1
|
Liu S, Zhang B, Zhang B, Liu Y, Chen X, Li M, Liu B, Huo J, Zhang X, Han Y. A new joint reconstruction technique in the treatment of giant cell tumors around the knee: Structural allograft and unicompartmental arthroplasty. J Surg Oncol 2023; 128:1179-1189. [PMID: 37519101 DOI: 10.1002/jso.27406] [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: 02/19/2023] [Revised: 07/04/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE The long-term prognosis of patients who underwent unicompartmental knee arthroplasty (UKA) with a structural allograft or hemiarticular allograft transplantation to treat giant cell tumors (GCTs) around the knee and the prosthesis survival rate were analyzed. METHODS We retrospectively reviewed 73 patients who were diagnosed with GCTs around the knee and underwent surgery to restore joint function from 2000 to 2015. Patients were divided into two groups according to the surgical procedure used for functional knee reconstruction: hemiarticular allograft transplantation or structural allograft and UKA. The Knee Society Score (KSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used to analyze postoperative knee function between the two groups. The Kellgren-Lawrence (K-L) classification system was used to evaluate the progression of osteoarthritis. The incidence of complications and the prosthesis survival rate were also investigated. RESULTS Patients who underwent UKA to treat GCT demonstrated significantly improved knee function. The rate of an excellent or good KSS was significantly different between the two groups (p = 0.041 at the 1-year follow-up, p = 0.033 at the last follow-up). The proportion of severe cases according to WOMAC in the two groups was also different (p = 0.030 at the 1-year follow-up, p = 0.021 at the last follow-up). According to the K-L grade of unaffected compartments, UKA better prevented the progression of osteoarthritis (p = 0.034). CONCLUSIONS Patients with GCTs around the knee could benefit from UKA. In addition to providing better knee function and range of motion, UKA could also slow the progression of osteoarthritis in the knee joint. This new surgical method could meet the needs of patients wishing to preserve joint integrity and favorable joint function.
Collapse
Affiliation(s)
- Sikai Liu
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Bingshi Zhang
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Binquan Zhang
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Yawei Liu
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Xiao Chen
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Mengnan Li
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Bo Liu
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Jia Huo
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Xiaoxuan Zhang
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Yongtai Han
- Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| |
Collapse
|
2
|
Meng M, Wang J, Huang H, Liu X, Zhang J, Li Z. 3D printing metal implants in orthopedic surgery: Methods, applications and future prospects. J Orthop Translat 2023; 42:94-112. [PMID: 37675040 PMCID: PMC10480061 DOI: 10.1016/j.jot.2023.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023] Open
Abstract
Background Currently, metal implants are widely used in orthopedic surgeries, including fracture fixation, spinal fusion, joint replacement, and bone tumor defect repair. However, conventional implants are difficult to be customized according to the recipient's skeletal anatomy and defect characteristics, leading to difficulties in meeting the individual needs of patients. Additive manufacturing (AM) or three-dimensional (3D) printing technology, an advanced digital fabrication technique capable of producing components with complex and precise structures, offers opportunities for personalization. Methods We systematically reviewed the literature on 3D printing orthopedic metal implants over the past 10 years. Relevant animal, cellular, and clinical studies were searched in PubMed and Web of Science. In this paper, we introduce the 3D printing method and the characteristics of biometals and summarize the properties of 3D printing metal implants and their clinical applications in orthopedic surgery. On this basis, we discuss potential possibilities for further generalization and improvement. Results 3D printing technology has facilitated the use of metal implants in different orthopedic procedures. By combining medical images from techniques such as CT and MRI, 3D printing technology allows the precise fabrication of complex metal implants based on the anatomy of the injured tissue. Such patient-specific implants not only reduce excessive mechanical strength and eliminate stress-shielding effects, but also improve biocompatibility and functionality, increase cell and nutrient permeability, and promote angiogenesis and bone growth. In addition, 3D printing technology has the advantages of low cost, fast manufacturing cycles, and high reproducibility, which can shorten patients' surgery and hospitalization time. Many clinical trials have been conducted using customized implants. However, the use of modeling software, the operation of printing equipment, the high demand for metal implant materials, and the lack of guidance from relevant laws and regulations have limited its further application. Conclusions There are advantages of 3D printing metal implants in orthopedic applications such as personalization, promotion of osseointegration, short production cycle, and high material utilization. With the continuous learning of modeling software by surgeons, the improvement of 3D printing technology, the development of metal materials that better meet clinical needs, and the improvement of laws and regulations, 3D printing metal implants can be applied to more orthopedic surgeries. The translational potential of this paper Precision, intelligence, and personalization are the future direction of orthopedics. It is reasonable to believe that 3D printing technology will be more deeply integrated with artificial intelligence, 4D printing, and big data to play a greater role in orthopedic metal implants and eventually become an important part of the digital economy. We aim to summarize the latest developments in 3D printing metal implants for engineers and surgeons to design implants that more closely mimic the morphology and function of native bone.
Collapse
Affiliation(s)
- Meng Meng
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Jinzuo Wang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Huagui Huang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Xin Liu
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Jing Zhang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| | - Zhonghai Li
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, PR China
| |
Collapse
|
3
|
Palmquist A, Jolic M, Hryha E, Shah FA. Complex geometry and integrated macro-porosity: Clinical applications of electron beam melting to fabricate bespoke bone-anchored implants. Acta Biomater 2023; 156:125-145. [PMID: 35675890 DOI: 10.1016/j.actbio.2022.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/16/2022] [Accepted: 06/01/2022] [Indexed: 01/18/2023]
Abstract
The last decade has witnessed rapid advancements in manufacturing technologies for biomedical implants. Additive manufacturing (or 3D printing) has broken down major barriers in the way of producing complex 3D geometries. Electron beam melting (EBM) is one such 3D printing process applicable to metals and alloys. EBM offers build rates up to two orders of magnitude greater than comparable laser-based technologies and a high vacuum environment to prevent accumulation of trace elements. These features make EBM particularly advantageous for materials susceptible to spontaneous oxidation and nitrogen pick-up when exposed to air (e.g., titanium and titanium-based alloys). For skeletal reconstruction(s), anatomical mimickry and integrated macro-porous architecture to facilitate bone ingrowth are undoubtedly the key features of EBM manufactured implants. Using finite element modelling of physiological loading conditions, the design of a prosthesis may be further personalised. This review looks at the many unique clinical applications of EBM in skeletal repair and the ground-breaking innovations in prosthetic rehabilitation. From a simple acetabular cup to the fifth toe, from the hand-wrist complex to the shoulder, and from vertebral replacement to cranio-maxillofacial reconstruction, EBM has experienced it all. While sternocostal reconstructions might be rare, the repair of long bones using EBM manufactured implants is becoming exceedingly frequent. Despite the various merits, several challenges remain yet untackled. Nevertheless, with the capability to produce osseointegrating implants of any conceivable shape/size, and permissive of bone ingrowth and functional loading, EBM can pave the way for numerous fascinating and novel applications in skeletal repair, regeneration, and rehabilitation. STATEMENT OF SIGNIFICANCE: Electron beam melting (EBM) offers unparalleled possibilities in producing contaminant-free, complex and intricate geometries from alloys of biomedical interest, including Ti6Al4V and CoCr. We review the diverse range of clinical applications of EBM in skeletal repair, both as mass produced off-the-shelf implants and personalised, patient-specific prostheses. From replacing large volumes of disease-affected bone to complex, multi-material reconstructions, almost every part of the human skeleton has been replaced with an EBM manufactured analog to achieve macroscopic anatomical-mimickry. However, various questions regarding long-term performance of patient-specific implants remain unaddressed. Directions for further development include designing personalised implants and prostheses based on simulated loading conditions and accounting for trabecular bone microstructure with respect to physiological factors such as patient's age and disease status.
Collapse
Affiliation(s)
- Anders Palmquist
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Martina Jolic
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eduard Hryha
- Department of Materials and Manufacturing Technologies, Chalmers University of Technology, Gothenburg, Sweden
| | - Furqan A Shah
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
4
|
Advances in the Application of Three-dimensional Printing for the Clinical Treatment of Osteoarticular Defects. Curr Med Sci 2022; 42:467-473. [PMID: 35451806 DOI: 10.1007/s11596-022-2565-9] [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: 04/15/2021] [Accepted: 10/26/2021] [Indexed: 11/03/2022]
Abstract
As a promising manufacturing technology, three-dimensional (3D) printing technology is widely used in the medical field. In the treatment of osteoarticular defects, the emergence of 3D printing technology provides a new option for the reconstruction of functional articular surfaces. At present, 3D printing technology has been used in clinical applications such as models, patient-specific instruments (PSIs), and customized implants to treat joint defects caused by trauma, sports injury, and tumors. This review summarizes the application status of 3D printing technology in the treatment of osteoarticular defects and discusses its advantages, disadvantages, and possible future research strategies.
Collapse
|
5
|
Kermavnar T, Shannon A, O'Sullivan KJ, McCarthy C, Dunne CP, O'Sullivan LW. Three-Dimensional Printing of Medical Devices Used Directly to Treat Patients: A Systematic Review. 3D PRINTING AND ADDITIVE MANUFACTURING 2021; 8:366-408. [PMID: 36655011 PMCID: PMC9828627 DOI: 10.1089/3dp.2020.0324] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Until recently, three-dimensional (3D) printing/additive manufacturing has not been used extensively to create medical devices intended for actual clinical use, primarily on patient safety and regulatory grounds. However, in recent years there have been advances in materials, printers, and experience, leading to increased clinical use. The aim of this study was to perform a structured systematic review of 3D-printed medical devices used directly in patient treatment. A search of 13 databases was performed to identify studies of 3D-printed medical devices, detailing fabrication technology and materials employed, clinical application, and clinical outcome. One hundred and ten papers describing one hundred and forty medical devices were identified and analyzed. A considerable increase was identified in the use of 3D printing to produce medical devices directly for clinical use in the past 3 years. This is dominated by printing of patient-specific implants and surgical guides for use in orthopedics and orthopedic oncology, but there is a trend of increased use across other clinical specialties. The prevailing material/3D-printing technology used were titanium alloy/electron beam melting for implants, and polyamide/selective laser sintering or polylactic acid/fused deposition modeling for surgical guides and instruments. A detailed analysis across medical applications by technology and materials is provided, as well as a commentary regarding regulatory aspects. In general, there is growing familiarity with, and acceptance of, 3D printing in clinical use.
Collapse
Affiliation(s)
| | - Alice Shannon
- School of Design, University of Limerick, Limerick, Ireland
| | | | - Conor McCarthy
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Colum P. Dunne
- Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Leonard W. O'Sullivan
- School of Design, University of Limerick, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Address correspondence to: Leonard W. O'Sullivan, School of Design, University of Limerick, Limerick V94 T9PX, Ireland
| |
Collapse
|
6
|
A prospective study on outcome of patient-specific cones in revision knee arthroplasty. Arch Orthop Trauma Surg 2021; 141:2277-2286. [PMID: 34264382 DOI: 10.1007/s00402-021-04047-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/01/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Cones are known to be good substitutes for metaphyseal and diaphyseal bone loss during revision total knee arthroplasty (RTKA). Often the off-the-shelf cones do not fit to the individual patient's anatomy. New 3D-printing additive technologies allow to develop patient-specific cones. The aim of this prospective study was to describe their outcome. METHODS From 2017 until 2020, 35 patient-specific titanium cones (15 femoral and 20 tibial) were implanted during 31 RTKAs (45% varus-valgus constrained implants and 55% rotating hinges). Clinical outcome was evaluated using KSS, WOMAC and FJS-12 scoring systems at 12 and 24 months. No patients were lost for follow-up. RESULTS In all cases, there were no technical difficulties in adapting the cones to both the host bone and the revision implant. By the time of performing data analysis (January 2021), none of the 31 patients needed revision surgery for any reason. At 12 months of follow-up, the mean values of scores for knee function improved significantly from baseline (p < 0.01): KSS-103.00 (min 100-max 111, SD 5.35), WOMAC-16.5 (min 9-max 24, SD 6.45), FJS-12-61.60 (min 52-max 76, SD 9.20). At 24 months, the trend towards improvement of functional results continued but did not reached statistical significance comparing to 12 months: KSS was 105.92 (min 95-max 155, SD 16.18), WOMAC-14.07 (min 0-max 42, SD 12.42), FJS-12-83.78 (min 65-max 97, SD 09.64). Radiographic signs of osteointegration were detected within the first 6 month after surgery in all cases. Loosening of femoral or tibial components as well as peri-prosthetic infection was not observed in any of the patients during the follow-up. CONCLUSION The original additive technology for designing and producing patient-specific metaphyseal and diaphyseal cones with different porosity zones for extensive femoral and tibial bone defects in RTKA is precise and clinically effective solution, at least in the short term. It could be a valid alternative to "off-the-shelf" cones or sleeves as well as structural allografts and even mega-prosthesis, but a longer follow-up period is required to assess its medium- and long-term reliability.
Collapse
|
7
|
Kotsougiani-Fischer D, Fischer S, Warszawski J, Gruetzner PA, Reiter G, Hirche C, Kneser U. Multidisciplinary team meetings for patients with complex extremity defects: a retrospective analysis of treatment recommendations and prognostic factors for non-implementation. BMC Surg 2021; 21:168. [PMID: 33781250 PMCID: PMC8006355 DOI: 10.1186/s12893-021-01169-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to assess a multidisciplinary team (MDT) meeting approach for the management of patients with complex extremity defects, analyze treatment recommendations, and evaluate factors influencing non-implementation. Methods All patients introduced to an MDT meeting for complex extremity defects from 2015 to 2017 were included in a retrospective cohort study. Patients’ characteristics and defect causes were evaluated. Treatment recommendations (TR) of MDT meetings and subsequent implementation were reviewed (cohort with implementation of TR versus cohort with non-implementation of TR), and factors associated with non-adherence to recommendations were statistically analyzed using logistic regression. Results Fifty-one patients (41 male) with a mean age of 54 years were presented in 27 MDT meetings. Most of the patients (70%) suffered from reconstructive challenging or combined bone- and soft tissue defects, primarily located at the lower extremity (88%). Large skeletal defects, chronic osteomyelitis, and multi-fragmented fractures were present in 65% of cases. Forty-five percent of the patients suffered from peripheral vascular disease, necessitating surgical optimization. Of the 51 MDT decisions, 40 were implemented (78%; (32/40) limb salvage versus 22%; (8/40) limb amputation). Limb salvage was successfully achieved in 91% (29/32) of the cases. Failed limb salvages were due to flap failure (33%; 1/3), recurring periprosthetic joint infections (66%; 2/3) and concomitant reconstructive failure. Patients who underwent limb amputation, as recommended, showed proper stump healing and regained mobility with a prosthesis. Overall the MDT treatment plan was effective in 92.5% (37/40) of the patients, who adhered to the MDT treatment recommendation. In eleven patients (22%; 11/51), the MDT treatment was not implemented. MDT decisions were less likely to be implemented, if amputation was recommended (p = 0.029). Conclusions MDT meetings represent a valid tool to formulate individualized treatment plans, avoiding limb amputation in most patients with severe extremity defects. Recommendation for limb amputation is less likely to be implemented than plans for limb salvage. Trial registration: Retrospectively registered
Collapse
Affiliation(s)
- Dimitra Kotsougiani-Fischer
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center-BG Trauma Center Ludwigshafen, Hand and Plastic Surgery of the University of Heidelberg, Ludwig Guttmann Str. 13, 67071, Ludwigshafen, Germany.
| | - Sebastian Fischer
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center-BG Trauma Center Ludwigshafen, Hand and Plastic Surgery of the University of Heidelberg, Ludwig Guttmann Str. 13, 67071, Ludwigshafen, Germany
| | - Jan Warszawski
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center-BG Trauma Center Ludwigshafen, Hand and Plastic Surgery of the University of Heidelberg, Ludwig Guttmann Str. 13, 67071, Ludwigshafen, Germany
| | - Paul A Gruetzner
- Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen, Ludwig Gutmann Strasse 13, Ludwigshafen, 67071, Germany
| | - Gregor Reiter
- Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen, Ludwig Gutmann Strasse 13, Ludwigshafen, 67071, Germany
| | - Christoph Hirche
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center-BG Trauma Center Ludwigshafen, Hand and Plastic Surgery of the University of Heidelberg, Ludwig Guttmann Str. 13, 67071, Ludwigshafen, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center-BG Trauma Center Ludwigshafen, Hand and Plastic Surgery of the University of Heidelberg, Ludwig Guttmann Str. 13, 67071, Ludwigshafen, Germany
| |
Collapse
|
8
|
Zhu X, Huang R, Hu P, Yan P, Zhai S, Zhang J, Zhuang J, Yin H, Meng T, Yang D, Huang Z. Prognostic Factors for Survival in Patients with Malignant Giant Cell Tumor of Bone: A Risk Nomogram Analysis Based on the Population. Med Sci Monit 2021; 27:e929154. [PMID: 33594036 PMCID: PMC7899048 DOI: 10.12659/msm.929154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Malignant giant cell tumor of bone (MGCTB) is a rare histological type of malignant tumor that has a high tendency for local relapse and distant metastasis and ultimately leads to a poor prognosis. The purpose of this study was to describe the epidemiological features, identify the prognostic factors, and construct nomograms for patients with MGCTB. Material/Methods Patients with MGCTB that was histologically diagnosed between 1973 and 2014 were selected from the Surveillance, Epidemiology, and End Results (SEER) database as a training set. Survival analysis, Lasso regression, and random forests were used to identify the prognostic variables and establish the nomograms for patients with MGCTB, while an external cohort of 37 patients from our own institution and an external cohort of 163 patients from the SEER database in 2016 were used to validate the generalization performance of the nomograms. Results In total, univariate and multivariable analysis indicated that age, International Classification of Diseases for Oncology, historical stage, primary site, surgery information, radiotherapy, and chemotherapy were independent prognostic variables for overall survival or cause-specific survival. Nomograms based on the multivariable models were built to predict survival, and we achieved a higher C-index in subsequent multidimensional validation. Conclusions Age, historical stage, and chemotherapy were independent prognostic variables for overall survival and cause-specific survival of MGCTB patients, and radiotherapy and primary site were independent prognostic variables for overall survival. Nomograms based on significant clinicopathological features and clinical experience can be effective in predicting the probability of survival for MGCTB patients.
Collapse
Affiliation(s)
- Xiaolong Zhu
- Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Runzhi Huang
- Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland).,Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Peng Hu
- Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Penghui Yan
- Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Suna Zhai
- Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Jie Zhang
- Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China (mainland)
| | - Junwei Zhuang
- Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Huabin Yin
- Department of Orthopedics, Shanghai Bone Tumor Institute, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (mainland)
| | - Tong Meng
- Department of Orthopedics, Shanghai Bone Tumor Institute, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China (mainland)
| | - Daoke Yang
- Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Zongqiang Huang
- Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| |
Collapse
|
9
|
Zhang A, Chen H, Liu Y, Wu N, Chen B, Zhao X, Han Q, Wang J. Customized reconstructive prosthesis design based on topological optimization to treat severe proximal tibia defect. Biodes Manuf 2020. [DOI: 10.1007/s42242-020-00102-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Han Q, Wang C, Chen H, Zhao X, Wang J. Porous Tantalum and Titanium in Orthopedics: A Review. ACS Biomater Sci Eng 2019; 5:5798-5824. [PMID: 33405672 DOI: 10.1021/acsbiomaterials.9b00493] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Porous metal is metal with special porous structures, which can offer high biocompatibility and low Young's modulus to satisfy the need for orthopedic applications. Titanium and tantalum are the most widely used porous metals in orthopedics due to their excellent biomechanical properties and biocompatibility. Porous titanium and tantalum have been studied and applied for a long history until now. Here in this review, various manufacturing methods of titanium and tantalum porous metals are introduced. Application of these porous metals in different parts of the body are summarized, and strengths and weaknesses of these porous metal implants in clinical practice are discussed frankly for future improvement from the viewpoint of orthopedic surgeons. Then according to the requirements from clinics, progress in research for clinical use is illustrated in four aspects. Various creative designs of microporous and functionally gradient structure, surface modification, and functional compound systems of porous metal are exhibited as reference for future research. Finally, the directions of orthopedic porous metal development were proposed from the clinical view based on the rapid progress of additive manufacturing. Controllable design of both macroscopic anatomical bionic shape and microscopic functional bionic gradient porous metal, which could meet the rigorous mechanical demand of bone reconstruction, should be developed as the focus. The modification of a porous metal surface and construction of a functional porous metal compound system, empowering stronger cell proliferation and antimicrobial and antineoplastic property to the porous metal implant, also should be taken into consideration.
Collapse
Affiliation(s)
- Qing Han
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Chenyu Wang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Hao Chen
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Xue Zhao
- Department of Endocrine and Metabolism, The First Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Jincheng Wang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| |
Collapse
|
11
|
Usman MA, Prasatia Sam AD, Wijaya M, Firdaus RM, Yudha K. En bloc giant cell tumor resection following direct hemiarthroplasty shoulder reconstruction-functional outcome: A case report. Int J Surg Case Rep 2019; 61:202-206. [PMID: 31377544 PMCID: PMC6698276 DOI: 10.1016/j.ijscr.2019.07.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/20/2019] [Accepted: 07/22/2019] [Indexed: 11/13/2022] Open
Abstract
Giant cell tumor is locally aggressive and destructive to the affected area. Reconstruction after tumour resection is challenging. Single stage surgery is performed and give satisfactory result.
Introduction Giant cell tumor is a type of benign tumor which has the characteristic of rapidly growing and a chance to metastasis. It is however locally aggressive and would typically affect young patients. They commonly present with pain and associated with pathological fracture. Presentation of case This is an uncommon case of 29 years old male with pathological fracture and giant cell tumor in proximal humerus. A plain radiograph revealed pathological fracture in head of humerus and histopathology examination was consistent with giant cell tumor. The patient had surgical option with en bloc giant cell tumor resection following hemiarthroplasty with cementless endoprosthetic implant for humerus, which aimed to provide a single step surgery without any interval debulking surgery. The patient had achieved bony union between 6 weeks after the surgery and recurrence was not found by the time of the last follow-up. Discussion Based on Campanacci’s classification the tumor is divided into 3 stages. The management of giant cell tumors continues to be one of the most challenging areas in orthopedic oncology. Surgery is the first line option; however, it is depending on the tumor staging and can vary from intralesional curettage to total resection of the tumor. Since the local behavior of giant cell tumors has a high risk of local recurrence, en bloc resection and reconstruction were chosen for these Grade III lesions. Conclusion The aim of this procedure is to preserve the shoulder joint shown satisfaction in a clinical, radiological, functional and esthetic result.
Collapse
Affiliation(s)
- Muhammad Andry Usman
- Consultant of Orthopaedic and Traumatology Department, Hasanuddin University, Makassar, Indonesia.
| | - Andi Dhedie Prasatia Sam
- Consultant of Orthopaedic and Traumatology Department, Hasanuddin University, Makassar, Indonesia.
| | - Marcell Wijaya
- Orthopaedic and Traumatology Department, Hasanuddin University, Makassar, Indonesia.
| | | | - Khrisna Yudha
- Orthopaedic and Traumatology Department, Hasanuddin University, Makassar, Indonesia.
| |
Collapse
|
12
|
Cherny AA, Kovalenko AN, Bilyk SS, Denisov AO, Kazemirskiy AV, Kulyaba TA, Kornilov NN. Early Outcomes of Patient-Specific Modular Cones for Substitution of Methaphysial and Diaphysial Bone Defects in Revision Knee Arthroplasty. ACTA ACUST UNITED AC 2019. [DOI: 10.21823/2311-2905-2019-25-2-9-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this study was the assessment of early outcomes of patient-specific three-dimensional titanium cones with specified porosity parameters to compensate for extensive metaphysical-diaphyseal bone defects in RTKA.Materials and Methods. Since 2017 till 2019 30 patient-specific titanium cones (12 femoral and 18 tibial) implanted during 26 RTKAS. Clinical outcomes evaluated using KSS, WOMAC and fjS-12 scoring systems on average 10 (2–18) months after surgery. At the same time the stability of implant fixation analyzed using frontal, lateral and axial knee roentgenograms.Results. During all procedures there were no technical difficulties in positioning and implantation of custom-made titanium cones. At the time of preparation of the publication, none of the patients had indications for further surgical intervention, as well as intra- and postoperative complications. Six months after surgery all scores improved significantly: KSS from 23 (2–42, SD 19.96) to 66.5 (62–78, SD 7.68), WOMAC from 59 (56–96, SD 28.31) to 32.25 (19–46, SD 11.76), the index FJS-12 was 29.16 points (0–68.75, SD 30.19). The average scores continued to improve up to 18 months: KSS — 97.5 (88–108, SD 9.14), WOMAC — 16.5 (9–24, SD 6.45), FJS-12 — 45.85 (25–75, SD 22.03). No radiolucent lines were noticed during this period of observation.Conclusion. The original additive technology of designing and producing patient-specific titanium cones for compensation of extensive metaphyseal-diaphyseal bone defects in RTKA is a valid solution at least in the short term. A longer follow-up period is required to assess its medium-and long-term reliability compared to existing alternative surgical solutions.
Collapse
Affiliation(s)
- A. A. Cherny
- Vreden Russian Research Institute of Traumatology and Orthopedics
| | - A. N. Kovalenko
- Vreden Russian Research Institute of Traumatology and Orthopedics
| | - S. S. Bilyk
- Vreden Russian Research Institute of Traumatology and Orthopedics
| | - A. O. Denisov
- Vreden Russian Research Institute of Traumatology and Orthopedics
| | | | - T. A. Kulyaba
- Vreden Russian Research Institute of Traumatology and Orthopedics
| | - N. N. Kornilov
- Vreden Russian Research Institute of Traumatology and Orthopedics
| |
Collapse
|
13
|
Cui Y, Li Z, Wan Q, Wang X, Li S, Ren Z, Wang Z, Yang F, Liu H, Wu D. [Clinical application of three-dimensional printed metal prosthesis in joint surgery]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2019; 33:774-777. [PMID: 31198009 DOI: 10.7507/1002-1892.201901022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To summarize the application progress of three-dimensional (3D) printed metal prosthesis in joint surgery. Methods The related literature was extensively reviewed. The effectiveness of 3D printed metal prosthesis in treatment of joint surgery diseases were discussed and summarized, including the all key issues in prosthesis transplantation such as prosthesis stability, postoperative complications, bone ingrowth, etc. Results 3D printed metal prosthesis has good matching degree, can accurately reconstruct and restore joint function, reduce operation time, and achieve high patient satisfaction in short- and medium-term follow-up. Its application in joint surgery has made good progress. Conclusion The personalized microporous structure prostheses of different shapes produced by 3D printing can solve the problem of poor personalized matching of joints for special patients existing in traditional prostheses. Therefore, 3D printing technology is full of hope and will bring great potential to the reform of orthopedic practice in the future.
Collapse
Affiliation(s)
- Yutao Cui
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China
| | - Zuhao Li
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China
| | - Qian Wan
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China;Clinical Medical College of Jilin University, Changchun Jilin, 130041, P.R.China
| | - Xianggang Wang
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China;Clinical Medical College of Jilin University, Changchun Jilin, 130041, P.R.China
| | - Shengyang Li
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China
| | - Zhenxiao Ren
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China;Clinical Medical College of Jilin University, Changchun Jilin, 130041, P.R.China
| | - Zhonghan Wang
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China
| | - Fan Yang
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041, P.R.China
| | - He Liu
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041,
| | - Dankai Wu
- Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun Jilin, 130041,
| |
Collapse
|
14
|
Guo X, Liu B, Lu Z. Correlation Between Conditional Approval and Customized Bone Implant Devices. Orthop Surg 2019; 11:10-14. [PMID: 30834707 PMCID: PMC6430462 DOI: 10.1111/os.12415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/29/2022] Open
Abstract
This report aims to summarize key concerns regarding customized devices and conditional approval during the premarket evaluation of bone implants, and to explore the correlation between them. Based on the experience of approval of the first domestic custom-designed bone implant, we consider the process of gaining conditional approval for urgently-needed medical devices and medical devices for rare diseases, as well as the guidance available for clinical investigation. We also streamlined the scientifically administrative concept of this unique device, from the design and development of premarket technical evaluation to continuous post-market study. The present study found that those two aspects have certain connections, but they are not directly correlated to each other. In contrast to the USA, Canada, Australia and the EU, where regulations and guidelines have been established for the use of customized devices, in this regard, China is still it its infancy. Thus, there is considerable potential for China to develop and perfect the policies relating to customized devices and to develop relevant strategies to ensure their efficacy with the aid of conditional approval. Appropriate scientific conditional approval for mass production of individualized anatomy-matching bone implants could become a valuable approach for precision medicine.
Collapse
Affiliation(s)
| | - Bin Liu
- Centre for Medical Device EvolutionBeijingChina
| | - Zhong Lu
- Centre for Medical Device EvolutionBeijingChina
| |
Collapse
|
15
|
Using 3D models in orthopedic oncology: presenting personalized advantages in surgical planning and intraoperative outcomes. 3D Print Med 2018; 4:12. [PMID: 30649645 PMCID: PMC6261090 DOI: 10.1186/s41205-018-0035-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 11/16/2018] [Indexed: 11/21/2022] Open
Abstract
Background Three Dimensional (3D) printed models can aid in effective pre-operative planning by defining the geometry of tumor mass, bone loss, and nearby vessels to help determine the most accurate osteotomy site and the most appropriate prosthesis, especially in the case of complex acetabular deficiency, resulting in decreased operative time and decreased blood loss. Methods Four complicated cases were selected, reconstructed and printed. These 4 cases were divided in 3 groups of 3D printed models. Group 1 consisted of anatomical models with major vascular considerations during surgery. Group 2 consisted of an anatomical model showing a bone defect, which was intended to be used for substantial instrumentation, pre-operatively. Group 3 consisted of an extra-compartmental bone tumor which displayed a deteriorated cortical outline; thus, using CT and MRI fused images to reconstruct the model accurately. An orthopedic surgeon created the 3D models of groups 1 and 2 using standard segmentation techniques. Because group 3 required complex techniques, an engineer assisted during digital model construction. Results These models helped to guide the orthopedic surgeon in creating a personalized pre-operative plan and a physical simulation. The models proved to be beneficial and assisted with all 4 cases, by decreasing blood loss, operative time and surgical incision length, and helped to select the appropriate acetabular supporting ring in complex acetabular deficiency, pre-operatively. Conclusion Qualitatively, using 3D printing in tumor cases, provides personalized advantages regarding the various characteristics of each skeletal tumor.
Collapse
|
16
|
Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, Santiago L, Ballard DH, Wang KC, Weadock W, Ionita CN, Mitsouras D, Morris J, Matsumoto J, Christensen A, Liacouras P, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med 2018; 4:11. [PMID: 30649688 PMCID: PMC6251945 DOI: 10.1186/s41205-018-0030-y] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023] Open
Abstract
Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
Collapse
Affiliation(s)
- Leonid Chepelev
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY USA
- Sackler Institute of Graduate Biomedical Sciences, NYU School of Medicine, New York, NY USA
| | | | - Waleed Althobaity
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Ashish Gupta
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Elsa Arribas
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lumarie Santiago
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO USA
| | - Kenneth C Wang
- Baltimore VA Medical Center, University of Maryland Medical Center, Baltimore, MD USA
| | - William Weadock
- Department of Radiology and Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI USA
| | - Ciprian N Ionita
- Department of Neurosurgery, State University of New York Buffalo, Buffalo, NY USA
| | - Dimitrios Mitsouras
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | | | | | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Frank J Rybicki
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| |
Collapse
|
17
|
Li Z, Wang C, Li C, Wang Z, Yang F, Liu H, Qin Y, Wang J. What we have achieved in the design of 3D printed metal implants for application in orthopedics? Personal experience and review. RAPID PROTOTYPING JOURNAL 2018; 24:1365-1379. [DOI: 10.1108/rpj-10-2017-0205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
PurposeThis paper aims to review the latest applications in terms of three-dimensional printed (3DP) metal implants in orthopedics, and, importantly, the design of 3DP metal implants through a series of cases operated at The Second Hospital of Jilin University were presented.Design/methodology/approachThis paper is available to practitioners who are use 3DP implants in orthopedics. This review began with the deficiency of traditional prostheses and basic concepts of 3DP implants. Then, representative 3DP clinical cases were summarized and compared, and the experiences using customized prostheses and directions for future potential development are also shown.FindingsThe results obtained from the follow-up of clinical applications of 3DP implants show that the 3D designed and printed metal implants could exhibit good bone defect matching, quick and safe joint functional rehabilitation as well as saving time in surgery, which achieved high patient satisfaction collectively.Originality/valueSingle center experiences of 3DP metal implants design were shared and the detailed technical points between various regions were compared and analyzed. In conclusion, the 3DP technology is infusive and will present huge potential to reform future orthopedic practice.
Collapse
|
18
|
Wang J, Yang L, Ma M, Li G, Xu S, Li Q, Xu Z, Liu J, Ye C. Development and Application of a No-Clog Surgical Suction Tip Using 3D Printing Technology. Med Sci Monit 2018; 24:6765-6773. [PMID: 30251710 PMCID: PMC6180918 DOI: 10.12659/msm.909900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Clogging of the suction tip frequently occurs during orthopedic surgery. We developed a novel anti-clog suction tip using 3D printing technology to improve orthopedic surgery efficiency. Material/Methods We studied the root causes of obstructions in suction tips currently employed in orthopedic surgery during actual surgical cases. CAD software and 3D printer was used to design, modify, and print the novel suction tip. The frequency of clogging, the frequency of replacement of the suction tip, the time lost in replacing suction tips or connecting tubes, surgical duration, intraoperative surgical blood loss, and the satisfaction scores for the suction tips as rated by the surgeons were compared between the novel suction tip and the conventional suction tip. Comparisons were made first in laboratory experiments using a simulant liquid and then during total hip replacement surgeries. Results In the simulant liquid experiments, the novel suction tips showed significantly reduced frequency of complete clogging and decreased time spent removing all fluid in comparison to the conventional suction tips (p<0.05). In the clinical trials, the novel suction tips exhibited significantly reduced frequency of complete clogging, shorter surgical duration, and reduced intraoperative surgical blood loss compared to the conventional suction tips (p<0.05). Surgeon satisfaction scores were higher for the novel tips than for the conventional tips (p<0.05). Conclusions Our surgeon-designed and -produced surgical suction tip utilizing 3D desktop printing technology was highly effective in resolving the problem of clogged suction tips during orthopedic surgery and yielded high surgeon satisfaction.
Collapse
Affiliation(s)
- Jianji Wang
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland).,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Long Yang
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland).,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Minxian Ma
- Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, Guizhou, China (mainland).,Stomatology Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Guangdi Li
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Shunen Xu
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Qingjun Li
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Zhe Xu
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland).,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Jun Liu
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland).,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, Guizhou, China (mainland)
| | - Chuan Ye
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China (mainland).,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, Guizhou, China (mainland).,China Orthopedic Regenerative Medicine Group (CORMed), Guiyang, Guizhou, China (mainland)
| |
Collapse
|
19
|
Gao C, Wang C, Jin H, Wang Z, Li Z, Shi C, Leng Y, Yang F, Liu H, Wang J. Additive manufacturing technique-designed metallic porous implants for clinical application in orthopedics. RSC Adv 2018; 8:25210-25227. [PMID: 35542139 PMCID: PMC9082573 DOI: 10.1039/c8ra04815k] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/03/2018] [Indexed: 11/28/2022] Open
Abstract
Traditional metallic scaffold prostheses, as vastly applied implants in clinical orthopedic operations, have achieved great success in rebuilding limb function. However, mismatch of bone defects and additional coating requirements limit the long-term survival of traditional prostheses. Recently, additive manufacturing (AM) has opened up unprecedented possibilities for producing complicated structures in prosthesis shapes and microporous surface designs of customized prostheses, which can solve the drawback of traditional prostheses mentioned above. This review presents the most commonly used metallic additive manufacturing techniques, the microporous structure design of metallic scaffolds, and novel applications of customized prostheses in the orthopedic field. Challenges and future perspectives on AM fabricated scaffolds are also summarized.
Collapse
Affiliation(s)
- Chaohua Gao
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Chenyu Wang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
- Hallym University 1 Hallymdaehak-gil Chuncheon Gangwon-do 200-702 Korea
| | - Hui Jin
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Zuhao Li
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Chenyu Shi
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
- School of Nursing, Jilin University Changchun 130041 P. R. China
| | - Yi Leng
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Fan Yang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| |
Collapse
|
20
|
Li Z, Liu C, Wang B, Wang C, Wang Z, Yang F, Gao C, Liu H, Qin Y, Wang J. Heat treatment effect on the mechanical properties, roughness and bone ingrowth capacity of 3D printing porous titanium alloy. RSC Adv 2018; 8:12471-12483. [PMID: 35539383 PMCID: PMC9079356 DOI: 10.1039/c7ra13313h] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/23/2018] [Indexed: 01/06/2023] Open
Abstract
The weak mechanical strength and biological inertia of Ti-6Al-4V porous titanium alloy limit its clinical application in the field of orthopedics. The present study investigated the influence of different solution temperatures (e.g. 800 °C, 950 °C and 1000 °C) on the mechanical properties, roughness and bone ingrowth capacity of Ti-6Al-4V porous titanium alloy prepared by Electron Beam Melting. It was found that the compressive and shear strength were promoted with the increase of solution temperature because of the transformed crystallinity of Ti-6Al-4V titanium alloy and phase changes from TiAl to TiAl + TiV. In addition, the topological morphology, surface roughness and wettability of the porous titanium alloy scaffolds were improved after heat treatment, and in turn, the adhesion rate and cell proliferation of bone marrow mesenchymal stem cells were enhanced. Compared with the scaffolds before and after heat treatment at 800 °C, the scaffolds heat-treated at 950 °C and 1000 °C achieved better bone ingrowth, extracellular matrix deposition and osseointegration. These findings indicate the great potential of heat treatment in possessing Ti-6Al-4V porous titanium alloy for orthopedic implant.
Collapse
Affiliation(s)
- Zuhao Li
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Chang Liu
- School of Materials Science and Engineering, Central South University Changsha 410083 P. R. China
| | - Bingfeng Wang
- School of Materials Science and Engineering, Central South University Changsha 410083 P. R. China
| | - Chenyu Wang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
- Department of Orthopedics, Hallym University 1 Hallymdaehak-gil Chuncheon Gangwon-do 200-702 Korea
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Fan Yang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Chaohua Gao
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Yanguo Qin
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University Changchun 130041 P. R. China
| |
Collapse
|
21
|
Wang Z, Wang C, Li C, Qin Y, Zhong L, Chen B, Li Z, Liu H, Chang F, Wang J. Analysis of factors influencing bone ingrowth into three-dimensional printed porous metal scaffolds: A review. JOURNAL OF ALLOYS AND COMPOUNDS 2017; 717:271-285. [DOI: 10.1016/j.jallcom.2017.05.079] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
|