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Liang H, Chen B, Duan S, Yang L, Xu R, Zhang H, Sun M, Zhou X, Liu H, Wen H, Cai Z. Treatment of complex limb fractures with 3D printing technology combined with personalized plates: a retrospective study of case series and literature review. Front Surg 2024; 11:1383401. [PMID: 38817945 PMCID: PMC11137251 DOI: 10.3389/fsurg.2024.1383401] [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: 02/09/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
Background In recent years, 3D printing technology has made significant strides in the medical field. With the advancement of orthopedics, there is an increasing pursuit of high surgical quality and optimal functional recovery. 3D printing enables the creation of precise physical models of fractures, and customized personalized steel plates can better realign and more comprehensively and securely fix fractures. These technologies improve preoperative diagnosis, simulation, and planning for complex limb fractures, providing patients with better treatment options. Patients and methods Five typical cases were selected from a pool of numerous patients treated with 3D printing technology combined with personalized custom steel plates at our hospital. These cases were chosen to demonstrate the entire process of printing 3D models and customizing individualized steel plates, including details of the patients' surgeries and treatment procedures. Literature reviews were conducted, with a focus on highlighting the application of 3D printing technology combined with personalized custom steel plates in the treatment of complex limb fractures. Results 3D printing technology can produce accurate physical models of fractures, and personalized custom plates can achieve better fracture realignment and more comprehensive and robust fixation. These technologies provide patients with better treatment options. Conclusion The use of 3D printing models and personalized custom steel plates can improve preoperative diagnosis, simulation, and planning for complex limb fractures, realizing personalized medicine. This approach helps reduce surgical time, minimize trauma, enhance treatment outcomes, and improve patient functional recovery.
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Affiliation(s)
- Hairui Liang
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Beibei Chen
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Siyu Duan
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Lei Yang
- School of Pharmacy, Inner Mongolia Medical University, Inner Mongolia Autonomous Region, Shenyang, China
| | - Rongda Xu
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - He Zhang
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Ming Sun
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Xueting Zhou
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Hanfei Liu
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Hang Wen
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Zhencun Cai
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
- Key Laboratory of Human Ethnic Specificity and Phenomics of Critical Illness in Liaoning Province, Shenyang Medical College, Shenyang, China
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Lee JH, Gong HS. Volumetric assessment of ulnar nerves in cubital tunnel syndrome with 3D modeling of the MRI and its relationship with electrodiagnostic findings. J Plast Reconstr Aesthet Surg 2024; 92:244-251. [PMID: 38574571 DOI: 10.1016/j.bjps.2024.03.014] [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: 01/08/2023] [Revised: 09/06/2023] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Thickened nerve cross-sectional areas (CSA) have been investigated in compressive neuropathy, but the longitudinal extent of nerve swelling has yet to be evaluated. We did a volumetric assessment of the ulnar nerve in cubital tunnel syndrome (CuTS) with three-dimensional (3D) magnetic resonance imaging (MRI) modeling and investigated this relationship with clinical and electrodiagnostic parameters. METHODS We compared 40 CuTS patient elbow MRIs to 46 patient elbow MRIs with lateral elbow epicondylitis as controls. The ulnar nerve was modeled with Mimics software and was assessed qualitatively and quantitatively. The CSA and ulnar nerve volumes were recorded, and the area under the receiver operating characteristic (ROC) curve was calculated for diagnostic performance. We analyzed clinical and electrodiagnostic parameters to investigate their relationship with the 3D ulnar nerve parameters. RESULTS For the diagnosis of CuTS, the area under the curve value was 0.915 for the largest CSA and 0.910 for the volume in the ROC curve. The optimal cut-off was 14.53 mm2 and 529 mm3 respectively. When electrodiagnostic parameters were investigated, the 3D ulnar nerve volume was significantly inversely associated with motor conduction velocity, although there was no association between the largest CSA and any of the electrodiagnostic parameters. CONCLUSIONS The 3D ulnar nerve volume, which is an integration or multilevel measurement of CSAs, showed diagnostic usefulness similar to CSA, but it correlated better with conduction velocity, indicating demyelination or early-to-moderate nerve damage in CuTS.
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Affiliation(s)
- Jeong Hyun Lee
- Department of Orthopedic Surgery, Armed Forces Capital Hospital, Seongnam, South Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
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MacFadden LN, Adams LW, Boerhave C, O'Connor HA, VanDerWolde BK, Skelley NW. Mechanical Analysis of a Novel 3D-printed External Fixator Design Versus Industry-standard External Fixators. J Am Acad Orthop Surg 2024; 32:e331-e345. [PMID: 38417145 DOI: 10.5435/jaaos-d-23-00926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/25/2023] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION External fixation is a critical component of orthopaedic fracture management and is used for various conditions, including trauma and pediatric orthopaedics. However, the availability and high cost of external fixation devices are a concern, especially in rural and developing countries. 3D printing technology has shown promise in reducing manufacturing costs and improving accessibility to external fixation devices. The purpose of this study was to evaluate the mechanical properties of a fully 3D-printed desktop external fixation device and compare the results with the mechanical properties of commonly used, clinically available external fixators. METHODS A fully 3D printable external fixator was designed and printed in polylactic acid at two infill densities, 20% and 100%. The mechanical properties of the 3D-printed external fixators and several commercially available fixators were tested according to applicable sections of the American Society for Testing and Materials F1541 standard protocol in axial, medial-lateral, and anterior-posterior orientations. The primary outcomes measured included failure load, safe load, rigidity, and yield load. The mean differences between experimental and control groups were calculated using one-way analysis of variance and Tukey tests. RESULTS The 20% infill 3D-printed construct showed poor performance compared with commercially available external fixators in all testing conditions and across most variables. The 100% infill 3D-printed construct was comparable with or superior to all commercially available devices in most testing conditions. The cost for printing a single 3D-printed 100% infill external fixator was $14.49 (United States Dollar). DISCUSSION This study demonstrates that a low-cost desktop 3D printer can create an entirely 3D-printed external fixator that resists clinically relevant forces similar to medical-grade industry-standard external fixators. Therefore, there is potential for customizable and low-cost external fixators to be manufactured with desktop 3D printing for use in remote areas and other resource-constrained environments for fracture care.
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Affiliation(s)
- Lisa N MacFadden
- From the Sanford Orthopaedics and Sports Medicine, Sioux Falls, SD (Mr. Adams and Dr. Skelley), University of South Dakota Sanford School of Medicine, Sioux Falls, SD (Dr. MacFadden, Mr. O'Connor, Ms. VanDerWolde, and Dr. Skelley), University of South Dakota, Department of Biomedical Engineering, Sioux Falls, SD (Dr. MacFadden and Dr. Skelley), Viaflex, Sioux Falls, SD (Mr. Boerhave)
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Shah KN, Kamal RN. Bone Graft Substitutes-What Are My Options? Hand Clin 2024; 40:13-23. [PMID: 37979985 DOI: 10.1016/j.hcl.2023.09.001] [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] [Indexed: 11/20/2023]
Abstract
We examine the range of available bone graft substitutes often used in nonunion and malunion surgery of the upper extremity. Synthetic materials such as calcium sulfate, beta-calcium phosphate ceramics, hydroxyapatite, bioactive glass, and 3D printed materials are discussed. We delve into the advantages, disadvantages, and clinical applications for each, considering factors such as biocompatibility, osteoconductivity, mechanical strength, and resorption rates. This review provides upper extremity surgeons with insights into the available array of bone graft substitutes. We hope that the reviews helps in the decision-making process to achieve optimal outcomes when treating nonunion and malunion of the upper extremity.
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Affiliation(s)
- Kalpit N Shah
- Department of Orthopedic Surgery, Scripps Clinic, San Diego, CA, USA.
| | - Robin N Kamal
- Department of Orthopedic Surgery, Stanford University, Palo Alto, CA, USA
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Liang H, Zhang H, Chen B, Yang L, Xu R, Duan S, Cai Z. 3D printing technology combined with personalized plates for complex distal intra-articular fractures of the trimalleolar ankle. Sci Rep 2023; 13:22667. [PMID: 38114629 PMCID: PMC10730506 DOI: 10.1038/s41598-023-49515-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
This study investigated the effectiveness of 3D printing technology in combination with personalized custom-made steel plates in the treatment of complex distal intra-articular trimalleolar fractures, with the aim of providing a new approach to improve ankle joint function in patients. The 48 patients with complex distal intra-articular trimalleolar fractures included in the study were randomly divided into two groups: the personalized custom-made steel plate group (n = 24) and the conventional steel plate group (n = 24). A comparison was made between the two groups in terms of preoperative preparation time, hospitalization duration, surgical time, fracture reduction and internal fixation time, intraoperative fluoroscopy instances, surgical incision length, fracture healing time, follow-up duration, degree of fracture reduction, ankle joint functional recovery, and the occurrence of complications. The personalized steel plate group exhibited longer preoperative preparation time and hospitalization duration compared to the conventional steel plate group (p < 0.001). However, the personalized steel plate group demonstrated significantly shorter surgical duration, time for fracture reduction and internal fixation, reduced intraoperative fluoroscopy frequency, and a shorter overall surgical incision length (p < 0.001). Both groups displayed similar fracture healing times and follow-up durations (p > 0.05). The personalized steel plate group showed a higher rate of successful fracture reduction (87.5% vs. 79.2%, p > 0.05) and a lower incidence of complications (8.3% vs. 20.8%, p = 0.22), although these differences did not reach statistical significance. Furthermore, the personalized steel plate group exhibited superior ankle joint function scores during follow-up compared to the conventional steel plate group (p < 0.05). By utilizing 3D printing technology in conjunction with personalized custom-made steel plates, personalized treatment plans are provided for patients with complex comminuted tri-malleolar ankle fractures, enabling safer, more efficient, and satisfactory orthopedic surgeries.
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Affiliation(s)
- Hairui Liang
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - He Zhang
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Beibei Chen
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Lei Yang
- School of Pharmacy, Inner Mongolia Medical University, 5 Xinhua Street, Hohhot, 010107, Inner Mongolia Autonomous Region, China
| | - Rongda Xu
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Siyu Duan
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Zhencun Cai
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China.
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Zhang D, Garg R, Elhassan B. 3D-printing assisted clavicle osteotomy for scapulothoracic abnormal motion: a case report. JSES REVIEWS, REPORTS, AND TECHNIQUES 2023; 3:553-556. [PMID: 37928983 PMCID: PMC10624991 DOI: 10.1016/j.xrrt.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Dafang Zhang
- Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA
- Mass General Brigham Brachial Plexus and Peripheral Nerve Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Rohit Garg
- Mass General Brigham Brachial Plexus and Peripheral Nerve Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Bassem Elhassan
- Mass General Brigham Brachial Plexus and Peripheral Nerve Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
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Menozzi GC, Depaoli A, Ramella M, Alessandri G, Frizziero L, Liverani A, Rocca G, Trisolino G. Side-to-Side Flipping Wedge Osteotomy: Virtual Surgical Planning Suggested an Innovative One-Stage Procedure for Aligning Both Knees in "Windswept Deformity". J Pers Med 2023; 13:1538. [PMID: 38003853 PMCID: PMC10671880 DOI: 10.3390/jpm13111538] [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: 09/18/2023] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: The adoption of Virtual Surgical Planning (VSP) and 3D technologies is rapidly growing within the field of orthopedic surgery, opening the door to highly innovative and individually tailored surgical techniques. We present an innovative correction approach successfully used in a child affected by "windswept deformity" of the knees. (2) Methods: We report a case involving a child diagnosed with "windswept deformity" of the knees. This condition was successfully addressed through a one-stage bilateral osteotomy of the distal femur. Notably, the wedge removed from the valgus side was flipped and employed on the varus side to achieve the correction of both knees simultaneously. The surgical technique was entirely conceptualized, simulated, and planned in a virtual environment. Customized cutting guides and bony models were produced at an in-hospital 3D printing point of care and used during the operation. (3) Results: The surgery was carried out according to the VSP, resulting in favorable outcomes. We achieved good corrections of the angular deformity with an absolute difference from the planned correction of 2° on the right side and 1° on the left side. Moreover, this precision not only improved surgical outcomes but also reduced the procedure's duration and overall cost, highlighting the efficiency of our approach. (4) Conclusions: The integration of VSP and 3D printing into the surgical treatment of rare limb anomalies not only deepens our understanding of these deformities but also opens the door to the development of innovative, personalized, and adaptable approaches for addressing these unique conditions.
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Affiliation(s)
- Grazia Chiara Menozzi
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (A.D.); (M.R.); (G.R.)
| | - Alessandro Depaoli
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (A.D.); (M.R.); (G.R.)
| | - Marco Ramella
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (A.D.); (M.R.); (G.R.)
| | - Giulia Alessandri
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.A.); (L.F.); (A.L.)
| | - Leonardo Frizziero
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.A.); (L.F.); (A.L.)
| | - Alfredo Liverani
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.A.); (L.F.); (A.L.)
| | - Gino Rocca
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (A.D.); (M.R.); (G.R.)
| | - Giovanni Trisolino
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (A.D.); (M.R.); (G.R.)
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Urlings J, de Jong G, Maal T, Henssen D. Views on Augmented Reality, Virtual Reality, and 3D Printing in Modern Medicine and Education: A Qualitative Exploration of Expert Opinion. J Digit Imaging 2023; 36:1930-1939. [PMID: 37162654 PMCID: PMC10406734 DOI: 10.1007/s10278-023-00833-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/05/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023] Open
Abstract
Although an increased usage and development of 3D technologies is observed in healthcare over the last decades, full integration of these technologies remains challenging. The goal of this project is to qualitatively explore challenges, pearls, and pitfalls of AR/VR/3D printing applications usage in the medical field of a university medical center. Two rounds of face-to-face interviews were conducted using a semi-structured protocol. First an explorative round was held, interviewing medical specialists (8), PhD students (7), 3D technology specialists (5), and university teachers (3). In the second round, twenty employees in high executive functions of relevant departments were interviewed on seven statements that resulted from the first interviewing round. Data analysis was performed using direct content analyses. The first interviewing round resulted in challenges and opportunities in 3D technology usage that were grouped in 5 themes: aims of using AR/VR/3D printing (1), data acquisition (2), data management plans (3), software packages and segmentation tools (4), and output data and reaching end-user (5). The second interviewing round resulted in an overview of ideas and insights on centralization of knowledge, improving implementation of 3D technology in daily healthcare, reimbursement of 3D technologies, recommendations for further studies, and requirement of using certified software. An overview of challenges and opportunities of 3D technologies in healthcare was provided. Well-designed studies on clinical effectiveness, implementation and cost-effectiveness are warranted for further implementation into the clinical setting.
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Affiliation(s)
- Julie Urlings
- Department of Neurosurgery, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
- 3D Lab Radboudumc, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
- Department of Medical Imaging, Radboud University Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
| | - Guido de Jong
- 3D Lab Radboudumc, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Thomas Maal
- 3D Lab Radboudumc, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Dylan Henssen
- Department of Medical Imaging, Radboud University Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands
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Demehri S, Baffour FI, Klein JG, Ghotbi E, Ibad HA, Moradi K, Taguchi K, Fritz J, Carrino JA, Guermazi A, Fishman EK, Zbijewski WB. Musculoskeletal CT Imaging: State-of-the-Art Advancements and Future Directions. Radiology 2023; 308:e230344. [PMID: 37606571 PMCID: PMC10477515 DOI: 10.1148/radiol.230344] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 08/23/2023]
Abstract
CT is one of the most widely used modalities for musculoskeletal imaging. Recent advancements in the field include the introduction of four-dimensional CT, which captures a CT image during motion; cone-beam CT, which uses flat-panel detectors to capture the lower extremities in weight-bearing mode; and dual-energy CT, which operates at two different x-ray potentials to improve the contrast resolution to facilitate the assessment of tissue material compositions such as tophaceous gout deposits and bone marrow edema. Most recently, photon-counting CT (PCCT) has been introduced. PCCT is a technique that uses photon-counting detectors to produce an image with higher spatial and contrast resolution than conventional multidetector CT systems. In addition, postprocessing techniques such as three-dimensional printing and cinematic rendering have used CT data to improve the generation of both physical and digital anatomic models. Last, advancements in the application of artificial intelligence to CT imaging have enabled the automatic evaluation of musculoskeletal pathologies. In this review, the authors discuss the current state of the above CT technologies, their respective advantages and disadvantages, and their projected future directions for various musculoskeletal applications.
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Affiliation(s)
- Shadpour Demehri
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Francis I. Baffour
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Joshua G. Klein
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Elena Ghotbi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Hamza Ahmed Ibad
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Kamyar Moradi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Katsuyuki Taguchi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Jan Fritz
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - John A. Carrino
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Ali Guermazi
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Elliot K. Fishman
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
| | - Wojciech B. Zbijewski
- From the Russell H. Morgan Department of Radiology and Radiological
Science (S.D., J.G.K., E.G., H.A.I., K.M., K.T., E.K.F.) and Department of
Biomedical Engineering (W.B.Z.), Johns Hopkins University School of Medicine,
601 N Carolina St, Baltimore, MD 21287; Division of Musculoskeletal Imaging,
Department of Radiology, Mayo Clinic, Rochester, Minn (F.I.B.); Department of
Radiology, New York University Grossman School of Medicine, New York, NY (J.F.);
Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY
(J.A.C.); and Department of Radiology, Quantitative Imaging Center, Boston
University School of Medicine, Boston, Mass (A.G.)
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10
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O'Connor HA, Adams LW, MacFadden LN, Skelley NW. 3D Printed Orthopaedic External Fixation Devices: A Systematic Review. 3D Print Med 2023; 9:15. [PMID: 37284965 DOI: 10.1186/s41205-023-00180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/30/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND External fixators are complex, expensive orthopaedic devices used to stabilize high-energy and complex fractures of the extremities. Although the technology has advanced dramatically over the last several decades, the mechanical goals for fracture stabilization of these devices have remained unchanged. Three-dimensional (3D) printing technology has the potential to advance the practice and access to external fixation devices in orthopaedics. This publication aims to systematically review and synthesize the current literature on 3D printed external fixation devices for managing orthopaedic trauma fractures. METHODS The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols were followed for this manuscript with minor exceptions. PubMed, Embase, Cochrane Review, Google Scholar, and Scopus online databases were systematically searched. Two independent reviewers screened the search results based on predetermined inclusion and exclusion criteria related to 3D printing and external fixation of fractures. RESULTS Nine studies met the inclusion criteria. These included one mechanical testing study, two computational simulation studies, three feasibility studies, and three clinical case studies. Fixator designs and materials varied significantly between authors. Mechanical testing revealed similar strength to traditional metal external fixators. Across all clinical studies, five patients underwent definitive treatment with 3D printed external fixators. They all had satisfactory reduction and healing with no reported complications. CONCLUSIONS The current literature on this topic is heterogeneous, with highly variable external fixator designs and testing techniques. A small and limited number of studies in the scientific literature have analyzed the use of 3D printing in this area of orthopaedic surgery. 3D printed external fixation design advancements have yielded promising results in several small clinical case studies. However, additional studies on a larger scale with standardized testing and reporting techniques are needed.
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Affiliation(s)
- Hunter A O'Connor
- University of South Dakota Sanford School of Medicine, Sioux Falls, SD, 57104, USA
| | - Luke W Adams
- Sanford Orthopedics and Sports Medicine, 1210 W. 18th St, Sioux Falls, SD, 57104, USA
| | - Lisa N MacFadden
- University of South Dakota Sanford School of Medicine, Sioux Falls, SD, 57104, USA
| | - Nathan Wm Skelley
- University of South Dakota Sanford School of Medicine, Sioux Falls, SD, 57104, USA.
- Sanford Orthopedics and Sports Medicine, 1210 W. 18th St, Sioux Falls, SD, 57104, USA.
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11
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Gao H, Zhang F, Tang K, Luo X, Pu Z, Zhao J, Jiao Z, Yang W. Green Cleaning of 3D-Printed Polymeric Products by Micro-/Nano-Bubbles. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:nano13111804. [PMID: 37299707 DOI: 10.3390/nano13111804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
3D printing technology has been used to directly produce various actual products, ranging from engines and medicines to toys, especially due to its advantage in producing items of complicated, porous structures, which are inherently difficult to clean. Here, we apply micro-/nano-bubble technology to the removal of oil contaminants from 3D-printed polymeric products. Micro-/nano-bubbles show promise in the enhancement of cleaning performance with or without ultrasound, which is attributed to their large specific surface area enhancing the adhesion sites of contaminants, and their high Zeta potential which attracts contaminant particles. Additionally, bubbles produce tiny jets and shock waves at their rupture, driven by coupled ultrasound, which can remove sticky contaminants from 3D-printed products. As an effective, efficient, and environmentally friendly cleaning method, micro-/nano-bubbles can be used in a range of applications.
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Affiliation(s)
- Haoxiang Gao
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Fenghua Zhang
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Kangkang Tang
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Xianyu Luo
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Ziang Pu
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jiuzhou Zhao
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Zhiwei Jiao
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
| | - Weimin Yang
- College of Mechanical and Electrical Engineering, Beijing University of Chemical Technology, Beijing 100029, China
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12
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Sun J, Mu Y, Cui Y, Qu J, Lian F. Application of 3D-printed osteotomy guide plates in proximal femoral osteotomy for DDH in children: a retrospective study. J Orthop Surg Res 2023; 18:315. [PMID: 37095575 PMCID: PMC10124023 DOI: 10.1186/s13018-023-03801-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Patients with developmental dysplasia of the hip (DDH) have complex proximal femoral deformities, and orthopedic surgery lacks objectivity. Expectations for surgical outcomes are often not achieved, and postoperative problems are common. Using 3D-printed technology in orthopedics offers a novel approach to precise and individualized treatment in modern orthopedics. The aim of this study was to investigate the value of the application of 3D-printed osteotomy guide plates in femoral osteotomy. The clinical indices of femoral osteotomy in children with DDH using 3D-printed osteotomy guide plates were compared with those of traditional osteotomy. METHODS The clinical data of children with DDH who underwent open reduction and Salter pelvic osteotomy combined with femoral osteotomy from September 2010 to September 2020 were retrospectively collected and analyzed. Based on the inclusion and exclusion criteria, a total of 36 patients were included in the study: 16 in the guide plate group and 20 in the conventional group. Operation time (total), operation time (femoral side), X-ray fluoroscopy times (total), X-ray fluoroscopy times (femoral side) and intraoperative blood loss were analyzed and compared between the two groups. Comparison of treatment-related indicators such as postoperative neck-shaft angle, postoperative anteversion angle, hospitalization time, and hospitalization expenses is made between the two groups. The two groups of patients were evaluated at the last follow-up using the McKay clinical evaluation criteria. RESULTS Between the two groups, there were significant differences in operation time (total), operation time (femoral side), X-ray fluoroscopy times (total), X-ray fluoroscopy times (femoral side) and intraoperative blood loss (P < 0.05). The postoperative neck-shaft angle, postoperative anteversion angle, hospitalization time and hospitalization expenses did not differ significantly (P > 0.05). The MacKay clinical evaluation did not significantly differ at the most recent follow-up (P > 0.05). CONCLUSIONS Children with DDH undergoing proximal femoral osteotomy using 3D-printed osteotomy guide plates benefit from a simpler surgical procedure, shorter operative time, less bleeding and less radiation exposure during surgery. This technique is of great clinical value.
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Affiliation(s)
- Jian Sun
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yiyuan Street, Nangang District, Harbin City, 150001, Heilongjiang Province, China
| | - Yulei Mu
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yiyuan Street, Nangang District, Harbin City, 150001, Heilongjiang Province, China
| | - Yong Cui
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yiyuan Street, Nangang District, Harbin City, 150001, Heilongjiang Province, China
| | - Jing Qu
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yiyuan Street, Nangang District, Harbin City, 150001, Heilongjiang Province, China
| | - Feng Lian
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yiyuan Street, Nangang District, Harbin City, 150001, Heilongjiang Province, China.
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13
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Bachy M, Tadley M, Kozin SH, Trehan SK, Daluiski A, Zlotolow DA. Early Results of 3-Dimensional Planning and Customized Cutting Guides for the Treatment of Severe Madelung Defofrmity. J Hand Surg Am 2023:S0363-5023(22)00772-9. [PMID: 36774321 DOI: 10.1016/j.jhsa.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/01/2022] [Accepted: 12/14/2022] [Indexed: 02/13/2023]
Abstract
PURPOSE Surgical treatment of Madelung deformity can present challenges due to a need for multiplanar correction. Developing customized cutting guides for osteotomies may improve surgical outcomes by enhancing the surgeon's understanding and surgical correction. METHODS All patients who underwent forearm osteotomies for Madelung deformity using computed tomography planning with 3-dimensional-printed customized cutting guides were retrospectively reviewed (n = 8). Seven patients underwent a double osteotomy of the radius, and 1 underwent a single osteotomy. RESULTS Ulnar tilt was improved in all cases. Correction of deformity was significant on anteroposterior but not on lateral views. The mean preoperative and postoperative radial bow was measured in 2 planes, with an average preoperative bow of 32° (± 21°) on anteroposterior radiographs and 36° (± 17°) on lateral radiographs, and an average bow of 10° (± 6°) on anteroposterior radiographs and 7° (± 6°) on lateral films after surgery. The predicted radial bow was calculated to be 9.1° (± 8°). CONCLUSIONS Three-dimensional planning allows predictable deformity correction across multiple but not all parameters. Future studies comparing clinical and radiographic outcomes of guided versus nonguided osteotomies are required to justify the additional expense and preoperative planning efforts. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic V.
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Affiliation(s)
- Manon Bachy
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Pediatric Orthopaedic Surgery, Sorbonne University - APHP Trousseau Hospital, Paris, France.
| | - Madeline Tadley
- Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA
| | - Scott H Kozin
- Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA
| | - Samir K Trehan
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY
| | - Aaron Daluiski
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY
| | - Dan A Zlotolow
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA
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14
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Bodansky DMS, Sandow MJ, Volk I, Luria S, Verstreken F, Horwitz MD. Insights and trends review: the role of three-dimensional technology in upper extremity surgery. J Hand Surg Eur Vol 2023; 48:383-395. [PMID: 36748271 DOI: 10.1177/17531934221150498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The use of three-dimensional (3-D) technology in upper extremity surgery has the potential to revolutionize the way that hand and upper limb procedures are planned and performed. 3-D technology can assist in the diagnosis and treatment of conditions, allowing virtual preoperative planning and surgical templating. 3-D printing can allow the production of patient-specific jigs, instruments and implants, allowing surgeons to plan and perform complex procedures with greater precision and accuracy. Previously, cost has been a barrier to the use of 3-D technology, which is now falling rapidly. This review article will discuss the current status of 3-D technology and printing, including its applications, ethics and challenges in hand and upper limb surgery. We have provided case examples to outline how clinicians can incorporate 3-D technology in their clinical practice for congenital deformities, management of acute fracture and malunion and arthroplasty.
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Affiliation(s)
- David M S Bodansky
- Department of Plastic Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK
| | | | - Ido Volk
- Hadassah Medical Organisation, Jerusalem, Israel
| | - Shai Luria
- Hadassah Medical Organisation, Jerusalem, Israel
| | | | - Maxim D Horwitz
- Department of Plastic Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK
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15
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Sun Z, Yin M, Sun Y, Cheng M, Fang M, Huang W, Ma J, Yan W. Customized Multilevel 3D Printing Implant for Reconstructing Spine Tumor: A Retrospective Case Series Study in a Single Center. Orthop Surg 2022; 14:2016-2022. [PMID: 35894154 PMCID: PMC9483039 DOI: 10.1111/os.13357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022] Open
Abstract
Objective To investigate the clinical efficacy and safety of 3D printed artificial vertebral body for patients who underwent multilevel total en bloc spondylectomy (TES) and analyze whether it could reduce the incidence of implant subsidence. Methods This is a retrospective study. From January 2017 to May 2018, eight consecutive cases with spine tumor undergoing multilevel TES were analyzed. All patients underwent X‐ray and CT examinations to evaluate the stability of internal fixation during the postoperative follow‐up. Demographic, surgical details, clinical data, and perioperative complications was collected. Visual analog scale, Frankel score, and spinal instability neoplastic score (SINS) classification were also recorded. Results There were six cases of primary spinal tumor and two cases of metastatic spinal tumor. All patients achieved remarkable pain relief and improvement in neurological function. Five patients underwent operation through the posterior approach, one patient underwent operation through the anterior approach and the remaining two patients through a combined anterior and posterior approach. At the last follow‐up period, X‐rays showed that the 3D printed artificial vertebral body of all cases matched well, and the fixation was reliable. Hardware failure such as loosening, sinking, breaking, and displacement wasn't observed during the follow‐up period. Conclusion 3D printed customized artificial vertebral body can provide satisfying good clinical and radiological outcomes for patients who have undergone multilevel TES.
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Affiliation(s)
- Zhengwang Sun
- Department of Musculoskeletal Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Mengchen Yin
- Department of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yueli Sun
- Department of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mo Cheng
- Department of Musculoskeletal Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | | | - Wending Huang
- Department of Musculoskeletal Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Junming Ma
- Department of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wangjun Yan
- Department of Musculoskeletal Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
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16
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Wu W, Liu S, Wang L, Wu B, Zhao L, Jiang W, Dai K, Hao Y, Fu L, Ai S. Application of 3D printing individualized guide plates in percutaneous needle biopsy of acetabular tumors. Front Genet 2022; 13:955643. [PMID: 35957679 PMCID: PMC9358354 DOI: 10.3389/fgene.2022.955643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: The objective of the study was to investigate the effectiveness of applying the individualized guide plate which is based on digital image processing and 3D printing technology to percutaneous needle biopsy of periacetabular tumor. Methods: From July 2017 to August 2019, 11 patients (5 males and 6 females, aged 13–70 years, mean 42.3 years) with acetabular tumors diagnosed by needle biopsy in our hospital were enrolled in this retrospective study. Preoperative CT and MRI enhancement examination were performed routinely, and the DICOM data were collected and imported into Medraw Print software. According to the specific anatomical morphology of acetabula, this study adopted the reverse calculation and direct design to print the individualized puncture guide plate using 3D printing technology. The puncture point and sampling approaches were determined by the guide plate morphology and the “double guide-hole and slideable groove” design. First, we evaluated the fitness of the 3D guide plate to the local anatomical structure, its assisted-puncture accuracy was estimated by imaging examinations, and postoperative complications were recorded. The accuracy of the needle biopsy pathological result was estimated with reference to that of the tumor resection. Results: Our results showed that the 3D printing individualized guide plate matched the patients’ pelvic skin well, the puncture approach was consistent with the preoperative design, and no significant anatomical injuries including vascular and neural complications occurred after surgery. Nine patients’ (90%) biopsy results were consistent with their postoperative pathological results, and one patient gave up the tumor resection. Conclusion: Based on digital image processing and 3D printing technology, the individualized guide plate can be used to guide the needle biopsy of acetabular tumors which makes the operation simpler and more precise.
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Affiliation(s)
- Wen Wu
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, China
| | - Siyu Liu
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Wang
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, China
| | - Bing Wu
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lulu Zhao
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbo Jiang
- Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, China
| | - Kerong Dai
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, China
| | - Yongqiang Hao
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, China
| | - Lingjie Fu
- Department of Orthopaedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai, China
- *Correspondence: Lingjie Fu, ; Songtao Ai,
| | - Songtao Ai
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Lingjie Fu, ; Songtao Ai,
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17
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Mittwede PN. CORR Insights®: Are 3D-printed Models of Tibial Plateau Fractures a Useful Addition to Understanding Fractures for Junior Surgeons? Clin Orthop Relat Res 2022; 480:1178-1180. [PMID: 35254328 PMCID: PMC9263491 DOI: 10.1097/corr.0000000000002170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 02/18/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Peter N Mittwede
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Clinical applications and prospects of 3D printing guide templates in orthopaedics. J Orthop Translat 2022; 34:22-41. [PMID: 35615638 PMCID: PMC9117878 DOI: 10.1016/j.jot.2022.03.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 12/05/2022] Open
Abstract
Background With increasing requirements for medical effects, and huge differences among individuals, traditional surgical instruments are difficult to meet the patients' growing medical demands. 3D printing is increasingly mature, which connects to medical services critically as well. The patient specific surgical guide plate provides the condition for precision medicine in orthopaedics. Methods In this paper, a systematic review of the orthopedic guide template is presented, where the history of 3D-printing-guided technology, the process of guides, and basic clinical applications of orthopedic guide templates are described. Finally, the limitations of the template and possible future directions are discussed. Results The technology of 3D printing surgical templates is increasingly mature, standard, and intelligent. With the help of guide templates, the surgeon can easily determine the direction and depth of the screw path, and choose the angle and range of osteotomy, increasing the precision, safety, and reliability of the procedure in various types of surgeries. It simplifies the difficult surgical steps and accelerates the growth of young and mid-career physicians. But some problems such as cost, materials, and equipment limit its development. Conclusions In different fields of orthopedics, the use of guide templates can significantly improve surgical accuracy, shorten the surgical time, and reduce intraoperative bleeding and radiation. With the development of 3D printing, the guide template will be standardized and simplified from design to production and use. 3D printing guides will be further sublimated in the application of orthopedics and better serve the patients. The translational potential of this paper Precision, intelligence, and individuation are the future development direction of orthopedics. It is more and more popular as the price of printers falls and materials are developed. In addition, the technology of meta-universe, digital twin, and artificial intelligence have made revolutionary effects on template guides. We aim to summarize recent developments and applications of 3D printing guide templates for engineers and surgeons to develop more accurate and efficient templates.
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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.
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20
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Moriel-Garceso DJ, González-Quevedo D, García de Quevedo D, Tamimi I. Three-dimensional printed titanium pseudo-prosthesis for the treatment of a tumoral bone defect. JSES REVIEWS, REPORTS, AND TECHNIQUES 2022; 2:81-86. [PMID: 37588280 PMCID: PMC10426679 DOI: 10.1016/j.xrrt.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
| | - David González-Quevedo
- Department of Orthopaedic Surgery, Regional University Hospital of Malaga, Malaga, Spain
| | | | - Iskandar Tamimi
- Department of Orthopaedic Surgery, Regional University Hospital of Malaga, Malaga, Spain
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21
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Three-Dimensional Printing in Hand Surgery. J Hand Surg Am 2021; 46:1016-1022. [PMID: 34274209 DOI: 10.1016/j.jhsa.2021.05.028] [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: 01/21/2021] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 02/02/2023]
Abstract
The medical application of 3-dimensional printing technology has evolved in the last decade, with an increasing variety of uses in hand surgery. The ability for patient-specific design, rapid prototyping, and low cost of production of 3-dimensional printed materials has led to this rise in clinical applications, both for common procedures and complex reconstructions. Within hand surgery, 3-dimensional printing can be applied in several broad categories: to construct patient-specific models for preoperative planning, to design orthotics and prosthetics to meet specific patient demands, to create patient-specific aids for intraoperative use, to generate patient-specific hardware and prostheses for implantation, and for applications for trainee education.
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22
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Valdovino A, Ryan J, Gholami P, Bomar JD, Upasani VV. Proximal Femur Osteotomy Guided with Patient-Specific 3D Print Technology: A Case Report. JBJS Case Connect 2021; 11:01709767-202109000-00097. [PMID: 34449444 DOI: 10.2106/jbjs.cc.21.00392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We present a 17-month-old female infant with a left lower extremity infection. After treating the infection, she developed a pathologic femur fracture malunion with a complex femoral deformity. Three-dimensional (3D) patient-specific prints of her affected and unaffected femora were made, and a corrective osteotomy was templated on the prints. CONCLUSION By printing the contralateral proximal femur and templating the osteotomy and correction based on the native anatomy of the patient, we were able to simulate the 3D deformity correction and customize an implant to fit the patient's anatomy.
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Affiliation(s)
- Alan Valdovino
- University of California, San Diego Medical Center, San Diego, California
| | - Justin Ryan
- Rady Children's Hospital, San Diego, San Diego, California
| | - Parham Gholami
- Rady Children's Hospital, San Diego, San Diego, California
| | - James D Bomar
- Rady Children's Hospital, San Diego, San Diego, California
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23
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Applications of 3D Printing Technology in Orthopedic Treatment. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9892456. [PMID: 34423040 PMCID: PMC8378991 DOI: 10.1155/2021/9892456] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022]
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Liu PR, Lu L, Zhang JY, Huo TT, Liu SX, Ye ZW. Application of Artificial Intelligence in Medicine: An Overview. Curr Med Sci 2021; 41:1105-1115. [PMID: 34874486 PMCID: PMC8648557 DOI: 10.1007/s11596-021-2474-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023]
Abstract
Artificial intelligence (AI) is a new technical discipline that uses computer technology to research and develop the theory, method, technique, and application system for the simulation, extension, and expansion of human intelligence. With the assistance of new AI technology, the traditional medical environment has changed a lot. For example, a patient's diagnosis based on radiological, pathological, endoscopic, ultrasonographic, and biochemical examinations has been effectively promoted with a higher accuracy and a lower human workload. The medical treatments during the perioperative period, including the preoperative preparation, surgical period, and postoperative recovery period, have been significantly enhanced with better surgical effects. In addition, AI technology has also played a crucial role in medical drug production, medical management, and medical education, taking them into a new direction. The purpose of this review is to introduce the application of AI in medicine and to provide an outlook of future trends.
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Affiliation(s)
- Peng-ran Liu
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Lin Lu
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Jia-yao Zhang
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Tong-tong Huo
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Song-xiang Liu
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Zhe-wei Ye
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
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Persad U, Mencia M. The value of 3D Printing in Orthopaedics. CARIBBEAN MEDICAL JOURNAL 2020. [DOI: 10.48107/cmj.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Umesh Persad
- Mechanical Engineering, Manufacturing, and Entrepreneurship Unit, The University of Trinidad and Tobago, Brechin Castle, Couva, Trinidad and Tobago, West Indies
| | - Marlon Mencia
- Department of Clinical Surgical Sciences, School of Medicine, The University of The West Indies, St. Augustine, Trinidad and Tobago, West Indies
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