Also known as additive manufacturing, 3D printing has reinvented the way various medical pathologies are addressed. By constructing objects layer by layer, this technology not only allows for flexible design but also enables efficient production of medical products that can be personalized to cater to individual patient needs. In orthopedic surgery, 3D printing provides solutions to challenges that were previously hard to manage with conventional subtractive manufacturing methods.
Conventional subtractive manufacturing, which typically involves cutting and shaping materials from a solid block, has been the hallmark of medical device production for years. While this method is well-established, it often results in limitations and difficulties when creating highly customized and intricate orthopedic implants and instrumentation.
3D printing has the potential to offer a precise fit for implants when compared to traditional manufacturing methods. This precision facilitates osseointegration into the remaining bone, creating a stable and long-lasting construct. Moreover, it significantly reduces surgical time. In contrast, traditional manufacturing often results in off-the-shelf products with limited adaptability, making it challenging to achieve such precise fits.
The ability to reconstruct bone defects is a primary advantage of 3D printing. By using 3D reconstructed imaging, manufacturing companies can create jigs to guide surgeons in making precise bone cuts that would have otherwise relied on estimation. Conventional manufacturing methods lack the degree of precision and customization that 3D printing offers, making it more challenging to achieve these critical cuts with confidence.
Whereas the conventional manufacturing methods typically involve standardized implants, 3D printing can create custom implants, tailored to the patient’s unique anatomy, that can also help preserve joints when dealing with malignant bone tumors near the joint. Preoperative planning software, in combination with 3D printing, allows for the execution of plans that conserve the joint without sacrificing the required tumor margin. This approach not only ensures the preservation of a functional joint but also restores normal biomechanics to the affected extremity.
In the preoperative phase, 3D printing offers surgeons a significant advantage by enabling them to create patient-specific resection guides and implants. This preoperative planning process allows for the identification of critical structures that can be spared during surgery, minimizing the impact on the patient while ensuring the safe removal of the tumor.
Despite its numerous benefits, the use of 3D printing in orthopedic surgery does come with its share of challenges. One of the significant concerns is the lead time between ordering a 3D-printed tool and its delivery to the clinician. This delay can be problematic, particularly in oncology cases where the tumor is dynamic. In-house 3D printing has been proposed as a solution to reduce lead times, ensuring that the tumor does not progress during the waiting period.
Cost is another critical issue associated with the use of 3D printing in orthopedic oncology. The design work involving engineers, computer experts, and mechanical experts, along with the machinery required for the process, adds to the overall expenses. Traditional manufacturing, while potentially cost-effective, may not offer the same level of customization and precision that 3D printing provides.
While concerns persist, doctors remain hopeful about the future of 3D printing in orthopedic surgery. 3D printing offers tailored solutions for complex cases. While challenges such as lead times and cost exist, the continuous evolution of 3D printing technology holds the promise of transforming orthopedic surgery, ultimately benefiting patients facing complex musculoskeletal issues.
References:
Three-dimensional Printing in Orthopaedic Surgery: Current Applications and Future Developments
Surgeons push barriers with 3D printing for bone tumors
Do surgeons need to utilize 3D printing in orthopedic oncology?
