3D Printing in Bone Surgery

Filling a gap in the literature, this is the first book to comprehensively discuss 3D printing applied to bone surgery. It provides both the scientific basics and practical applications, with a special focus on 3D-printed, custom-made titanium prostheses (3DPCMP) used for bone reconstruction following tumor resection. Initially applied to pelvic and scapular prostheses – because of their of highly complex anatomy – this technology is increasingly being adopted in other fields of orthopedics, such as limb surgery, traumatology and degenerative diseases. Throughout the book, experts from various fields share their knowledge, describing 3D printing applied to the reconstruction of different bone segments, reviewing each application and comparing it with traditional reconstruction. They also present real-world case studies from their clinical practice. Uniquely responding to the growing interest surrounding 3D printing for bone reconstruction, this book is invaluable for orthopedic, neuro- , head and neck as well as maxillofacial surgeons wishing to gain insights into this new and promising field. Foreword Preface Contents 1: Indications: Didactical Use of 3D Printing, Surgical Didactical Use, Surgical Planning, Patient Information, Custom-Made Prosthesis, Spacer and Template, External Prosthesis, Cast 1.1 3D Model Development 1.2 Didactical Use and Patient Information 1.3 Surgical Planning 1.4 Custom-Made Prosthesis 1.5 Conclusions References 2: The Rationale of 3D Printing in Oncological Orthopaedics 2.1 Introduction 2.1.1 3D Models 2.1.2 Guiding JIGS 2.1.3 3D Prostheses 2.1.3.1 Evolution of Reconstruction Concept and Technology 2.2 Intercalary 3D Prosthesis 2.3 3D Scaffolds 2.4 Conclusion References 3: The 3D Printing Production Procedure 3.1 Introduction 3.2 From Diagnostic Imaging to the Anatomical Model 3.3 3D Printing Technology Used in Orthopedics 3.3.1 Stereolithography 3.3.2 Selective Laser Sintering 3.3.3 Electron Beam Melting 3.3.4 Selective Laser Melting 3.3.5 Fused Deposition Modeling 3.4 Materials Used to Print Surgical Devices and Implants 3.5 Finishing and Cleaning of the 3D Printed Piece 3.6 Sterilization Methods Available for 3D Printing Materials 3.6.1 Steam Autoclave 3.6.2 Ehylene Oxide Gas 3.6.3 Hydrogen Peroxide Gas Plasma 3.6.4 Gamma Radiation 3.7 Conclusion References 4: The Engineer’s Point of View 4.1 Introduction 4.2 3D Technologies and Medical Application 4.3 Production Flow of a Custom-Made Medical Device 4.3.1 Image Acquisition 4.3.2 Planning & Design 4.3.2.1 Anatomic Models for Surgical Planning 4.3.2.2 Blood Vessels Visualization 4.3.2.3 Anatomical Cutting Guides 4.3.2.4 Design of Patient-Specific Implant and Instruments 4.4 Intraoperative Execution 4.5 Advantages of 3D-Printed Custom Implants 4.6 Limitations and Potential Future Development References 5: 3D Pelvis/Hip Prosthesis 5.1 Introduction 5.2 How to Create a Medical 3D-Printed Implant for Pelvic Reconstructions 5.2.1 Step 1: Ideation 5.2.2 Step 2: Image Acquisition 5.2.3 Step 3: Multidisciplinary Work on 3D Virtual Model 5.2.4 Step 4: Printing 5.3 Patient-Specific Tools and Guides 5.4 3D-Printed Prostheses in Pelvic Reconstructions: Revision Surgery 5.5 3D-Printed Prostheses in Pelvic Reconstructions: Tumors 5.6 Conclusions References 6: Custom Reconstruction Around the Knee 6.1 Introduction 6.1.1 Image Processing 6.1.2 PSIs (Guides) 6.1.3 Tools 6.1.4 Implants 6.1.5 Surgery 6.2 Material and Methods 6.3 Results 6.4 Discussion 6.5 Conclusions References 7: When the Bone Is Not Enough: The Role of Custom-Made Implants in Cup Revision Surgery 7.1 Acetabular Bone Defects Classifications and Possible Solution 7.1.1 Severe Acetabular Bone Defect 7.1.2 Pelvic Discontinuity 7.1.3 Bone Defect Extended Beyond the Acetabulum 7.2 PreOperative Evaluation 7.3 Design and Construction of the Model 7.4 Surgery 7.5 PostOperative Rehabilitation Program 7.6 PostOperative Evaluation 7.7 Clinical Experience and Failures References 8: 3D Scapula/Shoulder Prosthesis 8.1 Introduction 8.2 3D-Printed Titanium Custom-Made Prosthesis 8.3 Conclusion References 9: 3D Vertebral Prosthesis 9.1 Introduction 9.2 3D-Printing in Spine: Review 9.3 En Bloc Resection 9.4 Anterior Column Reconstruction: Goals and Options 9.4.1 Biological Options (Bone Grafts) 9.4.2 Prosthetic Options 9.5 Preoperative Planning and Implant Design 9.6 3D-Printed Reconstruction After Surgery for Spinal Tumors 9.6.1 3D-Printed Vertebral Prosthesis: Pros 9.6.2 3D-Printed Vertebral Prosthesis: Cons References 10: 3D Skull Prosthesis 10.1 Introduction 10.2 Types of Cranial Prosthesis (Standard Pre-Curved and Custom-Made). 3D Technology 10.3 Indications for Use 10.4 Surgical Procedures 10.5 Comparison Between Custom-Made 3D-Printed Prostheses and Standard Pre-Curved Prostheses 10.6 Single Step Surgery (Resection–Reconstruction) 10.7 Conclusions References 11: 3D Facial Prosthesis 11.1 Introduction 11.2 Upper Third: Naso-Fronto-Orbital Region 11.3 Middle Third: Maxillary Region 11.4 Lower Third: Mandibular Region 11.5 Maxillo-Mandibular Complex: Orthognathic Surgery References 12: 3D Carpal (Hand) Prosthesis 12.1 Introduction 12.2 Indications 12.3 Review of Literature 12.4 Discussion References 13: 3D Tarsal (Foot) Prosthesis 13.1 Introduction 13.2 Indications and Contraindications 13.3 3D Printed Custom Cages 13.4 Total Talar Prosthesis 13.5 Total Calcaneus Prosthesis 13.6 Conclusions References 14: The Composite Custom-Made Prosthesis 14.1 Introduction 14.2 The Composite Custom-Made Prosthesis 14.3 Exemplificative Case 14.4 Discussion References 15: 3D-Printed Custom-Made Instruments 15.1 3D-Printed Custom-Made Instrumentations 15.2 Clinical Applications References 16: Future Developments of 3D Printing in Bone Surgery 16.1 Technical Innovations: New 3D Printers and Materials 16.2 Surgical Applications: Optimization of Constructs 16.3 Bioprinting: 3DP in Regenerative Medicine and Drug Delivery Systems 16.4 Considerations on 4D Printing 16.5 3D Graphy Banking: To Go Over the Patient’s Specific Bio-Modeling 16.6 Conclusions References