Use of 3-dimensional stereolithographic polymer models for heterotopic ossification surgical excision

3D-Printed Model in Preoperative Planning of Sciatic Nerve Decompression Because of Heterotopic Ossification: A Case Report

CASE

A 31-year-old patient presented with an encapsulated sciatic nerve secondary to extensive hip heterotopic ossification (HO), which prevented visualization of a safe osteotomy site to avoid nerve damage. The 3D-printed model demonstrated an easily identifiable osseous reference point along the inferior aspect of the heterotopic mass, allowing for a vertical osteotomy to be safely performed.

CONCLUSION

HO is associated with loss of normal anatomic topography. The current case report illustrates the use of a 3D-printed model to identify pertinent anatomic landmarks required for safe decompression of an encapsulated sciatic nerve within the anatomic region of the hip.

Sterility of 3D-Printed Orthopedic Implants Using Fused Deposition Modeling

The use of 3-dimensional (3D) printing in orthopedics is developing rapidly and impacting the areas of preoperative planning, surgical guides, and simulation. As this technology continues to improve, the greatest impact of 3D printing may be in low- and middle-income countries where surgical items are in short supply. This study investigated sterility of 3D-printed ankle fracture fixation plates and cortical screws. The hypothesis was that the process of heated extrusion in fused deposition modeling printing would create sterile prints in a timely fashion that would not require postproduction sterilization. A free computer-assisted design program was used to design the implant models. One control group and 8 study groups were printed. Print construct, orientation, size, and postproduction sterilization differed among the groups. Sterility was assessed using thioglycollate broth cultures at 24 hours, 48 hours, and 7 days. Positive growth was speciated for aerobic and anaerobic bacteria. Print time and failed prints were recorded. Control samples were 100% positive for bacterial growth. All test samples remained sterile at all time points (100%). Speciation of control samples was obtained, and Staphylococcus was the most common species. Print times varied; however, no print time exceeded 6.75 minutes. Eighteen prints (17%) failed in the printing process. These findings demonstrate an intrinsic sterilization process associated with fused deposition modeling 3D printing and indicate the feasibility of 3D-printed surgical implants and equipment for orthopedic applications. With future research, 3D-printed implants may be a treatment modality to assist orthopedic surgeons in low- and middle-income countries. [Orthopedics. 2020; 43(1): 46-51.].

Three-dimensional printing in cardiac surgery and interventional cardiology: a single-centre experience

OBJECTIVES

In individual cases, routine preoperative imaging might not be sufficient for optimal planning of cardiovascular procedures. Three-dimensional printing (3D), a widely used technique to build life-like replicas of anatomical structures that has proven value in different medical disciplines, might overcome these shortcomings. However, data on 3D printing in cardiovascular medicine are limited to single reports. This stimulated us to present our single-centre experience with 3D printing models in cardiac surgery and interventional cardiology.

METHODS

Between the years 2006 and 2013, we fabricated 3D printing models using preoperative computed tomography or magnetic resonance imaging data in paediatric and adult cardiac surgery, as well as interventional cardiology. We present the 8 most representative cases.

RESULTS

The models were very helpful for perioperative planning and orientation, as well as simulation of procedures due to the exact and life-like illustration of the cardiovascular anatomy.

CONCLUSIONS

The fabrication of 3D printing models is feasible for perioperative planning and simulation in a variety of complex cases in paediatric and adult cardiac surgery, as well as in interventional cardiology. Further studies including more patients and providing more data are expected to demonstrate that the use of 3D printing may decrease morbidity and mortality of complex, non-routine procedures in cardiovascular medicine.