Diana Popescu, Dan Laptoiu, Rodica Marinescu and Iozefina Botezatu
This paper aims to fill a research gap by presenting design and 3D printing guidelines and considerations which apply to the development process of patient-specific osteotomy…
Abstract
Purpose
This paper aims to fill a research gap by presenting design and 3D printing guidelines and considerations which apply to the development process of patient-specific osteotomy guides for orthopaedic surgery.
Design/methodology/approach
Analysis of specific constraints related to patient-specific surgical guides design and 3D printing, lessons learned during the development process of osteotomy guides for orthopaedic surgery, literature review of recent studies in the field and data gathered from questioning a group of surgeons for capturing their preferences in terms of surgical guides design corresponding to precise functionality (materializing cutting trajectories, ensuring unique positioning and stable fixation during surgery), were all used to extract design recommendations.
Findings
General design rules for patient-specific osteotomy guides were inferred from examining each step of the design process applied in several case studies in relation to how these guides should be designed to fulfill medical and manufacturing (fused deposition modelling process) constraints. Literature was also investigated for finding other information than the simple reference that the surgical guide is modelled as negative of the bone. It was noticed that literature is focussed more on presenting and discussing medical issues and on assessing surgical outcomes, but hardly at all on guides’ design and design for additive manufacturing aspects. Moreover, surgeons’ opinion was investigated to collect data on different design aspects, as well as interest and willingness to use such 3D-printed surgical guides in training and surgery.
Practical implications
The study contains useful rules and recommendations for engineers involved in designing and 3D printing patient-specific osteotomy guides.
Originality/value
A synergetic approach to identify general rules and recommendations for the patient-specific surgical guides design is presented. Specific constraints are identified and analysed using three case studies of wrist, femur and foot osteotomies. Recent literature is reviewed and surgeons’ opinion is investigated.
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Diana Popescu, Aurelian Zapciu, Cristian Tarba and Dan Laptoiu
This paper aims to propose a new solution for producing customized three-dimensional (3D)-printed flat-shaped splints, which are then thermoformed to fit the patient’s hand. The…
Abstract
Purpose
This paper aims to propose a new solution for producing customized three-dimensional (3D)-printed flat-shaped splints, which are then thermoformed to fit the patient’s hand. The splint design process is automated and is available to clinicians through an online application.
Design/methodology/approach
Patient anthropometric data measured by clinicians are associated with variables of parametric 3D splint models. Once these variables are input by clinicians in the online app, customized stereo lithography (STL) files for both splint and half mold, in the case of the bi-material splint, are automatically generated and become available for download. Bi-materials splints are produced by a hybrid manufacturing process involving 3D printing and overmolding.
Findings
This approach eliminates the need for 3D CAD-proficient clinicians, allows fast generation of customized splints, generates two-dimensional (2D) drawings of splints for verifying shape and dimensions before 3D printing and generates the STL files. Automation reduces splint design time and cost, while manufacturing time is diminished by 3D printing the splint in a flat position.
Practical implications
The app could be used in clinical practice. It meets the demands of mass customization using 3D printing in a field where individualization is mandatory. The solution is scalable – it can be extended to other splint designs or to other limbs. 3D-printed tailored splints can offer improved wearing comfort and aesthetic appearance, while maintaining hand immobilization, allowing visually controlled follow-up for edema and rapidly observing the need for revision if necessary.
Originality/value
An online application was developed for uploading patient measurements and downloading 2D drawings and STL files of customized splints. Different models of splints can be designed and included in the database as alternative variants. A method for producing bi-materials flat splints combining soft and rigid polymers represents another novelty of the research.