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Séguin B, Liptak JM. Updates in Surgical Oncology. Vet Clin North Am Small Anim Pract 2024; 54:577-589. [PMID: 38238221 DOI: 10.1016/j.cvsm.2023.12.010] [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: 03/25/2024]
Abstract
New knowledge and data can influence the treatment options of dogs and cats affected by neoplasms. Partial limb amputation with the use of a prosthesis is possible in dogs. Newer studies attempt to define better and understand the complications and limb function associated with this approach. Limb sparing is an alternative to amputation, and three-dimensional printing allows the manufacturing of personalized endoprostheses. Finally, the recommended approach for the excision of cutaneous mast cell tumors (MCTs) is with proportional margins. In dogs, grade shifting might have occurred when removing a recurrent MCT or soft tissue sarcoma.
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Affiliation(s)
- Bernard Séguin
- Central Victoria Veterinary Hospital, 760 Roderick Street, Victoria, British Columbia V8X 2R3, Canada.
| | - Julius M Liptak
- Capital City Specialty & Emergency Animal Hospital, 747 Silver Seven Road, Kanata, Ontario K2V 0A2, Canada
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2
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Polak S, Beever L, Wade A, Fukuoka M, Worth AJ. Biomechanical comparison of titanium alloy additively manufactured and conventionally manufactured plate-screw constructs. N Z Vet J 2024; 72:17-27. [PMID: 37772312 DOI: 10.1080/00480169.2023.2264805] [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: 06/25/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023]
Abstract
AIM To biomechanically compare the bending stiffness, strength, and cyclic fatigue of titanium additively manufactured (AM) and conventionally manufactured (CM) limited contact plates (LCP) of equivalent dimensions using plate-screw constructs. METHODS Twenty-four 1.5/2.0-mm plate constructs (CM: n = 12; AM: n = 12) were placed under 4-point bending conditions. Data were collected during quasi-static single cycle to failure and cyclic fatigue testing until implants plastically deformed or failed. Bending stiffness, bending structural stiffness, and bending strength were determined from load-displacement curves. Fatigue life was determined as number of cycles to failure. Median test variables for each method were compared using the Wilcoxon rank sum test within each group. Fatigue data was also analysed by the Kaplan-Meier estimator of survival function. RESULTS There was no evidence for a difference in bending stiffness and bending structural stiffness between AM and CM constructs. However, AM constructs exhibited greater bending strength (median 3.07 (min 3.0, max 3.4) Nm) under quasi-static 4-point bending than the CM constructs (median 2.57 (min 2.5, max 2.6) Nm, p = 0.006). Number of cycles to failure under dynamic 4-point bending was higher for the CM constructs (median 164,272 (min 73,557, max 250,000) cycles) than the AM constructs (median 18,704 (min 14,427, max 33,228) cycles; p = 0.02). Survival analysis showed that 50% of AM plates failed by 18,842 cycles, while 50% CM plates failed by 78,543 cycles. CONCLUSION AND CLINICAL RELEVANCE Additively manufactured titanium implants, printed to replicate a conventional titanium orthopaedic plate, were more prone to failure in a shorter fatigue period despite being stronger in single cycle to failure. Patient-specific implants made using this process may be brittle and therefore not comparable to CM orthopaedic implants. Careful selection of their use on a case/patient-specific basis is recommended.
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Affiliation(s)
- S Polak
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - L Beever
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - A Wade
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - M Fukuoka
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - A J Worth
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Chambers A, Traverson M, Neal S, Konala S, Harrysson O. Performances of novel custom 3D-printed cutting guide in canine caudal maxillectomy: a cadaveric study. Front Vet Sci 2023; 10:1127025. [PMID: 37360408 PMCID: PMC10285408 DOI: 10.3389/fvets.2023.1127025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Caudal maxillectomies are challenging procedures for most veterinary surgeons. Custom guides may allow the procedure to become more accessible. Methods A cadaveric study was performed to evaluate the accuracy and efficiency of stereolithography guided (3D-printed) caudal maxillectomy. Mean absolute linear deviation from planned to performed cuts and mean procedure duration were compared pairwise between three study groups, with 10 canine cadaver head sides per group: 3D-printed guided caudal maxillectomy performed by an experienced surgeon (ESG) and a novice surgery resident (NSG), and freehand procedure performed by an experienced surgeon (ESF). Results Accuracy was systematically higher for ESG versus ESF, and statistically significant for 4 of 5 osteotomies (p < 0.05). There was no statistical difference in accuracy between ESG and NSG. The highest absolute mean linear deviation for ESG was <2 mm and >5 mm for ESF. Procedure duration was statistically significantly longer for ESG than ESF (p < 0.001), and for NSG than ESG (p < 0.001). Discussion Surgical accuracy of canine caudal maxillectomy was improved with the use of our novel custom cutting guide, despite a longer duration procedure. Improved accuracy obtained with the use of the custom cutting guide could prove beneficial in achieving complete oncologic margins. The time increase might be acceptable if hemorrhage can be adequately controlled in vivo. Further development in custom guides may improve the overall efficacy of the procedure.
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Affiliation(s)
- Aidan Chambers
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Marine Traverson
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Center for Additive Manufacturing and Logistics, College of Engineering, North Carolina State University, Raleigh, NC, United States
| | - Shelby Neal
- Center for Additive Manufacturing and Logistics, College of Engineering, North Carolina State University, Raleigh, NC, United States
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC, United States
| | - Satyanarayana Konala
- Center for Additive Manufacturing and Logistics, College of Engineering, North Carolina State University, Raleigh, NC, United States
- Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, United States
| | - Ola Harrysson
- Center for Additive Manufacturing and Logistics, College of Engineering, North Carolina State University, Raleigh, NC, United States
- Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, United States
- Department of Biomedical Engineering, College of Engineering, North Carolina State University, Raleigh, NC, United States
- Department of Material Science and Engineering, College of Engineering, North Carolina State University, Raleigh, NC, United States
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Baumgartner D, Schramel JP, Kau S, Unger E, Oberoi G, Peham C, Eberspächer-Schweda M. 3D printed plates based on generative design biomechanically outperform manual digital fitting and conventional systems printed in photopolymers in bridging mandibular bone defects of critical size in dogs. Front Vet Sci 2023; 10:1165689. [PMID: 37065217 PMCID: PMC10098091 DOI: 10.3389/fvets.2023.1165689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023] Open
Abstract
Conventional plate osteosynthesis of critical-sized bone defects in canine mandibles can fail to restore former functionality and stability due to adaption limits. Three-dimensional (3D) printed patient-specific implants are becoming increasingly popular as these can be customized to avoid critical structures, achieve perfect alignment to individual bone contours, and may provide better stability. Using a 3D surface model for the mandible, four plate designs were created and evaluated for their properties to stabilize a defined 30 mm critical-size bone defect. Design-1 was manually designed, and further shape optimized using Autodesk ® Fusion 360 (ADF360) and finite element analysis (FE) to generate Design-2. Design-4 was created with the generative design (GD) function from ADF360 using preplaced screw terminals and loading conditions as boundaries. A 12-hole reconstruction titanium locking plate (LP) (2.4/3.0 mm) was also tested, which was scanned, converted to a STL file and 3D printed (Design-3). Each design was 3D printed from a photopolymer resin (VPW) and a photopolymer resin in combination with a thermoplastic elastomer (VPWT) and loaded in cantilever bending using a customized servo-hydraulic mechanical testing system; n = 5 repetitions each. No material defects pre- or post-failure testing were found in the printed mandibles and screws. Plate fractures were most often observed in similar locations, depending on the design. Design-4 has 2.8-3.6 times ultimate strength compared to other plates, even though only 40% more volume was used. Maximum load capacities did not differ significantly from those of the other three designs. All plate types, except D3, were 35% stronger when made of VPW, compared to VPWT. VPWT D3 plates were only 6% stronger. Generative design is faster and easier to handle than optimizing manually designed plates using FE to create customized implants with maximum load-bearing capacity and minimum material requirements. Although guidelines for selecting appropriate outcomes and subsequent refinements to the optimized design are still needed, this may represent a straightforward approach to implementing additive manufacturing in individualized surgical care. The aim of this work is to analyze different design techniques, which can later be used for the development of implants made of biocompatible materials.
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Affiliation(s)
- Doris Baumgartner
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
- Small Animals Surgery Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
- *Correspondence: Doris Baumgartner
| | - Johannes Peter Schramel
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Silvio Kau
- Department of Pathobiology, Institute of Morphology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gunpreet Oberoi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Christian Peham
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Matthias Eberspächer-Schweda
- Small Animals Surgery Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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Santos B, Gordo I, Mullins RA. Acute limb shortening and modified pantarsal arthrodesis for the treatment of a highly comminuted distal tibial articular fracture in a dog. J Vet Sci 2023; 24:e28. [PMID: 37012036 PMCID: PMC10071285 DOI: 10.4142/jvs.22257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 03/11/2023] Open
Abstract
A three-year-old female spayed Lurcher was referred for the treatment of a highly comminuted distal tibial articular fracture. Resection of the area of comminution with a transverse osteotomy of the tibial diaphysis and talar ridges was performed, followed by modified pantarsal arthrodesis and a calcaneotibial screw. The treatment resulted in 7 cm of tibial shortening, equating to a 28% reduction in the total tibial length. Radiographic union of the arthrodesis was successful. Fair use of the pelvic limb was documented long-term. Combined acute limb shortening and modified pantarsal arthrodesis resulted in an acceptable outcome and could be considered in cases of highly comminuted distal tibial fractures.
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Affiliation(s)
- Bruno Santos
- Section of Small Animal Clinical Studies, University College Dublin, Belfield, Dublin 4, Ireland
| | - Inês Gordo
- Section of Small Animal Clinical Studies, University College Dublin, Belfield, Dublin 4, Ireland
| | - Ronan A. Mullins
- Section of Small Animal Clinical Studies, University College Dublin, Belfield, Dublin 4, Ireland
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Rodríguez-Pombo L, Awad A, Basit AW, Alvarez-Lorenzo C, Goyanes A. Innovations in Chewable Formulations: The Novelty and Applications of 3D Printing in Drug Product Design. Pharmaceutics 2022; 14:pharmaceutics14081732. [PMID: 36015355 PMCID: PMC9412656 DOI: 10.3390/pharmaceutics14081732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Since their introduction, chewable dosage forms have gained traction due to their ability to facilitate swallowing, especially in paediatric, geriatric and dysphagia patients. Their benefits stretch beyond human use to also include veterinary applications, improving administration and palatability in different animal species. Despite their advantages, current chewable formulations do not account for individualised dosing and palatability preferences. In light of this, three-dimensional (3D) printing, and in particular the semi-solid extrusion technology, has been suggested as a novel manufacturing method for producing customised chewable dosage forms. This advanced approach offers flexibility for selecting patient-specific doses, excipients, and organoleptic properties, which are critical for ensuring efficacy, safety and adherence to the treatment. This review provides an overview of the latest advancements in chewable dosage forms for human and veterinary use, highlighting the motivations behind their use and covering formulation considerations, as well as regulatory aspects.
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Affiliation(s)
- Lucía Rodríguez-Pombo
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia, Materials Institute iMATUS and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Atheer Awad
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Abdul W. Basit
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
- FabRx Ltd., Henwood House, Henwood, Ashford, Kent TN24 8DH, UK
| | - Carmen Alvarez-Lorenzo
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia, Materials Institute iMATUS and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Correspondence: (C.A.-L.); (A.G.)
| | - Alvaro Goyanes
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, I+D Farma (GI-1645), Facultad de Farmacia, Materials Institute iMATUS and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK
- FabRx Ltd., Henwood House, Henwood, Ashford, Kent TN24 8DH, UK
- Correspondence: (C.A.-L.); (A.G.)
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Mendaza-DeCal R, Ballesteros Y, Peso-Fernandez S, Paz E, del Real-Romero JC, Rodriguez-Quiros J. Biomechanical Test of a New Endoprosthesis for Cylindrical Medullary Canals in Dogs. Front Vet Sci 2022; 9:887676. [PMID: 35847635 PMCID: PMC9280675 DOI: 10.3389/fvets.2022.887676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
Exo-endoprosthesis is a limb salvage procedure for animals, although only expensive metal devices have been described. Now-a-days, new materials for this type of implant could be considered due to novel and affordable manufacturing techniques. However, a factor of safety (FoS) should be considered. There are kinetic and kinematic studies of canine natural gaits, which can be used to establish an FoS for mechanical tests for new non-metallic devices. Polyetheretherketone (PEEK) is used in different specialties in human medicine. Its mechanical properties (and its close mechanical stiffness to that of bone) make this polymer an alternative to metals in veterinary traumatology. PEEK could also be used in 3D printing. The suitability of a novel inner part of an exo-endoprosthesis manufactured by fuse deposition modeling (FDM) was presented in this study for long canine bones. Mechanical characterization of 3D-printed PEEK material and ex vivo mechanical tests of a customized endoprosthesis were performed to address it. Young's modulus of 3D-printed PEEK suffered a reduction of 30% in relation to bulk PEEK. Customized 3D-printed PEEK endoprostheses had promising outcomes for the tibiae of 20 kg dogs. Pure compression tests of the non-inserted endoprostheses showed a maximum force of 936 ± 199 N. In the bending tests of non-inserted endoprostheses, the PEEK part remained intact. Quasistatic mechanical tests of bone-inserted endoprostheses (compression-bending and pure compression tests) reached a maximum force of 785 ± 101 N and 1,642 ± 447 N, respectively. In fatigue tests, the samples reached 500,000 cycles without failure or detriment to their quasistatic results. These outcomes surpass the natural weight-bearing of dogs, even during a galloping pace. In conclusion, the 3D-printed PEEK part of the endoprosthesis for an exo-endoprosthesis can withstand loading, even during a galloping pace.
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Affiliation(s)
- Rosa Mendaza-DeCal
- Animal Medicine and Surgery Department, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
- ABAX Innovation Technologies, Villanueva de la Cañada, Madrid, Spain
- *Correspondence: Rosa Mendaza-DeCal
| | - Yolanda Ballesteros
- Institute for Research in Technology/Mechanical Engineering Department, Universidad Pontificia Comillas, Madrid, Spain
| | | | - Eva Paz
- Institute for Research in Technology/Mechanical Engineering Department, Universidad Pontificia Comillas, Madrid, Spain
| | - Juan Carlos del Real-Romero
- Institute for Research in Technology/Mechanical Engineering Department, Universidad Pontificia Comillas, Madrid, Spain
| | - Jesus Rodriguez-Quiros
- Animal Medicine and Surgery Department, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
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8
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Magidenko SR, Peterson NW, Pisano G, Buote NJ. Analysis of patient outcome and owner satisfaction with double limb amputations: 14 dogs and four cats. J Am Vet Med Assoc 2022; 260:884-891. [PMID: 35333746 DOI: 10.2460/javma.21.04.0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the indications for, complications of, and surgical outcomes of dogs and cats that were treated with double limb amputations. ANIMALS 14 dogs and 4 cats that underwent double limb amputations. PROCEDURES Data collected retrospectively included patient-specific (species, age, weight, breed, sex, existing comorbidities) and amputation-specific (indication for amputation, full or partial limb amputation, associated complications, need for revision surgeries) variables. Owner satisfaction scores were also collected. RESULTS The most common indication for double amputations was trauma (12/18) patients. Eleven patients had both amputations performed simultaneously. Nine patients had double partial limb amputations versus full limb amputations. Twelve patients underwent bilateral pelvic limb amputations, 4 underwent bilateral thoracic limb amputations, and 2 had 1 pelvic and 1 contralateral thoracic limb amputated. Five patients had reported complications over the course of the follow-up period, and complications for 3 patients were considered major. Revision surgery was reported for 2 animals. Owner satisfaction scores were reported as very satisfied/excellent (14/18), mildly satisfied (3/18), and strongly dissatisfied (1/18). Median time to follow-up was 450 days (range, 85 to 4,380 days). CLINICAL RELEVANCE Double limb amputation may be a viable alternative to advanced limb-sparing procedures or humane euthanasia based on the owner satisfaction data and the relatively low rate of major complications in this study. Future studies should clarify patient selection criteria and differences in function between surgical types.
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Affiliation(s)
- Steven R Magidenko
- Hospital for Animals, Small Animal Surgery Section, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Nathan W Peterson
- Hospital for Animals, Emergency and Critical Care Section, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Guido Pisano
- Centro Veterinario Pisani, Carli, Chiodo Luni Mare, Luni SP, Italy
| | - Nicole J Buote
- Hospital for Animals, Small Animal Surgery Section, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
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Memarian P, Pishavar E, Zanotti F, Trentini M, Camponogara F, Soliani E, Gargiulo P, Isola M, Zavan B. Active Materials for 3D Printing in Small Animals: Current Modalities and Future Directions for Orthopedic Applications. Int J Mol Sci 2022; 23:ijms23031045. [PMID: 35162968 PMCID: PMC8834768 DOI: 10.3390/ijms23031045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 12/15/2022] Open
Abstract
The successful clinical application of bone tissue engineering requires customized implants based on the receiver's bone anatomy and defect characteristics. Three-dimensional (3D) printing in small animal orthopedics has recently emerged as a valuable approach in fabricating individualized implants for receiver-specific needs. In veterinary medicine, because of the wide range of dimensions and anatomical variances, receiver-specific diagnosis and therapy are even more critical. The ability to generate 3D anatomical models and customize orthopedic instruments, implants, and scaffolds are advantages of 3D printing in small animal orthopedics. Furthermore, this technology provides veterinary medicine with a powerful tool that improves performance, precision, and cost-effectiveness. Nonetheless, the individualized 3D-printed implants have benefited several complex orthopedic procedures in small animals, including joint replacement surgeries, critical size bone defects, tibial tuberosity advancement, patellar groove replacement, limb-sparing surgeries, and other complex orthopedic procedures. The main purpose of this review is to discuss the application of 3D printing in small animal orthopedics based on already published papers as well as the techniques and materials used to fabricate 3D-printed objects. Finally, the advantages, current limitations, and future directions of 3D printing in small animal orthopedics have been addressed.
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Affiliation(s)
- Parastoo Memarian
- Department of Animal Medicine, Productions and Health, University of Padova, 35020 Padova, Italy; (P.M.); (M.I.)
| | - Elham Pishavar
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.P.); (F.Z.); (M.T.); (F.C.)
| | - Federica Zanotti
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.P.); (F.Z.); (M.T.); (F.C.)
| | - Martina Trentini
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.P.); (F.Z.); (M.T.); (F.C.)
| | - Francesca Camponogara
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.P.); (F.Z.); (M.T.); (F.C.)
| | - Elisa Soliani
- Engineering Department, King’s College, London WC2R 2LS, UK;
| | - Paolo Gargiulo
- Institute for Biomedical and Neural Engineering, Reykjavík University, 101 Reykjavík, Iceland;
- Department of Science, Landspítali, 101 Reykjavík, Iceland
| | - Maurizio Isola
- Department of Animal Medicine, Productions and Health, University of Padova, 35020 Padova, Italy; (P.M.); (M.I.)
| | - Barbara Zavan
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.P.); (F.Z.); (M.T.); (F.C.)
- Correspondence:
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Altwal J, Wilson CH, Griffon DJ. Applications of 3-dimensional printing in small-animal surgery: A review of current practices. Vet Surg 2021; 51:34-51. [PMID: 34633081 DOI: 10.1111/vsu.13739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/27/2021] [Accepted: 09/14/2021] [Indexed: 01/25/2023]
Abstract
Three-dimensional (3D) printing, also called rapid prototyping or additive manufacturing, transforms digital images into 3D printed objects, typically by layering consecutive thin films of material. This technology has become increasingly accessible to the public, prompting applications in veterinary surgery. Three-dimensional prints provide direct visualization of complex 3D structures and also haptic feedback relevant to surgery. The main objective of this review is to report current applications of 3D printing in small-animal surgery, including surgical education, preoperative planning, and treatment of tissue defects. The reported uses of 3D prints, their proposed advantages, and current limitations are discussed considering published evidence. Aspects of the manufacturing process specific to each application are described, along with current practices in veterinary surgery.
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Affiliation(s)
- Johnny Altwal
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.,Schmid College of Science and Technology, Chapman University, Orange, California, USA
| | - Caroline H Wilson
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, California, USA
| | - Dominique J Griffon
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
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Blake C, Birch S, Brandão J. Medical Three-Dimensional Printing in Zoological Medicine. Vet Clin North Am Exot Anim Pract 2019; 22:331-348. [PMID: 31395318 DOI: 10.1016/j.cvex.2019.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Medical 3-dimensional printing allows the creation of anatomic models by using a sequence of computer software programs. Diagnostic imaging data are used to create a physical model that allows clinicians to plan for surgical procedures and create prosthetics and surgical implants and instruments, among other applications. Its use in zoological medicine is limited, but is an area with a great growth potential. This publication reviews the process of creating a 3-dimensional anatomic model, its application in human and small animal medicine and surgery, and reviews peer-reviewed data regarding its use in exotic animals, wildlife, and zoo animals.
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Affiliation(s)
- Cara Blake
- Small Animal Surgery, Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, 2065 West Farm Road, Stillwater, OK 74078, USA.
| | - Scott Birch
- Pixelbeaker, 4834 Hillsdale Circle, Chattanooga, TN 37416, USA
| | - João Brandão
- Zoological Medicine, Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, 2065 West Farm Road, Stillwater, OK 74078, USA
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12
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Timercan A, Brailovski V, Petit Y, Lussier B, Séguin B. Personalized 3D-printed endoprostheses for limb sparing in dogs: Modeling and in vitro testing. Med Eng Phys 2019; 71:17-29. [PMID: 31327657 DOI: 10.1016/j.medengphy.2019.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 06/21/2019] [Accepted: 07/04/2019] [Indexed: 01/01/2023]
Abstract
Osteosarcoma is the most common type of bone cancer in dogs, treatable by amputation or limb-sparing surgery. For the latter, commercially available plate - endoprosthesis assemblies require contouring, to be adapted to the patient's bone geometry, and lead to sub-optimal results. The use of additively-manufactured personalized endoprostheses and cutting guides for distal radius limb-sparing surgery in dogs presents a promising alternative. Specialized software is used for the bone structure reconstruction from the patient's CT scans and for the design of endoprostheses and cutting guides. The prostheses are manufactured from a titanium alloy using a laser powder bed fusion system, while the cutting guides are manufactured from an ABS plastic using a fused deposition modeling system. A finite element model of an instrumented limb was developed and validated using experimental testing of a cadaveric limb implanted with a personalized endoprosthesis. Personalized endoprostheses and cutting guides can reduce limb sparing surgery time by 25-50% and may reduce the risk of implant failure. The numerical model was validated using the kinematics and force-displacement diagrams of the implant-limb construct. The model indicated that a modulus of elasticity of an implant material ranging from 25 to 50 GPa would improve the stress distribution within the implant. The results of the current study will allow optimization of the design of the personal implants in both veterinary and human patients.
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Affiliation(s)
- Anatolie Timercan
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame West, Montreal, Quebec H3C1K3, Canada.
| | - Vladimir Brailovski
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame West, Montreal, Quebec H3C1K3, Canada.
| | - Yvan Petit
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame West, Montreal, Quebec H3C1K3, Canada.
| | - Bertrand Lussier
- Faculty of Veterinary Medicine, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Quebec J2S2M2, Canada.
| | - Bernard Séguin
- Colorado State University Flint Animal Cancer Center, 300 W Drake, Fort Collins, Colorado 80525, USA.
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Séguin B, Pinard C, Lussier B, Williams D, Griffin L, Podell B, Mejia S, Timercan A, Petit Y, Brailovski V. Limb-sparing in dogs using patient-specific, three-dimensional-printed endoprosthesis for distal radial osteosarcoma: A pilot study. Vet Comp Oncol 2019; 18:92-104. [PMID: 31209977 DOI: 10.1111/vco.12515] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/26/2019] [Accepted: 05/31/2019] [Indexed: 12/22/2022]
Abstract
Limb-sparing for distal radial osteosarcoma has a high rate of complications. Using personalized three-dimensional (3D)-printed implants might improve outcome. The goals of this study were to optimize use of patient-specific, 3D-printed endoprostheses for limb-sparing in dogs in the clinical environment and to report the outcome. This was a pilot study where five client-owned dogs were enrolled. Computed tomography (CT) of the thoracic limbs was performed, which was used to create patient-specific endoprostheses and cutting guides, and repeated on the day of surgery. Intra-arterial (IA) carboplatin was introduced in the clinical management. Limb-sparing was performed. Outcome measures were time required to produce the endoprosthesis and cutting guide, fit between cutting guide and endoprosthesis with host bones, gait analysis, size of the tumour, percent tumour necrosis, complications, disease-free interval (DFI) and survival time (ST). Four dogs received IA carboplatin. Excessive tumour growth between planning CT and surgery did not occur in any dog. The interval between the CT and surgery ranged from 14 to 70 days. Fit between the cutting-guide and endoprosthesis with the host bones was good to excellent. At least one complication occurred in all dogs. Two dogs were euthanized with STs of 192 and 531 days. The other dogs were alive with a follow up of 534 to 575 days. IA chemotherapy is a promising strategy to minimize the risk of excessive tumour growth while waiting for the endoprosthesis and cutting-guide to be made. The design of the cutting-guide was critical for best fit of the endoprosthesis with host bones.
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Affiliation(s)
- Bernard Séguin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Chris Pinard
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Bertrand Lussier
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Montréal, Québec, Canada
| | - Deanna Williams
- Veterinary Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Lynn Griffin
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Brendan Podell
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Sebastian Mejia
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Anatolie Timercan
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
| | - Vladimir Brailovski
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
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Choi S, Oh YI, Park KH, Lee JS, Shim JH, Kang BJ. New clinical application of three-dimensional-printed polycaprolactone/β-tricalcium phosphate scaffold as an alternative to allograft bone for limb-sparing surgery in a dog with distal radial osteosarcoma. J Vet Med Sci 2019; 81:434-439. [PMID: 30662043 PMCID: PMC6451899 DOI: 10.1292/jvms.18-0158] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Limb-sparing surgery is one of the surgical options for dogs with distal radial osteosarcoma (OSA). This case report highlights the novel application of a three-dimensional (3D)-printed patient-specific polycaprolactone/β-tricalcium phosphate (PCL/β-TCP) scaffold in limb-sparing surgery in a dog with distal radial OSA. The outcomes evaluated included postoperative gait analysis, complications, local recurrence of tumor, metastasis, and survival time. Post-operative gait evaluation showed significant improvement in limb function, including increased weight distribution and decreased asymmetry. The implant remained well in place and increased bone opacity was observed between the host bone and the scaffold. There was no complication due to scaffold or surgery. Significant improvement in limb function and quality of life was noted postoperatively. Local recurrence and pulmonary metastasis were identified at 8 weeks postoperatively. The survival time from diagnosis of OSA to death was 190 days. The PCL/β-TCP scaffold may be an effective alternative to cortical allograft in limb-sparing surgery for bone tumors.
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Affiliation(s)
- Seongjae Choi
- Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Ye-In Oh
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Keun-Ho Park
- Department of Mechanical Engineering, Korea Polytechnic University, Siheung 15073, Republic of Korea
| | - Jeong-Seok Lee
- Department of Mechanical Engineering, Korea Polytechnic University, Siheung 15073, Republic of Korea
| | - Jin-Hyung Shim
- Department of Mechanical Engineering, Korea Polytechnic University, Siheung 15073, Republic of Korea
| | - Byung-Jae Kang
- Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon 24341, Republic of Korea
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15
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Séguin B, Walsh PJ, Ehrhart EJ, Hayden E, Lafferty MH, Selmic LE. Lateral manus translation for limb-sparing surgery in 18 dogs with distal radial osteosarcoma in dogs. Vet Surg 2018; 48:247-256. [DOI: 10.1111/vsu.13132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/10/2018] [Accepted: 05/14/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Bernard Séguin
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
| | | | - E. J. Ehrhart
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
| | - Eva Hayden
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Mary H. Lafferty
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins Colorado
| | - Laura E. Selmic
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine; University of Illinois Urbana-Champaign; Urbana Illinois
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