By Dr. Vikas Gupta
The computer revolution began with the advent of the World Wide Web developed at CERN, France. Since then, the world has seen a rapid transformation in technology. Over the course of our lifetime, several technologies and products have become obsolete, replaced by new competent mechanisms across the spectrum. And a recent technological development that has taken the medical world by storm is 3D printing.
3D printing is part of a family of manufacturing technologies called additive manufacturing. This describes creating an object by adding material to the object layer by layer. The 3D printing process begins with the production of a graphic model of the object to be printed. These are usually designed using computer-aided design (CAD) software packages, and this can be the most laborious part of the process. One of the main advantages of 3D printing is that it allows rapid prototyping of almost anything. The only real limit to its use is your imagination.
Some objects are simply too complex to be created in a more traditional manufacturing or prototyping process like CNC milling or molding. It is also much cheaper than many other traditional manufacturing methods. After design, the next phase is to digitally cut the model to get it for printing. The slicing process breaks up the model into multiple layers. Each layer’s design is then sent to the printhead to be printed or deposited in order.
Once the slicer program has taken effect, the data is then sent to the printer for the final step. From there, the 3D printer itself takes over. It will start printing the model according to the specific instructions of the slicer program using different methods, depending on the type of printer used. So, after a brief overview of the presented process, let’s dive deeper into the use of 3D printing in medical sciences, with a focus on orthopedics.
According to a study published in the Global Health Journal, 3D models made by 3D printing reduce medical part development costs and surgical planning time. The integration of 3D printing with orthopedics helps to meticulously recognize and understand the problem and ensures a greater guarantee of success in operations. This technology can allow doctors/surgeons to design, produce, recreate and plan operations more accurately, thoroughly and economically. 3D models can help specialists visually understand patient-specific pathology and life structures. Innovation in 3D printing has launched a model for virtual contouring and performing medical procedures.
The most significant opportunity for 3D printing in orthopedics is that it helps design precise anatomical shapes and suggests that permeable bone substitute platforms can be incorporated into patient implants. It takes into account the natural bone growth, guaranteeing the stability of the implant over the long term.
Some of the avenues in which 3D printing offers significant help are listed below by the author:
Orthopedic medical procedure often encounters hurdles in cases of large essential wounds with different bone discontinuity, and in those with bone deformities, X-rays are regularly used for orthopedic surgeries, but they lack 3D degree data. exact bone imperfections. Here, 3D printing can be used successfully in these cases as it uses a 3D model that gives specific results/data required.
3D printing models are often used to aid the surgical planning process for restorative osteotomies, with the specific end goal of gaining more educational insight into vital systems and improving organizational detail, especially in the cases of minimally intrusive medical procedures. It produces an exact duplicate model of the organ/body part influenced by the patient, which can be viewed and felt. Various printed models of the hip, knee and shoulder can be used to create the specific custom design of the injured part and used as patient specific implants.
Surgical verification with reverse engineering
Another use of 3D printing is to identify orthoses using reverse engineering assistance with 3D scanners. This approach allows for a consistent fit to the patient’s living systems and streamlines the choice of plan and materials.
Custom tools and parts
The use of physical models for treatment organization and perception, rather than the sole use of computed tomography (CT), magnetic resonance imaging (MRI) information or virtual redesign, allows the physician to image different areas of the human body with greater precision.
AM decreases lead time by allowing changes to be made to an item sooner than expected. Rapid prototyping (RP) enables the engineering, manufacturing, and assembly of items on time in the planned procedure, with the goal of correcting the misstep and making changes while they are still economical. Dr. Vikas Gupta, Consultant, Hand and Upper Extremity Surgery (Orthopaedics) at Max Hospitals, cites the example of tumor removal procedure to highlight the benefits of 3D printing: “When Tumor removal, traditional methods of using a cast take time during which time the tumor can grow in size.3D printing effectively solves this problem as the process is fast.
Innovation in 3D printing can be used to improve the accuracy of specialist systems (operating procedures). Even a few printing technologies can produce mechanical bones, human tissues and organs used directly to manufacture in the patient’s body. Printing particular personalized gadgets for patients can be used to ensure ideal screw direction and integration layout with insignificant presentation.
Procedures such as modeling and pre-contouring an acetabular fracture Recon plate are fabricated using 3D printing. The result shows an improvement in surgical results and a reduction in overall surgical time. In another case, 3D printed jigs are used for total knee arthroplasty, which helps improve overall performance.
“Beyond cost-effective and time-saving items, 3D printing enables the creation of patient-specific products, allowing for a wide range of modifications to meet the needs of each patient. Additionally, 3D printing can be used in remote areas because it only requires the printer and the hardware, eliminating the need to carry expensive and bulky equipment,” explains the author. The benefits promised by 3D printing are numerous. However, as the most modern technologies, its use has some limitations, as shown below:
The shape opportunity of 3D printing brings new challenges to implant designers and producers. Designers and manufacturers should consider instrument cleaning prerequisites and incorporate them into the planning phase, as the enormous geometric flexibility can make cleaning demands even more challenging.
Limitation of bio-printable materials
Cutting-edge 3D printing, especially for creating implantable biomedical gadgets, is severely limited by printable materials. Thus, elective material manipulation techniques are needed to deal with materials that are not effectively printable.
Government guidelines, standardization and regulatory limits
The institutionalization of 3D printing is an ongoing process. Today, administrative offices are getting to grips with advances in 3D printing. However, they still presumably dictate 3D printing – from the particular necessities of catering gadget makers until such time as recognized standards are adopted and perceived by administrative experts.
Limitation of biodegradability and toxicity
Material degradation is an important issue in 3D stages. The use of degraded materials can lead to hypoxia and acidosis within the systems. Entry of acid debasement depends on the level of acidosis, which can damage seeded cells as well as impacted cells.
Whatever the limitations of this technology, 3D printing is set to revolutionize surgical procedures. Leading luminaries in the medical fraternity have voiced their support for the use of 3D printing. The possibilities promised are staggering and 3D printing can provide a much higher success rate than other existing technologies. And if the trajectory of technological advancements is any indication, it’s safe to say that the mechanical limitations of 3D printing will soon be overcome.
Considering the future of this technology, Dr. Gupta says: “Biological ink and matrix are becoming more and more prevalent. And cells can be made to grow into the biological matrix, including stem cells. So, soon, organs could also be printed, giving a great boost to the medical fraternity. Long wait times for organ transplants will soon be a thing of the past. Thus, 3D printing offers several advantages and will soon be an indispensable technology in the medical fraternity.
Dr. Vikas Gupta, Director – Orthopedics & Head – Hand & Shoulder Surgery, Max Hospital, Gurgaon & Max Smart Super Specialty Hospital, Saket.
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