3D Printing in Orthopedics: Advantages, Applications and Success Stories

Navigation

3D printing is a precision medical technology with a very low threshold
Levels of clinical application of 3D printing orthopedics
The unique advantages of 3D printing in the clinical application of orthopedics
Case Sharing
Current Situation for 3D Printing Application in Orthopedic
Conclusion

As one of the representative technologies of the third industrial revolution, 3D printing technology is becoming a high-speed engine to promote the advancement of orthopedics. As the most widely used subject of 3D printing in the medical field, the clinical application of 3D printing in orthopedics is developing rapidly, greatly enhancing the precision treatment of orthopedics.

This article will introduce several cases of incorporating 3D printing technology in orthopedics, and expound thoughts and opinions on the significance of the clinical application of 3D printing in orthopedics, the unique advantages of this technology, the main existing problems, and coping strategies.

3D printing is a precision medical technology with a very low threshold

The basis for the clinical application of 3D printing is to obtain data that can be used for the modeling of injured and diseased parts. At present, the simplest and most accurate data available for modeling is the data of hard tissue parts collected by CT. Meanwhile, orthopedics is the field with the simplest medical 3D data collection and modeling, the earliest and most common clinical application, and the most available parts and forms. The application scope of 3D printing technology in orthopedics currently covers trauma orthopedics, spine surgery, joint surgery, bone oncology, orthopedic surgery, pediatric orthopedics, foot and ankle surgery, hand surgery, repair and reconstruction, sports medicine, etc.

The application threshold of orthopedic 3D printing technology is very low. As the most commonly used equipment for orthopedic 3D printing data collection, CT equipment in China has been popularized in secondary hospitals, and even many primary hospitals have CT equipment, which creates a good prerequisite for the popularization and application of 3D printing. As long as they can correctly collect and provide patients’ CT scan data and application demands, even without 3D printing technology and equipment, preliminary hospitals still can apply 3D printing technology.

Levels of clinical application of 3D printing orthopedics

The clinical application of orthopedic 3D printing can be divided into four levels. Just like a pyramid, the first level is the printed model for preoperative planning and rehearsal; the second level is the printed guide plate for assisting precise surgery; the third level is the printed prosthesis and implants for reconstruction; and the fourth level is bio-printing, which is used to reconstruct the anatomical structure and biological function of tissues and organs. Although bio-printing is still in the initial stage of research, and only some simple attempts such as artificial bone and artificial cartilage have been tried clinically, the application prospects are the most valuable and can best reflect the technical advantages of 3D printing.

The unique advantages of 3D printing in the clinical application of orthopedics

1) Break through the limitations of product manufacturing

3D printing is not only particularly suitable for fast and cheap personalized customization but also the only technology that can realize controllable and lightweight manufacturing of porous structures. Porous surfaces are the best way to achieve permanent bio-fixation of prostheses.

The bone ingrowth effect of the prosthesis makes the bonding strength between the prosthesis and the host bone significantly better than the bone growth strength of the traditional subtractive prosthesis on the rough surface.

2) Innovate in orthopedic surgery

Orthopedic surgery often requires drilling and osteotomy. These operations are the key to surgery. 3D printing can effectively improve the quality and efficiency of drilling and osteotomy and reduce the risk. Although the current surgical navigator and the surgical robot can also realize the precise guidance of drilling and osteotomy, they will be useless for some operations with complex osteotomy shapes. This situation is precisely the advantage of the surgical guide plate. As long as the guiding surface of the guide plate is constructed according to the irregular osteotomy surface before the operation, preoperative osteotomy planning can be easily, quickly, and accurately realized during the operation.

The 3D printed guide plate can also accurately and conveniently assist the minimally invasive reduction and fixation of fractures, and the precise osteotomy and corrective alignment of deformed osteotomy orthopedic surgery.

For the special joint replacement surgery with complex shape and structure of the lesion, which was helpless in the past, through the combined application of 3D printing osteotomy, drilling, installation, and other series of guide plates, it can achieve just right and precise replacement.

1) Total hip arthroplasty for severe osteoporosis of the proximal femur

For patients with severe proximal femoral osteoporosis who need artificial hip replacement due to severe pain and severe mobility impairment, the bio-fixed femoral stem has subsidence and rotational instability, and cannot obtain immediate stability; It is unavoidable that the interface between the cement and the bone marrow cavity will loosen and fail in the medium and long term. The author designed and 3D printed a structure that fits the shape and the surface is porous, which can not only achieve instant stability, but also facilitate bone ingrowth and integration. According to the principle of biomechanics, the individualized stress-free joint and serial osteotomy, drilling, and surgical guide plate installation for permanent biological fixation can be obtained, and the artificial hip joint replacement operation was successfully performed for this patient. After two years of follow-up, the patient’s pain was relieved, activity function was significantly improved, and the prosthesis did not loosen.

2) Comminuted fracture of tibia plateau fixation

Comminuted fracture and collapse of the tibia plateau usually require a large incision under direct vision reduction and fixed with a large plate, resulting in greater damage, more damage to blood flow, and an increased chance of infection. By using 3D printing technology, instead of conventional open reduction plate internal fixation, the author designed the percutaneous 3D printing guide plate, accurately established the balloon reduction and bone grafting channel for the collapsed lateral tibia plateau, and planned and accurately established the fixation channel for all screws. With only 5 incisions about half a centimeter long, bone removal, reduction, bone grafting, and 3 screws were quickly and well completed, laying the foundation for a rapid and complete recovery of the knee.

More Cases: History and Application of Kirschner Wire in Orthopedic Surgery.

Current Situation for 3D Printing Application in Orthopedic

As 3D printing technology is a new high technology, clinical orthopedic doctors have little understanding at present. And while many doctors have learned to 3D print in recent years, most of them can only do Level 1 work, or they can do Level 2 work on a step-by-step basis with similar shapes and structures, such as pedicle nail guides. Because the innovative design and application of orthopedic clinical depend on experts with rich clinical experience, it is necessary to consider factors such as surgical incision, approach, visual field, operating space, peripheral vascular nerve and temporary fixation obstacles, and so on. It is not as simple as bare-bone design. As doctors are one of the professions with the longest growth process, it is difficult for young doctors to be qualified for the design of an innovation guide alone for a while.

imited by the training system of medical students in China, most orthopedic experts with rich clinical experience do not know engineering and lack computer operation skills, so they are unable to carry out innovative design and application of guide boards. In addition, today’s orthopedic specialists have a heavy workload that makes it difficult for them to find time to work closely with young people. Therefore, the popularity of orthopedic 3D printing in China is not high at present, and most of the units that have carried out applications only make use of relatively simple functions of 3D printing.

Conclusion

3D printing technology is rapidly advancing orthopedics, offering precise treatment options. It provides low-threshold accessibility, personalized customization, and improved surgical guidance. The case studies demonstrate successful applications, while challenges remain in expertise and widespread adoption. Continued research and collaboration will drive its integration, benefiting patients and advancing the field.