Three-dimensional (3D)-printed titanium sternum replacement: A case report

An overview of 3D printed metal implants in orthopedic applications: Present and future perspectives

With the ability to produce components with complex and precise structures, additive manufacturing or 3D printing techniques are now widely applied in both industry and consumer markets. The emergence of tissue engineering has facilitated the application of 3D printing in the field of biomedical implants. 3D printed implants with proper structural design can not only eliminate the stress shielding effect but also improve in vivo biocompatibility and functionality. By combining medical images derived from technologies such as X-ray scanning, CT, MRI, or ultrasonic scanning, 3D printing can be used to create patient-specific implants with almost the same anatomical structures as the injured tissues. Numerous clinical trials have already been conducted with customized implants. However, the limited availability of raw materials for printing and a lack of guidance from related regulations or laws may impede the development of 3D printing in medical implants. This review provides information on the current state of 3D printing techniques in orthopedic implant applications. The current challenges and future perspectives are also included.

Three-dimensional technologies in chest wall resection and reconstruction

Resection and reconstruction of the chest wall can pose unique challenges given its vital role in the protection of the thoracic viscera and the dynamic part it plays in respiration. A number of new three-dimensional (3D) technologies may be invaluable in tackling these challenges. Herein we review the use of 3D technologies in preoperative imaging with virtual 3D models, printing of 3D models for preoperative planning, and printing of 3D prostheses when approaching complex chest wall reconstruction.

Chest wall reconstruction with digitally designed materials for straight back syndrome with tracheal stenosis: a case report

Severe symptoms of straight back syndrome (SBS) occur through compression of the mediastinal structures. The treatment is to relieve compression, but surgical relief has not been reported. A 29-year-old woman was admitted to hospital because of dyspnea for 2 years. Physical examination showed the physiological curvature of the spine had disappeared and imaging examination confirmed that the spine was straight, the distance between the spine and the anterior chest wall was shortened, and the lower part of the trachea was obviously compressed with a severe stenosis. The chest wall was simulated by 3D technology, and a model was obtained by 3D printing. The surgical resection was simulated on the model, and the required replacement material was digitally designed and processed. The upper half of the sternum, the first and second costal cartilages, and the thymus were excised. After the chest wall defect was repaired with the digital material, the ascending aorta was suspended on the reconstruction to relieve the tracheal compression. The operation was completed in 135 min without any complications. All symptoms disappeared after operation. Postoperative imaging examination showed complete resolution of the tracheal stenosis. The patient was discharged 10 days after operation. Surgical reconstruction of the anterior chest wall is a good method for treating tracheal stenosis in SBS, and digitally produced material is ideal for the reconstruction.