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Trikoupis IG, Mavrodontis II, Papadopoulos DV, Goumenos SD, Georgoulis DA, Gavriil P, Melissaridou D, Savvidou OD, Kontogeorgakos VA, Papagelopoulos PJ. 3D-printed glenoid implant reconstruction, after partial scapulectomy for malignant tumors: a case series. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:1557-1562. [PMID: 38280074 PMCID: PMC10980628 DOI: 10.1007/s00590-024-03839-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE Glenoid tumors are extremely rare, and reconstruction remains very challenging. The aim of this study is to present the clinical and functional outcomes, of a new glenoid reconstruction method using 3-dimensional-printed implant. METHODS Four patients with primary glenoid tumors underwent reconstruction using 3-dimensional-printed glenoid implant linked with reverse shoulder arthroplasty. We retrospectively reviewed the clinical and functional outcome, using MSTS and DASH score, as well as complications' rate. RESULTS Wide excision was achieved in all patients. No local recurrence or distant metastasis was diagnosed at the follow-up period. The mean MSTS score was 80.5%, and DASH score was 15.2%. According to Hendersons' classification, there were no postoperative complications. CONCLUSION The use of 3-dimensional-printed implants, can be a very reliable solution with satisfying clinical and functional outcomes for reconstruction, in patients with musculoskeletal malignancies of the glenoid. Level of evidence IV Treatment Study.
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Affiliation(s)
- Ioannis G Trikoupis
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Ioannis I Mavrodontis
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Dimitrios V Papadopoulos
- Second Department of Orthopedics, National and Kapodistrian University of Athens, 'Agia Olga' Hospital, Th. Konstantopoulou 3-5, Nea Ionia, 14233, Athens, Greece
| | - Stavros D Goumenos
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Dimitrios A Georgoulis
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Panagiotis Gavriil
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Dimitra Melissaridou
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Olga D Savvidou
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Vasileios A Kontogeorgakos
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece
| | - Panayiotis J Papagelopoulos
- First Department of Orthopedic Surgery and Traumatology, National and Kapodistrian University of Athens, School of Medicine, "ATTIKON" University General Hospital, Rimini 1, Chaidari, 12462, Athens, Greece.
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Manescu (Paltanea) V, Antoniac I, Antoniac A, Laptoiu D, Paltanea G, Ciocoiu R, Nemoianu IV, Gruionu LG, Dura H. Bone Regeneration Induced by Patient-Adapted Mg Alloy-Based Scaffolds for Bone Defects: Present and Future Perspectives. Biomimetics (Basel) 2023; 8:618. [PMID: 38132557 PMCID: PMC10742271 DOI: 10.3390/biomimetics8080618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Treatment of bone defects resulting after tumor surgeries, accidents, or non-unions is an actual problem linked to morbidity and the necessity of a second surgery and often requires a critical healthcare cost. Although the surgical technique has changed in a modern way, the treatment outcome is still influenced by patient age, localization of the bone defect, associated comorbidities, the surgeon approach, and systemic disorders. Three-dimensional magnesium-based scaffolds are considered an important step because they can have precise bone defect geometry, high porosity grade, anatomical pore shape, and mechanical properties close to the human bone. In addition, magnesium has been proven in in vitro and in vivo studies to influence bone regeneration and new blood vessel formation positively. In this review paper, we describe the magnesium alloy's effect on bone regenerative processes, starting with a short description of magnesium's role in the bone healing process, host immune response modulation, and finishing with the primary biological mechanism of magnesium ions in angiogenesis and osteogenesis by presenting a detailed analysis based on a literature review. A strategy that must be followed when a patient-adapted scaffold dedicated to bone tissue engineering is proposed and the main fabrication technologies are combined, in some cases with artificial intelligence for Mg alloy scaffolds, are presented with examples. We emphasized the microstructure, mechanical properties, corrosion behavior, and biocompatibility of each study and made a basis for the researchers who want to start to apply the regenerative potential of magnesium-based scaffolds in clinical practice. Challenges, future directions, and special potential clinical applications such as osteosarcoma and persistent infection treatment are present at the end of our review paper.
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Affiliation(s)
- Veronica Manescu (Paltanea)
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania; (V.M.); (A.A.); (R.C.)
- Faculty of Electrical Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania; (G.P.); (I.V.N.)
| | - Iulian Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania; (V.M.); (A.A.); (R.C.)
- Academy of Romanian Scientists, 54 Splaiul Independentei, RO-050094 Bucharest, Romania
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania; (V.M.); (A.A.); (R.C.)
| | - Dan Laptoiu
- Department of Orthopedics and Trauma I, Colentina Clinical Hospital, 19-21 Soseaua Stefan cel Mare, RO-020125 Bucharest, Romania;
| | - Gheorghe Paltanea
- Faculty of Electrical Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania; (G.P.); (I.V.N.)
| | - Robert Ciocoiu
- Faculty of Material Science and Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania; (V.M.); (A.A.); (R.C.)
| | - Iosif Vasile Nemoianu
- Faculty of Electrical Engineering, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, District 6, RO-060042 Bucharest, Romania; (G.P.); (I.V.N.)
| | - Lucian Gheorghe Gruionu
- Faculty of Mechanics, University of Craiova, 13 Alexandru Ioan Cuza, RO-200585 Craiova, Romania;
| | - Horatiu Dura
- Faculty of Medicine, Lucian Blaga University of Sibiu, RO-550169 Sibiu, Romania;
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Liao GJ, Su Q, Zhang YQ, Chang LM. Resection for malignant tumors in the elbow and individualized reconstruction under assistance of 3D printing technology: A case report. Medicine (Baltimore) 2023; 102:e34854. [PMID: 37657014 PMCID: PMC10476851 DOI: 10.1097/md.0000000000034854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/31/2023] [Indexed: 09/03/2023] Open
Abstract
RATIONALE With a high failure rate and multiple postoperative complications, the resection for tumors in the elbow and reconstruction present a formidable challenge to orthopedic surgeons. The maturation of 3-dimension (3D) printing technology has facilitated the preoperative design, intraoperative navigation, and reconstruction of bone defects in patients with complex malignant tumors of the elbow joint. In order to improve prognosis, we explored a method of tumor resection and elbow reconstruction aided by 3D printing technology in this research. PATIENT CONCERNS The patient underwent nephrectomy for clear cell carcinoma of the left kidney 3 years ago. Six months ago, the patient presented with limited movement and lateral tenderness in the right elbow joint. The tumor puncture biopsy demonstrated renal clear cell carcinoma metastasis. DIAGNOSES Renal clear cell carcinoma with distal humerus bone metastasis. INTERVENTIONS Thin-layer CT scan data of the patient was acquired, and a 3D reconstruction of both upper limb bones and joints was conducted, followed by a simulation of diseased tissue excision. According to the model, individualized osteotomy guidelines and elbow prostheses were designed and manufactured. Then, prior to the completion of the actual operation, a simulation of the preoperative phase was performed. OUTCOMES The operation was completed without incident. At the 1-, 3-, and 6-month postoperative examinations, both the position and mobility of the prosthesis were found to be satisfactory, and no complications were observed. The hospital for special surgery score and mayo elbow performance score scores increased in comparison to the preoperative period. LESSONS For patients with complex tumors in the elbow joint, 3D printing technology may assist in the precise excision of the tumor and provide an individualized elbow joint prosthesis that is more precise and effective than traditional surgery. It can accomplish a satisfactory treatment effect for patients when combined with early postoperative scientific rehabilitation training, so it is a method worth promoting.
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Affiliation(s)
- Guang-Jun Liao
- Department of Orthopedic Oncology, Yantaishan Hospital, Yantai, Shandong, China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, Shandong, China
| | - Qing Su
- Department of Orthopedic Oncology, Yantaishan Hospital, Yantai, Shandong, China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, Shandong, China
| | - Yong-Quan Zhang
- Department of Orthopedic Oncology, Yantaishan Hospital, Yantai, Shandong, China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, Shandong, China
| | - Li-Ming Chang
- Department of Orthopedic Oncology, Yantaishan Hospital, Yantai, Shandong, China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, Shandong, China
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Yaneva A, Shopova D, Bakova D, Mihaylova A, Kasnakova P, Hristozova M, Semerdjieva M. The Progress in Bioprinting and Its Potential Impact on Health-Related Quality of Life. Bioengineering (Basel) 2023; 10:910. [PMID: 37627795 PMCID: PMC10451845 DOI: 10.3390/bioengineering10080910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
The intensive development of technologies related to human health in recent years has caused a real revolution. The transition from conventional medicine to personalized medicine, largely driven by bioprinting, is expected to have a significant positive impact on a patient's quality of life. This article aims to conduct a systematic review of bioprinting's potential impact on health-related quality of life. A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was undertaken using the PubMed, Scopus, Google Scholar, and ScienceDirect databases between 2019 and 2023. We have identified some of the most significant potential benefits of bioprinting to improve the patient's quality of life: personalized part production; saving millions of lives; reducing rejection risks after transplantation; accelerating the process of skin tissue regeneration; homocellular tissue model generation; precise fabrication process with accurate specifications; and eliminating the need for organs donor, and thus reducing patient waiting time. In addition, these advances in bioprinting have the potential to greatly benefit cancer treatment and other research, offering medical solutions tailored to each individual patient that could increase the patient's chance of survival and significantly improve their overall well-being. Although some of these advancements are still in the research stage, the encouraging results from scientific studies suggest that they are on the verge of being integrated into personalized patient treatment. The progress in bioprinting has the power to revolutionize medicine and healthcare, promising to have a profound impact on improving the quality of life and potentially transforming the field of medicine and healthcare.
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Affiliation(s)
- Antoniya Yaneva
- Department of Medical Informatics, Biostatistics and eLearning, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria;
| | - Dobromira Shopova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University, 4000 Plovdiv, Bulgaria
| | - Desislava Bakova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Anna Mihaylova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Petya Kasnakova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Maria Hristozova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Maria Semerdjieva
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
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Application of 3D Printing in Bone Grafts. Cells 2023; 12:cells12060859. [PMID: 36980200 PMCID: PMC10047278 DOI: 10.3390/cells12060859] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
The application of 3D printing in bone grafts is gaining in importance and is becoming more and more popular. The choice of the method has a direct impact on the preparation of the patient for surgery, the probability of rejection of the transplant, and many other complications. The aim of the article is to discuss methods of bone grafting and to compare these methods. This review of literature is based on a selective literature search of the PubMed and Web of Science databases from 2001 to 2022 using the search terms “bone graft”, “bone transplant”, and “3D printing”. In addition, we also reviewed non-medical literature related to materials used for 3D printing. There are several methods of bone grafting, such as a demineralized bone matrix, cancellous allograft, nonvascular cortical allograft, osteoarticular allograft, osteochondral allograft, vascularized allograft, and an autogenic transplant using a bone substitute. Currently, autogenous grafting, which involves removing the patient’s bone from an area of low aesthetic importance, is referred to as the gold standard. 3D printing enables using a variety of materials. 3D technology is being applied to bone tissue engineering much more often. It allows for the treatment of bone defects thanks to the creation of a porous scaffold with adequate mechanical strength and favorable macro- and microstructures. Bone tissue engineering is an innovative approach that can be used to repair multiple bone defects in the process of transplantation. In this process, biomaterials are a very important factor in supporting regenerative cells and the regeneration of tissue. We have years of research ahead of us; however, it is certain that 3D printing is the future of transplant medicine.
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Zhou H, Liu S, Li Z, Liu X, Dang L, Li Y, Li Z, Hu P, Wang B, Wei F, Liu Z. 3D-printed vertebral body for anterior spinal reconstruction in patients with thoracolumbar spinal tumors. J Neurosurg Spine 2022; 37:274-282. [PMID: 35213828 DOI: 10.3171/2022.1.spine21900] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/07/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A 3D-printed vertebral prosthesis can be used to reconstruct a bone defect more precisely because of its tailored shape, with its innermost porous structure inducing bone ingrowth. The aim of this study was to evaluate the clinical outcomes of using a 3D-printed artificial vertebral body for spinal reconstruction after en bloc resection of thoracolumbar tumors. METHODS This was a retrospective analysis of 23 consecutive patients who underwent surgical treatment for thoracolumbar tumors at our hospital. En bloc resection was performed in all cases, based on the Weinstein-Boriani-Biagini surgical staging system, and anterior reconstruction was performed using a 3D-printed artificial vertebral body. Prosthesis subsidence, fusion status, and instrumentation-related complications were evaluated. Stability of the anterior reconstruction method was evaluated by CT, and CT Hounsfield unit (HU) values were measured to evaluate fusion status. RESULTS The median follow-up was 37 (range 24-58) months. A customized 3D-printed artificial vertebral body was used in 10 patients, with an off-the-shelf 3D-printed artificial vertebral body used in the other 13 patients. The artificial vertebral body was implanted anteriorly in 5 patients and posteriorly in 18 patients. The overall fusion rate was 87.0%. The average prosthesis subsidence at the final follow-up was 1.60 ± 1.79 mm. Instrument failure occurred in 2 patients, both of whom had substantial subsidence (8.47 and 3.69 mm, respectively). At 3 months, 6 months, and 1 year postoperatively, the mean CT HU values within the artificial vertebral body were 1930 ± 294, 1997 ± 336, and 1994 ± 257, respectively, with each of these values being significantly higher than the immediate postoperative value of 1744 ± 321 (p < 0.05). CONCLUSIONS The use of a 3D-printed artificial vertebral body for anterior reconstruction after en bloc resection of the thoracolumbar spinal tumor may be a feasible and reliable option. The low incidence of prosthesis subsidence of 3D-printed endoprostheses can provide good stability instantly. Measurement of HU values with CT is a valuable method to evaluate the osseointegration at the bone-metal interface of a 3D-printed vertebral prosthesis.
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Affiliation(s)
- Hua Zhou
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Shanshan Liu
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Zhehuang Li
- 4Department of Bone and Soft Tumor, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaoguang Liu
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Lei Dang
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Yan Li
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Zihe Li
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Panpan Hu
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Ben Wang
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Feng Wei
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
| | - Zhongjun Liu
- 1Department of Orthopaedics, Peking University Third Hospital, Beijing
- 2Engineering Research Center of Bone and Joint Precision Medicine, Beijing
- 3Beijing Key Laboratory of Spinal Disease Research, Beijing; and
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Abstract
The importance of 3D printing applications in the surgery of musculoskeletal tumors has increased in recent years. Even prior to the era of 3D printing, computer-assisted techniques, such as navigation, have proved their utility. Due to the variable appearance of bone tumors, there is a need for individual solutions. The 3D printing can be used for the development of anatomical demonstration models, the construction of patient-specific instruments and custom-made implants. For these three applications, different regulatory hurdles exist. Especially for the resection of pelvic tumors, 3D printing technologies seem to provide advantages due to the complicated anatomy and the proximity to relevant neurovascular structures. With the introduction of titanium printing, construction of individualized implants that fit exactly into the defect became feasible.
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8
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Rudert M. Taking the Next Step in Personalised Orthopaedic Implantation. J Pers Med 2022; 12:jpm12030365. [PMID: 35330365 PMCID: PMC8953561 DOI: 10.3390/jpm12030365] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023] Open
Affiliation(s)
- Maximilian Rudert
- Orthopaedic Department, König-Ludwig-Haus, University of Wuerzburg, D-97074 Wuerzburg, Germany
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9
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Beitler BG, Abraham PF, Glennon AR, Tommasini SM, Lattanza LL, Morris JM, Wiznia DH. Interpretation of regulatory factors for 3D printing at hospitals and medical centers, or at the point of care. 3D Print Med 2022; 8:7. [PMID: 35106697 PMCID: PMC8809025 DOI: 10.1186/s41205-022-00134-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
3D printing is revolutionizing the medical device landscape through its ability to rapidly create patient-specific anatomic models, surgical instruments, and implants. Recent advances in 3D printing technology have allowed for the creation of point-of-care (PoC) 3D printing centers. These PoC centers blur the line between healthcare provider, medical center, and device manufacturer, creating regulatory ambiguity. The United States Food & Drug Administration (FDA) currently regulates 3D printed devices through existing medical device regulations. However, the FDA is increasingly interested in developing guidelines and regulations specifically for PoC 3D printing due to its rapid adoption across the healthcare institutions. In this article, we review the regulatory framework that governs medical devices, discuss how PoC 3D printing falls within this framework, and describe a novel conceptual framework that the FDA has proposed. Finally, through analysis of the aforementioned regulations and discussions with industry medical 3D printing regulatory experts, we provide recommendations for PoC medical 3D printing best practices so that institutions are best positioned to utilize this revolutionary technology safely and effectively.
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Affiliation(s)
- Brian G Beitler
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave 1st Floor, CT, 06519, New Haven, USA.
| | - Paul F Abraham
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | | | - Steven M Tommasini
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave 1st Floor, CT, 06519, New Haven, USA.,Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Lisa L Lattanza
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave 1st Floor, CT, 06519, New Haven, USA
| | | | - Daniel H Wiznia
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave 1st Floor, CT, 06519, New Haven, USA.,Department of Mechanical Engineering & Materials Science, School of Engineering & Applied Science, Yale University, New Haven, CT, USA
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Singh SP, Borthwick KG, Qureshi FM. Commentary: Development of a Computer-Aided Design and Finite Element Analysis Combined Method for Affordable Spine Surgical Navigation With 3D-Printed Customized Template. Front Surg 2021; 8:743290. [PMID: 34631786 PMCID: PMC8495061 DOI: 10.3389/fsurg.2021.743290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Som P Singh
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
| | - Kiera G Borthwick
- Department of Neurosciences, Washington & Lee University, Lexington, VA, United States
| | - Fahad M Qureshi
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
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