Road, Xinwei Nanshan District, Shenzhen 518055, China
| | - Maonan Wang
- Department of Chemical & Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, Singapore 117585, Singapore
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23
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Cornejo J, Cornejo-Aguilar JA, Vargas M, Helguero CG, Milanezi de Andrade R, Torres-Montoya S, Asensio-Salazar J, Rivero Calle A, Martínez Santos J, Damon A, Quiñones-Hinojosa A, Quintero-Consuegra MD, Umaña JP, Gallo-Bernal S, Briceño M, Tripodi P, Sebastian R, Perales-Villarroel P, De la Cruz-Ku G, Mckenzie T, Arruarana VS, Ji J, Zuluaga L, Haehn DA, Paoli A, Villa JC, Martinez R, Gonzalez C, Grossmann RJ, Escalona G, Cinelli I, Russomano T. Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6797745. [PMID: 35372574 PMCID: PMC8970887 DOI: 10.1155/2022/6797745] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.
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Affiliation(s)
- José Cornejo
- Facultad de Ingeniería, Universidad San Ignacio de Loyola, La Molina, Lima 15024, Peru
- Department of Medicine and Biology & Department of Physics and Engineering, Bioastronautics and Space Mechatronics Research Group, Lima 15024, Peru
| | | | | | | | - Rafhael Milanezi de Andrade
- Robotics and Biomechanics Laboratory, Department of Mechanical Engineering, Universidade Federal do Espírito Santo, Brazil
| | | | | | - Alvaro Rivero Calle
- Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
| | - Jaime Martínez Santos
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Aaron Damon
- Department of Neurosurgery, Mayo Clinic, FL, USA
| | | | | | - Juan Pablo Umaña
- Cardiovascular Surgery, Instituto de Cardiología-Fundación Cardioinfantil, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Manolo Briceño
- Villamedic Group, Lima, Peru
- Clínica Internacional, Lima, Peru
| | | | - Raul Sebastian
- Department of Surgery, Northwest Hospital, Randallstown, MD, USA
| | | | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Peru
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jiakai Ji
- Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA
| | - Laura Zuluaga
- Department of Urology, Fundación Santa Fe de Bogotá, Colombia
| | | | - Albit Paoli
- Howard University Hospital, Washington, DC, USA
| | | | | | - Cristians Gonzalez
- Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut of Image-Guided Surgery (IHU-Strasbourg), Strasbourg, France
| | | | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Ilaria Cinelli
- Aerospace Human Factors Association, Aerospace Medical Association, VA, USA
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Robb H, Scrimgeour G, Boshier P, Przedlacka A, Balyasnikova S, Brown G, Bello F, Kontovounisios C. The current and possible future role of 3D modelling within oesophagogastric surgery: a scoping review. Surg Endosc 2022; 36:5907-5920. [PMID: 35277766 PMCID: PMC9283150 DOI: 10.1007/s00464-022-09176-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/24/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND 3D reconstruction technology could revolutionise medicine. Within surgery, 3D reconstruction has a growing role in operative planning and procedures, surgical education and training as well as patient engagement. Whilst virtual and 3D printed models are already used in many surgical specialities, oesophagogastric surgery has been slow in their adoption. Therefore, the authors undertook a scoping review to clarify the current and future roles of 3D modelling in oesophagogastric surgery, highlighting gaps in the literature and implications for future research. METHODS A scoping review protocol was developed using a comprehensive search strategy based on internationally accepted guidelines and tailored for key databases (MEDLINE, Embase, Elsevier Scopus and ISI Web of Science). This is available through the Open Science Framework (osf.io/ta789) and was published in a peer-reviewed journal. Included studies underwent screening and full text review before inclusion. A thematic analysis was performed using pre-determined overarching themes: (i) surgical training and education, (ii) patient education and engagement, and (iii) operative planning and surgical practice. Where applicable, subthemes were generated. RESULTS A total of 56 papers were included. Most research was low-grade with 88% (n = 49) of publications at or below level III evidence. No randomised control trials or systematic reviews were found. Most literature (86%, n = 48) explored 3D reconstruction within operative planning. These were divided into subthemes of pre-operative (77%, n = 43) and intra-operative guidance (9%, n = 5). Few papers reported on surgical training and education (14%, n = 8), and were evenly subcategorised into virtual reality simulation (7%, n = 4) and anatomical teaching (7%, n = 4). No studies utilising 3D modelling for patient engagement and education were found. CONCLUSION The use of 3D reconstruction is in its infancy in oesophagogastric surgery. The quality of evidence is low and key themes, such as patient engagement and education, remain unexplored. Without high quality research evaluating the application and benefits of 3D modelling, oesophagogastric surgery may be left behind.
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Affiliation(s)
- Henry Robb
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | | | - Piers Boshier
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | - Anna Przedlacka
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | | | - Gina Brown
- Imperial College London, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Christos Kontovounisios
- Imperial College London, London, UK.
- The Royal Marsden NHS Foundation Trust, London, UK.
- Chelsea Westminster NHS Foundation Trust, London, UK.
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Chourasia S, Tyagi A, Pandey SM, Walia RS, Murtaza Q. Sustainability of Industry 6.0 in Global Perspective: Benefits and Challenges. MAPAN 2022; 37:443-452. [PMCID: PMC8905282 DOI: 10.1007/s12647-022-00541-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/07/2022] [Indexed: 06/20/2023]
Abstract
In the present area, the outbreak of COVID-19, customer behavior have been seen toward their individual specific need, which encourages advanced-manufacturing industries to provide mass personalization of goods and services. The Covid-19 crises bring opportunities for industries and service providers to enhance their capability for a fault-free environment, zero failure, anti-fragile, and improve production capacity. The present paper provides an overview of the sustainability of Industry 6.0 in a global perspective with vision, objective, and transformation of Industrial Revolutions. The sole aim of industry 6.0 is to seizure the new technologies, which can be applied worldwide and deliver wealth, prosperity away from the job and provide growth to nations across all planetary boundaries. This revolution would promote living harmony with nature, support the principle of sustainability where technology would not be a thing, and promote the human virtual digital twin where all can simultaneously see physical goods and virtual product information.
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Affiliation(s)
- Shubhangi Chourasia
- Department of Mechanical Engineering, SGT University, Gurugram, Haryana India
- Department of Mechanical Engineering, Delhi Technological University, Delhi, India
| | - Ankit Tyagi
- Department of Mechanical Engineering, SGT University, Gurugram, Haryana India
- Department of Mechanical Engineering, Delhi Technological University, Delhi, India
| | - S. M. Pandey
- Department of Mechanical Engineering, NIT Patna, Patna, India
| | - R. S. Walia
- Department of Production Industrial Engineering, PEC, Chandigarh, India
| | - Qasim Murtaza
- Department of Mechanical Engineering, Delhi Technological University, Delhi, India
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26
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Wong RMY, Wong PY, Liu C, Chung YL, Wong KC, Tso CY, Chow SKH, Cheung WH, Yung PSH, Chui CS, Law SW. 3D printing in orthopaedic surgery: a scoping review of randomized controlled trials. Bone Joint Res 2021; 10:807-819. [PMID: 34923849 PMCID: PMC8696518 DOI: 10.1302/2046-3758.1012.bjr-2021-0288.r2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aims The use of 3D printing has become increasingly popular and has been widely used in orthopaedic surgery. There has been a trend towards an increasing number of publications in this field, but existing literature incorporates limited high-quality studies, and there is a lack of reports on outcomes. The aim of this study was to perform a scoping review with Level I evidence on the application and effectiveness of 3D printing. Methods A literature search was performed in PubMed, Embase, and Web of Science databases. The keywords used for the search criteria were ((3d print*) OR (rapid prototyp*) OR (additive manufactur*)) AND (orthopaedic). The inclusion criteria were: 1) use of 3D printing in orthopaedics, 2) randomized controlled trials, and 3) studies with participants/patients. Risk of bias was assessed with Cochrane Collaboration Tool and PEDro Score. Pooled analysis was performed. Results Overall, 21 studies were included in our study with a pooled total of 932 participants. Pooled analysis showed that operating time (p < 0.001), blood loss (p < 0.001), fluoroscopy times (p < 0.001), bone union time (p < 0.001), pain (p = 0.040), accuracy (p < 0.001), and functional scores (p < 0.001) were significantly improved with 3D printing compared to the control group. There were no significant differences in complications. Conclusion 3D printing is a rapidly developing field in orthopaedics. Our findings show that 3D printing is advantageous in terms of operating time, blood loss, fluoroscopy times, bone union time, pain, accuracy, and function. The use of 3D printing did not increase the risk of complications. Cite this article: Bone Joint Res 2021;10(12):807–819.
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Affiliation(s)
- Ronald Man Yeung Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Pui Yan Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Chaoran Liu
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yik Lok Chung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kwok Chuen Wong
- Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Chi Yin Tso
- Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Chun Sing Chui
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Sheung Wai Law
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hong Kong, Hong Kong
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27
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Kumar L, Haleem A, Javaid M. Impact of three dimensional printing in orthopedics. GLOBAL HEALTH JOURNAL 2021. [DOI: 10.1016/j.glohj.2021.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Patralekh MK, Iyengar KP, Jain VK, Vaishya R. Bibliometric analysis of COVID-19 related publications in Indian orthopaedic journals. J Clin Orthop Trauma 2021; 22:101608. [PMID: 34608365 PMCID: PMC8480149 DOI: 10.1016/j.jcot.2021.101608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in an infodemic about the novel coronavirus SARS-CoV-2 outbreak to build knowledge and develop mitigation strategies. In addition, scientific journals across the world have studied the impact of COVID-19 on trauma and orthopaedics. METHODS A cross-sectional, bibliometric analysis of the literature was undertaken on COVID-19 related articles from three Pubmed and Scopus indexed orthopaedic journals from India, namely, Indian Journal of Orthopaedics(IJO),Journal of Clinical Orthopaedics and Trauma(JCOT), and Journal of Orthopaedics (JOO), in May 2021. All the article types and study designs were included for this review. The authors, institutions, countries, keywords, and co-authorship mapping were studied. RESULTS A total of 112 COVID-19 related documents were retrieved. Period of these publications was from 2nd April 2020 to 31st May 2021. Vaishya R. (n = 16) was the most cited author, and Indraprastha Apollo Hospitals (n = 16) was the most cited research Institution. India led the list of countries in academic publication output. On keyword mapping, telemedicine was the most prominent Medical Subject Headings (MeSH) search word. CONCLUSION The Indian orthopedic journals have addressed the impact of COVID-19 on orthopaedic practice in India and aborad whilst continuing to publish knowledge about basic science and clinical orthopaedic research studies. The JCOT has outperformed and become the most leading orthopaedic journal from India during the pandemic. COVID -19 articles have been fast tracked, open accessed and attracted more citations in reduced duration of time compared to non-COVID-19 papers.
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Affiliation(s)
- Mohit Kumar Patralekh
- Department of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110 029, India
| | - Karthikeyan P Iyengar
- Trauma and Orthopaedic Surgeon, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
- Corresponding author.
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, New Delhi, 110076, India
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29
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Menor Fusaro F, Di Felice Ardente P, Pérez Abad M, Yanguas Muns C. Three-dimensional imaging, modeling, and printing in the correction of a complex clavicle malunion. JSES Int 2021; 5:729-733. [PMID: 34223422 PMCID: PMC8246001 DOI: 10.1016/j.jseint.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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30
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Flaxman TE, Cooke CM, Miguel OX, Sheikh AM, Singh SS. A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery. 3D Print Med 2021; 7:17. [PMID: 34224043 PMCID: PMC8256564 DOI: 10.1186/s41205-021-00107-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited. Main text This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery. Conclusion Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.
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Affiliation(s)
- Teresa E Flaxman
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada. .,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Carly M Cooke
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Olivier X Miguel
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada.,Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada
| | - Adnan M Sheikh
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada.,Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Radiology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sukhbir S Singh
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, 1967 Riverside Dr, 7th Floor, Ottawa, ON, K1H7W9, Canada.,Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada
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31
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Clifton W, Damon A, Nottmeier E, Pichelmann M. Establishing a Cost-Effective 3-Dimensional Printing Laboratory for Anatomical Modeling and Simulation: An Institutional Experience. Simul Healthc 2021; 16:213-220. [PMID: 32649586 DOI: 10.1097/sih.0000000000000476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
SUMMARY STATEMENT Three-dimensional (3D) printing is rapidly growing in popularity for anatomical modeling and simulation for medical organizations across the world. Although this technology provides a powerful means of creating accurately representative models of anatomic structures, there remains formidable financial and workforce barriers to understanding the fundamentals of technology use, as well as establishing a cost- and time-effective system for standardized incorporation into a workflow for simulator design and anatomical modeling. There are many factors to consider when choosing the appropriate printer and accompanying software to succeed in accomplishing the desired goals of the executing team. The authors have successfully used open-access software and desktop fused deposition modeling 3D printing methods to produce more than 1000 models for anatomical modeling and procedural simulation in a cost-effective manner. It is our aim to share our experience and thought processes of implementing 3D printing into our anatomical modeling and simulation workflow to encourage other institutions to comfortably adopt this technology into their daily routines.
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Affiliation(s)
- William Clifton
- From the Departments of Neurological Surgery (W.C., E.N.) and Education (A.D.), Mayo Clinic Florida; Jacksonville, FL; and Department of Neurosurgery (M.P.), Mayo Clinic Health Systems; Eau Claire, WI
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32
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Ferràs-Tarragó J, Sabalza-Baztán O, Sahuquillo-Arce JM, Angulo-Sánchez MÁ, De-La-Calva Ceinos C, Amaya-Valero JV, Baixauli-García F. Autoclave sterilization of an in-house 3D-printed polylactic acid piece: biological safety and heat-induced deformation. Eur J Trauma Emerg Surg 2021; 48:3901-3910. [PMID: 33959787 DOI: 10.1007/s00068-021-01672-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/12/2021] [Indexed: 12/17/2022]
Abstract
AIMS Fused filament fabrication 3D printing with polylactic acid filaments is the most widely used method to generate biomodels at hospitals throughout the world. The main limitation of this manufacturing system is related to the biomodels' temperature sensitivity, which all but prevents them to be sterilized using conventional methods. The purpose of this study is to define an autoclave temperature-resistant FFF-PLA 3D printing protocol to print 3D fractures biomodels during preoperative planning. METHODS AND RESULTS Six different printing protocols were established, each with a different infill percentage. Ten distal radius biomodels were printed with each protocol and each biomodel was subject to 3D scanning. The biomodels were subsequently autoclave-sterilized at 134 °C and subjected to a new scanning process, which was followed by a calculation of changes in area, volume and deformity using the Hausdorff-Besicovitch method. Finally, 192 polylactic acid models were produced using the printing protocol offering the greatest resistance and were contaminated with 31 common nosocomial pathogens to evaluate the effectiveness of sterilizing the model printed using the said protocol. Sterilization resulted in a mean deformation of the biomodel of 0.14 mm, a maximum deformity of 0.75 mm, and a 1% area and a 3.6% volume reduction. Sterilization of the pieces printed using the analyzed protocol was 100% effective. CONCLUSIONS The analyzed 3D printing protocol may be applied with any FFF-PLA 3D printer, it is safe and does not significantly alter the morphology of biomodels. These results indicate that 3D printing is associated with significant advantages for health centers as it increases their autonomy, allowing them to easily produce 3D biomodels that can be used for the treatment of fractures.
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Affiliation(s)
- Joan Ferràs-Tarragó
- Orthopaedic Surgery and Traumatology, Hospital La Fe, Av Fernando Abril Martorell 106, Valencia, Spain.
| | | | | | | | | | - Jose Vicente Amaya-Valero
- Orthopaedic Surgery and Traumatology, Hospital La Fe, Av Fernando Abril Martorell 106, Valencia, Spain
| | - Francisco Baixauli-García
- Orthopaedic Surgery and Traumatology, Hospital La Fe, Av Fernando Abril Martorell 106, Valencia, Spain
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Comparison in clinical performance of surgical guides for mandibular surgery and temporomandibular joint implants fabricated by additive manufacturing techniques. J Mech Behav Biomed Mater 2021; 119:104512. [PMID: 33930652 DOI: 10.1016/j.jmbbm.2021.104512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/01/2020] [Accepted: 04/07/2021] [Indexed: 01/27/2023]
Abstract
Additive manufacturing (AM) offers great design freedom that enables objects with desired unique and complex geometry and topology to be readily and cost-effectively fabricated. The overall benefits of AM are well known, such as increased material and resource efficiency, enhanced design and production flexibility, the ability to create porous structures and on-demand manufacturing. When AM is applied to medical devices, these benefits are naturally assumed. However, hard clinical evidence collected from clinical trials and studies seems to be lacking and, as a result, systematic assessment is yet difficult. In the present work, we have reviewed 23 studies on the clinical use of AM patient-specific surgical guides (PSGs) for the mandible surgeries (n = 17) and temporomandibular joint (TMJ) patient-specific implants (PSIs) (n = 6) with respect to expected clinical outcomes. It is concluded that the data published on these AM medical devices are often lacking in comprehensive evaluation of clinical outcomes. A complete set of clinical data, including those on time management, costs, clinical outcomes, range of motion, accuracy of the placement with respect to the pre-operative planning, and extra complications, as well as manufacturing data are needed to demonstrate the real benefits gained from applying AM to these medical devices and to satisfy regulatory requirements.
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34
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Calvo-Haro JA, Pascau J, Mediavilla-Santos L, Sanz-Ruiz P, Sánchez-Pérez C, Vaquero-Martín J, Perez-Mañanes R. Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from "do it yourself" to "point of care manufacturing". BMC Musculoskelet Disord 2021; 22:360. [PMID: 33863319 PMCID: PMC8051827 DOI: 10.1186/s12891-021-04224-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 04/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and to identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine. METHODS Observational, descriptive, retrospective and monocentric study of a total of 623 additive manufacturing processes carried out in a Department of Orthopedic Surgery and Traumatology from November 2015 to March 2020. Variables such as product type, utility, time or materials for manufacture were analyzed. RESULTS The areas of expertise that have performed more processes are Traumatology, Reconstructive and Orthopedic Oncology. Pre-operative planning is their primary use. Working and 3D printing hours, as well as the amount of 3D printing material used, vary according to the type of product or material delivered to perform the process. The most commonly used 3D printing material for manufacturing is polylactic acid, although biocompatible resin has been used to produce surgical guides. In addition, the hospital has worked on the co-design of customized implants with manufacturing companies. CONCLUSIONS The integration of 3D printing in a Department of Orthopedic Surgery and Traumatology allows identifying the conceptual evolution from "Do-It-Yourself" to "POC manufacturing".
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Affiliation(s)
- Jose Antonio Calvo-Haro
- Orthopaedic Surgery and Traumatology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, Postal code, 28007, Madrid, Spain.
- Advanced Planning and 3D 1Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
- Faculty of Medicine, Department of Surgery, Universidad Complutense, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Javier Pascau
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - Lydia Mediavilla-Santos
- Orthopaedic Surgery and Traumatology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, Postal code, 28007, Madrid, Spain
| | - Pablo Sanz-Ruiz
- Orthopaedic Surgery and Traumatology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, Postal code, 28007, Madrid, Spain
- Faculty of Medicine, Department of Surgery, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Coral Sánchez-Pérez
- Orthopaedic Surgery and Traumatology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, Postal code, 28007, Madrid, Spain
| | - Javier Vaquero-Martín
- Orthopaedic Surgery and Traumatology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, Postal code, 28007, Madrid, Spain
- Faculty of Medicine, Department of Surgery, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Rubén Perez-Mañanes
- Orthopaedic Surgery and Traumatology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, Postal code, 28007, Madrid, Spain
- Advanced Planning and 3D 1Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Faculty of Medicine, Department of Surgery, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Abstract
BACKGROUND 3D-printing, or additive manufacturing has become increasingly popular across scientific and engineering fields. The same trend has been observed in the medical field, with the main users being the dentists and the neurosurgeons. Within orthopaedic surgery, usage has been limited by accessibility and costs. The benefits of a 3D printed model in surgical planning and education in orthopaedic surgery is obvious, especially in fields like deformity correction and fracture fixation. METHODS An in-house 3D-printing facility was set up, with workflow processes defined. We utilised the described workflow to 3D-print models for four paediatric orthopaedic patients with differing pathologies. RESULTS These case examples show how 3D-printing of surgical models was easily performed, and they are useful in various clinical scenarios within paediatric orthopaedics. The steps involved in the process are accurately detailed, and are reproducible by any orthopaedic surgeon. The benefits of the application of 3D models in the deformity assessment and surgical planning of these cases are discussed individually. CONCLUSIONS An in-house 3D-printing facility is useful in paediatric orthopaedics due to the variety of complex pathologies and anatomy. We have shown that it is easy to set up with a defined work process. We advocate the application of this emerging technology into every orthopaedic practice.
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Affiliation(s)
- Kai Yet Lam
- KK Women's and Children's Hospital, Singapore, Singapore
| | | | - Sze Ying Yee
- Singapore General Hospital, Singapore, Singapore
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Andrés-Cano P, Calvo-Haro J, Fillat-Gomà F, Andrés-Cano I, Perez-Mañanes R. Role of the orthopaedic surgeon in 3D printing: current applications and legal issues for a personalized medicine. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021. [DOI: 10.1016/j.recote.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Branson TM, Shapiro L, Venter RG. Observation of Patients' 3D Printed Anatomical Features and 3D Visualisation Technologies Improve Spatial Awareness for Surgical Planning and in-Theatre Performance. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1334:23-37. [PMID: 34476743 DOI: 10.1007/978-3-030-76951-2_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Improved spatial awareness is vital in anatomy education as well as in many areas of medical practice. Many healthcare professionals struggle with the extrapolation of 2D data to its locus within the 3D volume of the anatomy. In this chapter, we outline the use of touch as an important sensory modality in the observation of 3D forms, including anatomical parts, with the specific neuroscientific underpinnings in this regard being described. We explore how improved spatial awareness is directly linked to improved spatial skill. The reader is offered two practical exercises that lead to improved spatial awareness for application in exploring external 3D anatomy volume as well as internal 3D anatomy volume. These exercises are derived from the Haptico-visual observation and drawing (HVOD) method. The resulting cognitive improvement in spatial awareness that these exercises engender can be of benefit to students in their study of anatomy and for application by healthcare professionals in many aspects of their medical practice. The use of autostereoscopic visualisation technology (AS3D) to view the anatomy from DICOM data, in combination with the haptic exploration of a 3D print (3Dp) of the same stereoscopic on-screen image, is recommended as a practice for improved understanding of any anatomical part or feature. We describe a surgical innovation that relies on the haptic perception of patients' 3D printed (3Dp) anatomical features from patient DICOM data, for improved surgical planning and in-theatre surgical performance. Throughout the chapter, underlying neuroscientific correlates to haptic and visual observation, memory, working memory, and cognitive load are provided.
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Affiliation(s)
- Toby M Branson
- Department of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Leonard Shapiro
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, University of Cape Town, Cape Town, South Africa.
| | - Rudolph G Venter
- Faculty of Medicine and Health Science, Division of Orthopaedic Surgery, Stellenbosch University, Stellenbosch, South Africa
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Edelmann A, Dubis M, Hellmann R. Selective Laser Melting of Patient Individualized Osteosynthesis Plates-Digital to Physical Process Chain. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5786. [PMID: 33352930 PMCID: PMC7767064 DOI: 10.3390/ma13245786] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022]
Abstract
We report on the exemplified realization of a digital to physical process chain for a patient individualized osteosynthesis plate for the tarsal bone area. Anonymized patient-specific data of the right feet were captured by computer tomography, which were then digitally processed to generate a surface file format (standard tessellation language, STL) ready for additive manufacturing. Physical realization by selective laser melting in titanium using optimized parameter settings and post-processing by stress relief annealing results in a customized osteosynthesis plate with superior properties fulfilling medical demands. High fitting accuracy was demonstrated by applying the osteosynthesis plate to an equally good 3D printed bone model, which likewise was generated using the patient-specific computer tomography (CT) data employing selective laser sintering and polyamid 12. Proper fixation has been achieved without any further manipulation of the plate using standard screws, proving that based on CT data, individualized implants well adapted to the anatomical conditions can be accomplished without the need for additional steps, such as bending, cutting and shape trimming of precast bone plates during the surgical intervention. Beyond parameter optimization for selective laser melting, this exemplified digital to physical process chain highlights the potential of additive manufacturing for individualized osteosynthesis.
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Affiliation(s)
- André Edelmann
- Applied Laser and Photonics Group, University of Applied Sciences Aschaffenburg, 63743 Aschaffenburg, Germany; (M.D.); (R.H.)
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Andrés-Cano P, Calvo-Haro JA, Fillat-Gomà F, Andrés-Cano I, Perez-Mañanes R. Role of the orthopaedic surgeon in 3D printing: current applications and legal issues for a personalized medicine. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 65:138-151. [PMID: 33298378 DOI: 10.1016/j.recot.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/14/2020] [Indexed: 12/16/2022] Open
Abstract
3D printing (I3D) is an additive manufacturing technology with a growing interest in medicine and especially in the specialty of orthopaedic surgery and traumatology. There are numerous applications that add value to the personalised treatment of patients: advanced preoperative planning, surgeries with specific tools for each patient, customised orthotic treatments, personalised implants or prostheses and innovative development in the field of bone and cartilage tissue engineering. This paper provides an update on the role that the orthopaedic surgeon and traumatologist plays as a user and prescriber of this technology and a review of the stages required for the correct integration of I3D into the hospital care flow, from the necessary resources to the current legal recommendations.
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Affiliation(s)
- P Andrés-Cano
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - J A Calvo-Haro
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, Madrid, España; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - F Fillat-Gomà
- Unidad de Planificación Quirúrgica 3D, Departamento de Cirugía Ortopédica y Traumatología, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - I Andrés-Cano
- Departamento de Radiodiagnóstico Hospital Universitario Puerta del Mar, Cádiz, España
| | - R Perez-Mañanes
- Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, Madrid, España; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Marinescu R, Popescu D, Laptoiu D. A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery. J Clin Med 2020; 9:E2908. [PMID: 32916844 PMCID: PMC7565448 DOI: 10.3390/jcm9092908] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 12/19/2022] Open
Abstract
This paper is a systematic review of the literature on 3D-printed anatomical replicas used as templates for precontouring the fixation plates in orthopedic surgery. Embase, PubMed, Cochrane, Scopus and Springer databases were consulted for information on design study, fracture anatomical location, number of patients, surgical technique, virtual modeling approach and 3D printing process. The initial search provided a total of 496 records. After removing the duplicates, the title and abstract screening, and applying exclusion criteria and citations searching, 30 papers were declared eligible and included in the final synthesis. Seven studies were identified as focusing on retrospective non-randomized series of clinical cases, while two papers presented randomized case control studies. Two main approaches were highlighted in developing 3D-printed anatomical models for precontouring fixation plates: (a.) medical reconstruction, virtual planning and fracture reduction followed by 3D printing the model; (b.) medical reconstruction followed by 3D printing the model of the mirrored uninjured side. Revised studies reported advantages such as surgical time and blood loss reduction, while the reduction quality is similar with that of the conventional surgery. During the last couple of years there was an increase in the number of studies focused on precontouring orthopedic plates using 3D printing technology. Three-dimensionally-printed templates for plate precontouring were mostly used for acetabular fractures. Knowledge on medical virtual modeling and reconstruction is mandatory.
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Affiliation(s)
- Rodica Marinescu
- Department of Orthopedics, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania;
| | - Diana Popescu
- Department of Robotics and Production Systems, University Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Dan Laptoiu
- Department of Orthopedics 2, Colentina Clinical Hospital, 020125 Bucharest, Romania;
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The utilization of computer planning and 3D-printed guide in the surgical management of a reverse Hill-Sachs lesion. JSES Int 2020; 4:569-573. [PMID: 32939488 PMCID: PMC7479040 DOI: 10.1016/j.jseint.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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An Easy and Economical Way to Produce a Three-Dimensional Bone Phantom in a Dog with Antebrachial Deformities. Animals (Basel) 2020; 10:ani10091445. [PMID: 32824895 PMCID: PMC7552735 DOI: 10.3390/ani10091445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Accurate planning, for corrective surgeries in case of bone cutting, is necessary to obtain a precise coordination of the skeleton and to achieve the owner’s satisfaction. The present experiment displays a simple and cost-effective technique for surgical planning, utilizing a 3-D bone phantom model in a dog with foreleg deformity. Abstract 3-D surgical planning for restorative osteotomy is costly and time-consuming because surgeons need to be helped from commercial companies to get 3-D printed bones. However, practitioners can save time and keep the cost to a minimum by utilizing free software and establishing their 3-D printers locally. Surgical planning for the corrective osteotomy of antebrachial growth deformities (AGD) is challenging for several reasons (the nature of the biapical or multiapical conformational abnormalities and lack of a reference value for the specific breed). Pre-operative planning challenges include: a definite description of the position of the center of rotation of angulation (CORA) and proper positioning of the osteotomies applicable to the CORA. In the present study, we demonstrated an accurate and reproducible bone-cutting technique using patient-specific instrumentations (PSI) 3-D technology. The results of the location precision showed that, by using PSIs, the surgeons were able to accurately replicate preoperative resection planning. PSI results also indicate that PSI technology provides a smaller standard deviation than the freehand method. PSI technology performed in the distal radial angular deformity may provide good cutting accuracy. In conclusion, the PSI technology may improve bone-cutting accuracy during corrective osteotomy by providing clinically acceptable margins.
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Javaid M, Haleem A. Impact of industry 4.0 to create advancements in orthopaedics. J Clin Orthop Trauma 2020; 11:S491-S499. [PMID: 32774017 PMCID: PMC7394797 DOI: 10.1016/j.jcot.2020.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 12/19/2022] Open
Abstract
Scientists and health professional are focusing on improving the medical sciences for the betterment of patients. The fourth industrial revolution, which is commonly known as Industry 4.0, is a significant advancement in the field of engineering. Industry 4.0 is opening a new opportunity for digital manufacturing with greater flexibility and operational performance. This development is also going to have a positive impact in the field of orthopaedics. The purpose of this paper is to present various advancements in orthopaedics by the implementation of Industry 4.0. To undertake this study, we have studied the available literature extensively on Industry 4.0, technologies of Industry 4.0 and their role in orthopaedics. Paper briefly explains about Industry 4.0, identifies and discusses the major technologies of Industry 4.0, which will support development in orthopaedics. Finally, from the available literature, the paper identifies twelve significant advancements of Industry 4.0 in orthopaedics. Industry 4.0 uses various types of digital manufacturing and information technologies to create orthopaedics implants, patient-specific tools, devices and innovative way of treatment. This revolution is to be useful to perform better spinal surgery, knee and hip replacement, and invasive surgeries.
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Affiliation(s)
- Mohd Javaid
- Corresponding author., https://scholar.google.co.in/citations?user=rfyiwvsAAAAJ&hl=en
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Jud L, Roth T, Fürnstahl P, Vlachopoulos L, Sutter R, Fucentese SF. The impact of limb loading and the measurement modality (2D versus 3D) on the measurement of the limb loading dependent lower extremity parameters. BMC Musculoskelet Disord 2020; 21:418. [PMID: 32605616 PMCID: PMC7329436 DOI: 10.1186/s12891-020-03449-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background Deformity assessment and preoperative planning of realignment surgery are conventionally based on weight-bearing (WB) radiographs. However, newer technologies such as three-dimensional (3D) preoperative planning and surgical navigation with patient-specific instruments (PSI) rely on non-weight bearing (NWB) computed tomography (CT) data. Additionally, differences between conventional two-dimensional (2D) and 3D measurements are known. The goal of the present study was to systematically analyse the influence of WB and the measurement modality (2D versus 3D) on common WB-dependent measurements used for deformity assessment. Methods 85 lower limbs could be included. Two readers measured the hip-knee-ankle angle (HKA) and the joint line convergence angle (JLCA) in 2D WB and 2D NWB radiographs, as well as in CT-reconstructed 3D models using an already established 3D measurement method for HKA, and a newly developed 3D measurement method for JLCA, respectively. Interrater and intermodality reliability was assessed. Results Significant differences between WB and NWB measurements were found for HKA (p < 0.001) and JLCA (p < 0.001). No significant difference could be observed between 2D HKA NWB and 3D HKA (p = 0.09). The difference between 2D JLCA NWB and 3D JLCA was significant (p < 0.001). The intraclass correlation coefficient (ICC) for the interrater agreement was almost perfect for all HKA and 3D JLCA measurements and substantial for 2D JLCA WB and 2D JLCA NWB. ICC for the intermodality agreement was almost perfect between 2D HKA WB and 2D HKA NWB as well as between 2D HKA NWB and 3D HKA, whereas it was moderate between 2D JLCA WB and 2D JLCA NWB and between 2D JLCA NWB and 3D JLCA. Conclusion Limb loading results in significant differences for both HKA and JLCA measurements. Furthermore, 2D projections were found to be insufficient to represent 3D joint anatomy in complex cases. With an increasing number of surgical approaches based on NWB CT-reconstructed models, research should focus on the development of 3D planning methods that consider the effects of WB on leg alignment.
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Affiliation(s)
- Lukas Jud
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland.
| | - Tabitha Roth
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.,Research in Orthopedic Computer Science (ROCS), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Philipp Fürnstahl
- Research in Orthopedic Computer Science (ROCS), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Lazaros Vlachopoulos
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
| | - Reto Sutter
- Department of Radiology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Sandro F Fucentese
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland
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Tong Y, Kaplan DJ, Spivak JM, Bendo JA. Three-dimensional printing in spine surgery: a review of current applications. Spine J 2020; 20:833-846. [PMID: 31731009 DOI: 10.1016/j.spinee.2019.11.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 02/03/2023]
Abstract
In recent years, the use of three-dimensional printing (3DP) technology has gained traction in orthopedic spine surgery. Although research on this topic is still primarily limited to case reports and small cohort studies, it is evident that there are many avenues for 3DP innovation in the field. This review article aims to discuss the current and emerging 3DP applications in spine surgery, as well as the challenges of 3DP production and limitations in its use. 3DP models have been presented as helpful tools for patient education, medical training, and presurgical planning. Intraoperatively, 3DP devices may serve as patient-specific surgical guides and implants that improve surgical outcomes. However, the time, cost, and learning curve associated with constructing a 3DP model are major barriers to widespread use in spine surgery. Considering the costs and benefits of 3DP along with the varying risks associated with different spine procedures, 3DP technology is likely most valuable for complex or atypical spine disorder cases. Further research is warranted to gain a better understanding of how 3DP can and will impact spine surgery.
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Affiliation(s)
- Yixuan Tong
- New York University Grossman School of Medicine, 550 1st Ave, New York, NY 10016, USA
| | - Daniel James Kaplan
- Spine Division, New York University Langone Orthopedic Hospital, 301 E 17th St, New York, NY 10010, USA
| | - Jeffrey M Spivak
- Spine Division, New York University Langone Orthopedic Hospital, 301 E 17th St, New York, NY 10010, USA
| | - John A Bendo
- Spine Division, New York University Langone Orthopedic Hospital, 301 E 17th St, New York, NY 10010, USA.
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Semba JA, Mieloch AA, Rybka JD. Introduction to the state-of-the-art 3D bioprinting methods, design, and applications in orthopedics. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.bprint.2019.e00070] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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47
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The global state of clinical research and trends in periprosthetic joint infection: A bibliometric analysis. Int J Infect Dis 2020; 96:696-709. [PMID: 32434084 DOI: 10.1016/j.ijid.2020.05.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The purpose of this study was to estimate the trends and state of research in periprosthetic joint infection (PJI). METHODS Publications on PJI published between 1998 and 2018 were searched in the Web of Science database and analyzed using bibliometrics. The Altmetric score and Research Interest score were combined to provide a weighted count. The scope of the Altmetric score includes >16 weighted composite scores from websites such as Twitter, Facebook, and YouTube, whereas the Research Interest score is calculated from information derived from ResearchGate. RESULTS Total of 3245 published documents were identified. The largest contribution was made by the United States, with the institution contributing most being the Rothman Institute. The most relative articles were published by the Journal of Arthroplasty, whereas the highest citation frequency journal was Clinical Orthopaedics and Related Research. There was a positive correlation between citation counts and Research Interest scores, while the Altmetric Attention score showed a negative value for highly cited articles. CONCLUSIONS Based on the current trends of globalization, there is a rising trend in publications on PJI, with the largest annual contributions made by the United States. The most influential contributors are researchers from the United States and Europe. Twitter is used as a platform to communicate knowledge by most PJI researchers. The most recent research has focused on the diagnosis and risk factors of PJI.
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Ozturk AM, Suer O, Derin O, Ozer MA, Govsa F, Aktuglu K. Surgical advantages of using 3D patient-specific models in high-energy tibial plateau fractures. Eur J Trauma Emerg Surg 2020; 46:1183-1194. [DOI: 10.1007/s00068-020-01378-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 04/20/2020] [Indexed: 01/17/2023]
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Moldovan F, Gligor A, Bataga T. Integration of Three-dimensional Technologies in Orthopedics: A Tool for Preoperative Planning of Tibial Plateau Fractures. Acta Inform Med 2020; 28:278-282. [PMID: 33627930 PMCID: PMC7879455 DOI: 10.5455/aim.2020.28.278-282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: There is a growing scientific interest in the use of three-dimensional (3D) technologies in orthopedic surgery. Digitalization makes research in orthopedics more accurate and quantitative. Scientific literature describes an overview of current 3D technologies applications in orthopedics, without any emphasis on integrating available technologies as a clinical workflow. Objective: To develop a clinical workflow integrating 3D technologies for patient-specific applications in orthopedics validated in practice by employment of a free 3D software solution with the aim of minimizing the intervention. Method: By exploring the applications of 3D technologies in orthopedic surgery, we have created a clinical workflow integrating 3D technologies for patient-specific applications in orthopedics. It is validated in practice for preoperative planning of a 49-year-old male patient who had a tibial plateau fracture of Schatzker type VI in his right leg. The software solution we have used is Democratiz3D, from Embodi3d platform, which allows patient-specific modeling and surgical planning. Results: By using the proposed methodology we obtained the model of the tibial plateau fracture Schatzker type VI, as a “solid” representation in stl type files, which represents a numerically defined geometry of the bones fragments. It helps surgeons in planning the surgical approach. The time from the beginning to the end of the analysis was 193 min, which is 15% lower than times reported in similar studies. Conclusion: The planning potential of the 3D solution is a valuable instrument for surgeons in exploring the nature of tibial plateau fractures and the formulation of a suitable surgical plan for surface alignment, design and screw fixation guides, strength calculations of bone fragments, and printing surgical objects.
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Affiliation(s)
- Flaviu Moldovan
- IOSUD Doctoral School, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - Adrian Gligor
- Biomedical Research Center, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - Tiberiu Bataga
- Department of Orthopedics-Traumatology, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
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Abstract
Three-dimensional (3-D) printing technology is affecting how orthopaedic surgeries are planned and executed. Like many innovations, 3-D printers are becoming smaller, more affordable, and more accessible. Free access to open-source 3-D imaging software has also made clinical implementation of this technology widely feasible. Within the last decade, 3-D printing advancements have improved the way orthopaedic surgeons can approach both common and complex cases. Advanced imaging studies can be used to create musculoskeletal models, which can then be used to create custom orthopaedic guides and instruments. Similarly, 3-D printing is being applied to improve the field of biologic therapies in orthopaedics. Application of 3-D printing technology has been associated with important improvements in education, preoperative planning, surgical care, and patient-specific devices and treatments. Improvements in cost-effectiveness, access, and usability of 3-D printing technology have made it possible for orthopaedic surgeons to use this powerful tool using desktop 3-D printers in their clinic or office. The types of printers and materials available to print are constantly expanding, but many of the basic 3-D printing principles persist throughout these advances in the field. A clear understanding of this technology is important to the clinical implementation of 3-D printing for current and future practice of orthopaedic care.
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