Role of the orthopaedic surgeon in 3D printing: current applications and legal issues for a personalized medicine

Biodegradable Tyramine Functional Gelatin/6 Arms-PLA Inks Compatible with 3D Two Photon-Polymerization Printing and Meniscus Tissue Regeneration

The meniscus regeneration can present major challenges such as mimicking tissue microstructuration or triggering cell regeneration. In the case of lesions that require a personalized approach, photoprinting offers the possibility of designing resolutive biomaterial structures. The photo-cross-linkable ink composition determines the process ease and the final network properties. In this study, we designed a range of hybrid inks composed of gelatin(G) and 6-PLA arms(P) that were photo-cross-linked using tyramine groups. The photo-cross-linking efficiency, mechanical properties, degradation, and biological interactions of inks with different G/P mass ratios were studied. The G50P50 network properties were suitable for meniscus regeneration, with Young's modulus of 6.5 MPa, degradation in 2 months, and good cell proliferation. We then confirmed the potential of these inks to produce high-resolution microstructures by printing well-defined microstructures using two-photon polymerization. These hybrid inks offer new perspectives for biocompatible, degradable, and microstructured tissue engineering scaffold creation.

A pilot study on preferences from surgeons to deal with an innovative customized and connected knee prosthesis - A discret choice experiment

Background

To address the increasing global demand for Total Knee Arthroplasty and reduce the need for revisions, several technologies combining 3D planning and artificial intelligence have emerged. These innovations aim to enhance customization, improve component positioning accuracy and precision. The integration of these advancements paves the way for the development of personalized and connected knee implant.

Questions/purposes

These groundbreaking advancements may necessitate changes in surgical practices. Hence, it is important to comprehend surgeons' intentions in integrating these technologies into their routine procedures. Our study aims to assess how surgeons' preferences will affect the acceptability of using this new implant and associated technologies within the entire care chain.

Methods

We employed a Discrete Choice Experiment, a predictive technique mirroring real-world healthcare decisions, to assess surgeons' trade-off evaluations and preferences.

Results

A total of 90 experienced surgeons, performing a significant number of procedures annually (mostly over 51) answered. Analysis indicates an affinity for technology but limited interest in integrating digital advancements like preoperative software and robotics. However, they are receptive to practice improvements and considering the adoption of future sensors.

Conclusions

In conclusion, surgeons prefer customized prostheses via augmented reality, accepting extra cost. Embedded sensor technology is deemed premature by them.

Custom 3D-Printed Cutting Guides for Femoral Osteotomy in Rotational Malalignment Due to Diaphyseal Fractures: Surgical Technique and Case Series

Femoral shaft fractures are one of the most common injuries in trauma patients. The gold standard treatment consists of closed reduction and intramedullary nailing, providing a high fracture healing rate and allowing early mobilization. However, rotational malalignment is a well-known complication following this procedure, and excessive femoral anteversion or femoral retroversion can trigger functional complaints. In order to achieve the ideal degree of femoral rotation, a 3D planning and printing cutting guides procedure was developed to correct femoral malrotation. A patient series with malalignment after a femoral diaphyseal fracture was operated on with the customized guides and evaluated in this study. Computed tomography scans were performed to accurately determine the number of degrees of malrotation, allowing the design of specific and personalized surgical guides to correct these accurately. Once designed, they were produced by 3D printing. After surgery with the customized guides to correct femoral malrotation, all patients presented a normalized anteversion angle of the femur (average −10.3°, range from −5° to −15°), according to their contralateral limb. These data suggest that the use of customized cutting guides for femoral osteotomy is a safe and reproducible surgical technique that offers precise results when correcting femoral malrotation.