Clinical applications of custom 3D printed implants in complex lower extremity reconstruction
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CASE STUDY
Open Access
Clinical applications of custom 3D printed implants in complex lower extremity reconstruction Rishin J. Kadakia* , Colleen M. Wixted, Nicholas B. Allen, Andrew E. Hanselman and Samuel B. Adams
Abstract Background: Three dimensional printing has greatly advanced over the past decade and has made an impact in several industries. Within the field of orthopaedic surgery, this technology has vastly improved education and advanced patient care by providing innovating tools to complex clinical problems. Anatomic models are frequently used for physician education and preoperative planning, and custom instrumentation can assist in complex surgical cases. Foot and ankle reconstruction is often complicated by multiplanar deformity and bone loss. 3D printing technology offers solutions to these complex cases with customized implants that conform to anatomy and patient specific instrumentation that enables precise deformity correction. Case presentation: The authors present four cases of complex lower extremity reconstruction involving segmental bone loss and deformity – failed total ankle arthroplasty, talus avascular necrosis, ballistic trauma, and nonunion of a tibial osteotomy. Traditional operative management is challenging in these cases and there are high complication rates. Each case presents a unique clinical scenario for which 3D printing technology allows for innovative solutions. Conclusions: 3D printing is becoming more widespread within orthopaedic surgery. This technology provides surgeons with tools to better tackle some of the more challenging clinical cases especially within the field of foot and ankle surgery. Keywords: Implants, Foot and ankle, Orthopaedic surgery, Surgery, Instrumentation
Introduction The use of 3D printing has revolutionized the manufacturing process across various industries and enabled the creation of precise customized products. The origin of this technology can be traced back to 1984 when Charles Hull filed a patent for the stereolithography fabrication system and eventually began selling 3D printers for commercial use in 1988 [1, 2]. This technology has drastically changed over the years and is currently being employed in almost every major manufacturing sector. Three dimensional printing technology has recently been * Correspondence: [email protected] Department of Orthopaedic Surgery, Duke University, 4709 Creekstone Drive, Suite 300, Durham, NC 27703, USA
more utilized in medicine and specifically in the field of orthopaedic surgery. Within orthopaedic surgery, 3D printing has allowed for the development of anatomical models that can be used for preoperative planning and education and more revolutionary, the development of patient specific instruments and implants that can be used intraoperatively. This technology can be helpful in cases of complex lower extremity reconstruction as deformity and bony defects can be challenging to manage. The ability to customize surgical instruments and implants to match the complex three dimensional deformity that is
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