THREE-DIMENSIONAL PRINTING IN ORTHOPEDICS: WHERE WE STAND AND WHERE WE ARE HEADING

Three-dimensional printing is a technology in expansion in the medical field. It also presents many applications in orthopedics. Our review article aims to describe 3D printing, types of 3D printers, and its use in the orthopedic field. 3D models can be created using tomography scans. Those models can then be manipulated, even simulating surgeries. It is possible to print biomodels, which will help us understand deformities and plan surgeries. Orthopedic surgeons must be updated in these disruptive technologies that may help their daily practice. Level of Evidence V, Expert opinion.

Keywords:
Orthopedics; Printing; Three-Dimensional; Models; Anatomic

Authorship

LEANDRO EJNISMAN

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil.

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.Hospital Israelita Albert EinsteinBrazilSão Paulo, SP, BrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.

https://orcid.org/0000-0002-9866-1960

CAMILO PARTEZANI HELITO

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Institute of Orthopedics and Traumatology, Knee Group, São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Institute of Orthopedics and Traumatology, Knee Group, São Paulo, SP, Brazil.

Hospital Sírio Libanês, São Paulo, SP, Brazil.Hospital Sírio LibanêsBrazilSão Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, Brazil.

https://orcid.org/0000-0003-1139-2524

ANDRÉ FERRARI DE FRANÇA CAMARGO

Hospital Sírio Libanês, São Paulo, SP, Brazil.Hospital Sírio LibanêsBrazilSão Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, Brazil.

Hospital Santa Paula, São Paulo, SP, Brazil.Hospital Santa PaulaBrazilSão Paulo, SP, BrazilHospital Santa Paula, São Paulo, SP, Brazil.

https://orcid.org/0000-0003-0317-3807

BRUNO ARAGÃO ROCHA

Hospital Sírio Libanês, São Paulo, SP, Brazil.Hospital Sírio LibanêsBrazilSão Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, Brazil.

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Institute of Radiology, São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Institute of Radiology, São Paulo, SP, Brazil.

Grupo Fleury, São Paulo, SP, Brazil.Grupo FleuryBrazilSão Paulo, SP, BrazilGrupo Fleury, São Paulo, SP, Brazil.

https://orcid.org/0000-0001-5288-8150

ANDRÉ MATHIAS BAPTISTA

https://orcid.org/0000-0002-0830-4602

OLAVO PIRES DE CAMARGO

https://orcid.org/0000-0002-1128-7292

Correspondence:
Leandro Ejnisman. Rua Dr. Ovídio Pires de Campos, 333, Cerqueira César, São Paulo, SP, Brazil, 05403010. leandro.ejnisman@gmail.com

All authors declare no potential conflict of interest related to this article.

AUTHORS’ CONTRIBUTIONS:

Each author contributed individually and significantly to the development of this article. LE: study conception, writing and critical review; CPH: study conception, writing and critical review; AFFC: study conception, writing and critical review; BAR: study conception, writing and critical review; AMB:study conception, writing and critical review; OPC: study conception, final approval of the manuscript.

SCIMAGO INSTITUTIONS RANKINGS

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.Hospital Israelita Albert EinsteinBrazilSão Paulo, SP, BrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Hospital Sírio Libanês, São Paulo, SP, Brazil.Hospital Sírio LibanêsBrazilSão Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, Brazil.

Hospital Santa Paula, São Paulo, SP, Brazil.Hospital Santa PaulaBrazilSão Paulo, SP, BrazilHospital Santa Paula, São Paulo, SP, Brazil.

Grupo Fleury, São Paulo, SP, Brazil.Grupo FleuryBrazilSão Paulo, SP, BrazilGrupo Fleury, São Paulo, SP, Brazil.

Figures

Figures (4)

Thumbnail

Figure 1
Schema demonstrating the steps for creating a 3D Biomodel.

Thumbnail

Figure 2
Example of segmentation performed in the 3D Slicer®. The patient’s pelvis is selected in green, the region of interest is selected in red.

Thumbnail

Figure 3
Example of using 3D printing for surgical planning in a patient of very short stature (1.38m). A) Anteroposterior knee radiography showing advanced osteoarthrosis of the knee; B) 3D model developed from computed tomography; C) Biomodel printed from the model of Figure 2B, in which a total knee arthroplasty was performed; D) Postoperative radiography demonstrating a result similar to the biomodel.

Thumbnail

Figure 4
Stages of making a customized implant. A) Creation of a 3D model of the affected area and planning of osteotomy cuts using CAD; B) With the bone defect created virtually, the implant can be designed and a test model is printed; C) Intraoperative aspect of the guide used to perform iliac osteotomy; D) Final tomographic result.

Figure 1 Schema demonstrating the steps for creating a 3D Biomodel.

Figure 2 Example of segmentation performed in the 3D Slicer®. The patient’s pelvis is selected in green, the region of interest is selected in red.

Figure 3 Example of using 3D printing for surgical planning in a patient of very short stature (1.38m). A) Anteroposterior knee radiography showing advanced osteoarthrosis of the knee; B) 3D model developed from computed tomography; C) Biomodel printed from the model of Figure 2B, in which a total knee arthroplasty was performed; D) Postoperative radiography demonstrating a result similar to the biomodel.

Figure 4 Stages of making a customized implant. A) Creation of a 3D model of the affected area and planning of osteotomy cuts using CAD; B) With the bone defect created virtually, the implant can be designed and a test model is printed; C) Intraoperative aspect of the guide used to perform iliac osteotomy; D) Final tomographic result.

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THREE-DIMENSIONAL PRINTING IN ORTHOPEDICS: WHERE WE STAND AND WHERE WE ARE HEADING

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[1] Correspondence:
Leandro Ejnisman. Rua Dr. Ovídio Pires de Campos, 333, Cerqueira César, São Paulo, SP, Brazil, 05403010. leandro.ejnisman@gmail.com