3D printing in experimental orthopaedic surgery: do it yourself
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ORIGINAL ARTICLE • BIOMATERIAL - EXPERIMENTAL SURGERY
3D printing in experimental orthopaedic surgery: do it yourself Irene I. López‑Torres1 · Pablo Sanz‑Ruíz1,2 · Victor E. León‑Román3 · Federico Navarro‑García4 · Rodrigo Priego‑Sánchez1 · Javier Vaquero‑Martín1,2 Received: 12 December 2018 / Accepted: 5 March 2019 © Springer-Verlag France SAS, part of Springer Nature 2019
Abstract Introduction Periprosthetic infection is considered an increasing incidence pathology whose therapeutic strategies can be defined as unsatisfactory. Currently, animal models are employed to study its physiopathology and strategic therapies, but non-species-specific materials are implanted as foreign bodies. The use of these implants implies intrinsic instability, which hinders the development of a biofilm on their surfaces and complicates the post-operative recovery of the animal. The objective of the present study is the design of a species-specific implant for the New Zealand white (NZW) rabbit by means of 3D printing. Materials and methods A CT scan of the knee of a NZW rabbit was performed, and the tibial surface was reconstructed in order to fabricate a species-specific tibial plateau using H oros® and Autodesk® Meshmixer™ software. This implant was inserted in fifteen NZW rabbits, and the assessment of its stability was based on the position of the limb at rest and the animal weight-bearing capacity. Biofilm formation on the surface was demonstrated by crystal violet staining. Results A 1.81 cm × 1 cm × 1.24 cm stainless steel implant was designed. It consisted of a 4-mm-thick tibial plate with a rough surface and an eccentric metaphyseal anchoring. All of the animals exhibited hyperflexion of the operated limb immediately post-operative, and 100% could apply full weight bearing from day 5 after surgery. Conclusions The species-specific design of implants in experimental surgery encourages rapid recovery of the animal and the development of a biofilm on their surfaces, making them ideal for the study of the physiopathology and for establishing possible therapeutic targets for prosthetic infection. Keywords Periprosthetic joint infection · Animal model · Implant · 3D printing
Introduction Infection following arthroplasty in orthopaedic surgery is a devastating complication whose presence can result in a significant functional loss of the affected limb and in a considerable risk of systemic complications. The increase in life expectancy of the population and the rising functional * Irene I. López‑Torres [email protected] 1
Gregorio Marañón General Hospital, C/Doctor Esquerdo 46, Madrid, Spain
2
Surgery Department, Faculty of Medicine, Complutense University, Madrid, Spain
3
General Hospital of Villalba, Collado Villalba, Madrid, Spain
4
Department of microbiology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
demands of young patients make periprosthetic infection (PJI) a growing pathology [1–3]. The treatment of PJI is based on systemic antibiotic therapy combined with
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