Role of the orthopaedic surgeon in 3D printing: current applications and legal issues for a personalized medicine

Role of 3D printing in healthcare: A comprehensive review on treatment and training

Additive manufacturing (AM) is revolutionizing healthcare by enabling the creation of customized 3D printed (3DP) medical equipment, implants, orthoses, prosthetics, drugs, and organs. With the availability of different types of materials suitable for 3DP and healthcare applications, this technology allows for the precise fabrication of patient-oriented prosthetics, dental implants, and orthopedic devices, significantly improving fit and functionality. Additionally, 3DP drugs, such as Oral Dispersible Formulations (ODFs) and polypills, are surpassing the traditional "one pill fits all" concept, offering more tailored medication solutions. This innovation also supports the development of personalized medications and bioprinted tissues, opening the way for advancements in regenerative medications and tailored therapies. 3D-bioprinted organs are addressing the growing demand for organ transplants. In surgical planning, 3D-printed anatomical models provide students and professionals with hands-on practice, which is crucial for skill development and understanding complex anatomies. Surgeons can also practice and refine techniques before actual procedures, enhancing precision and improving outcomes during real operations. This paper focus on highlighting the progression and motivations behind the cross-disciplinary applications of AM within the healthcare sector providing customized medical devices, drug delivery systems and diagnostic tools for personalized treatment and skill refinement. This paper is designed for a broad audience, including manufacturing professionals and researchers, who are interested in exploring the medical implications of this transformative technology.

A pilot study on preferences from surgeons to deal with an innovative customized and connected knee prosthesis - A discret choice experiment

Background

To address the increasing global demand for Total Knee Arthroplasty and reduce the need for revisions, several technologies combining 3D planning and artificial intelligence have emerged. These innovations aim to enhance customization, improve component positioning accuracy and precision. The integration of these advancements paves the way for the development of personalized and connected knee implant.

Questions/purposes

These groundbreaking advancements may necessitate changes in surgical practices. Hence, it is important to comprehend surgeons' intentions in integrating these technologies into their routine procedures. Our study aims to assess how surgeons' preferences will affect the acceptability of using this new implant and associated technologies within the entire care chain.

Methods

We employed a Discrete Choice Experiment, a predictive technique mirroring real-world healthcare decisions, to assess surgeons' trade-off evaluations and preferences.

Results

A total of 90 experienced surgeons, performing a significant number of procedures annually (mostly over 51) answered. Analysis indicates an affinity for technology but limited interest in integrating digital advancements like preoperative software and robotics. However, they are receptive to practice improvements and considering the adoption of future sensors.

Conclusions

In conclusion, surgeons prefer customized prostheses via augmented reality, accepting extra cost. Embedded sensor technology is deemed premature by them.

Additive Manufacturing Strategies for Personalized Drug Delivery Systems and Medical Devices: Fused Filament Fabrication and Semi Solid Extrusion

Novel additive manufacturing (AM) techniques and particularly 3D printing (3DP) have achieved a decade of success in pharmaceutical and biomedical fields. Highly innovative personalized therapeutical solutions may be designed and manufactured through a layer-by-layer approach starting from a digital model realized according to the needs of a specific patient or a patient group. The combination of patient-tailored drug dose, dosage, or diagnostic form (shape and size) and drug release adjustment has the potential to ensure the optimal patient therapy. Among the different 3D printing techniques, extrusion-based technologies, such as fused filament fabrication (FFF) and semi solid extrusion (SSE), are the most investigated for their high versatility, precision, feasibility, and cheapness. This review provides an overview on different 3DP techniques to produce personalized drug delivery systems and medical devices, highlighting, for each method, the critical printing process parameters, the main starting materials, as well as advantages and limitations. Furthermore, the recent developments of fused filament fabrication and semi solid extrusion 3DP are discussed. In this regard, the current state of the art, based on a detailed literature survey of the different 3D products printed via extrusion-based techniques, envisioning future directions in the clinical applications and diffusion of such systems, is summarized.