Alex Q. Lynn, BS* Lacey R. Pflibsen, MD† Anthony A. Smith, MD† Alanna M. Rebecca, MD, MBA† Chad M. Teven, MD†

From the *Midwestern University Arizona College of Osteopathic Medicine, Glendale, Ariz; and †Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Ariz.

Received for publication October 4, 2020; accepted January 13, 2021.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/GOX.0000000000003465

Background: Three-dimensional printing (3DP) is a rapidly advancing tool that has revolutionized plastic surgery. With ongoing research and development of new technology, surgeons can use 3DP for surgical planning, medical education, biological implants, and more. This literature review aims to summarize the currently published literature on 3DP’s impact on plastic surgery.

Methods: A literature review was performed using Pubmed and MEDLINE from 2016 to 2020 by 2 independent authors. Keywords used for literature search included 3-dimensional (3D), three-dimensional printing (3DP), printing, plastic, surgery, applications, prostheses, implants, medical education, bioprinting, and preoperative planning. All studies from the database queries were eligible for inclusion. Studies not in English, not pertaining to plastic surgery and 3DP, or focused on animal data were excluded.

Results: In total, 373 articles were identified. Sixteen articles satisfied all inclusion and exclusion criteria, and were further analyzed by the authors. Most studies were either retrospective cohort studies, case reports, or case series and with 1 study being prospective in design.

Conclusions: 3DP has consistently shown to be useful in the field of plastic surgery with improvements on multiple aspects, including the delivery of safe, effective methods of treating patients while improving patient satisfaction. Although the current technology may limit the ability of true bioprinting, research has shown safe and effective ways to incorporate biological material into the 3D printed scaffolds or implants. With an overwhelmingly positive outlook on 3DP and potential for more applications with updated technology, 3DP shall remain as an effective tool for the field of plastic surgery. (Plast Reconstr Surg Glob Open 2021;9:e3465; doi: 10.1097/GOX.0000000000003465; Published online 22 March 2021.)

Tak Man Wong1,2,3, Jimmy Jin3 , Tak Wing Lau1 , Christian Fang1,3, Chun Hoi Yan1,2,3, Kelvin Yeung1,2, Michael To1,2,3, and Frankie Leung1,2,3

Abstract

Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

Keywords

3-D printing, additive manufacturing, patient-specific instruments and implants, surgical planning, tissue engineering

Journal of Orthopaedic Surgery Volume: 25(1) 1–7 ª Journal of Orthopaedic Surgery 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/2309499016684077 journals.sagepub.com/home/osj

1Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong 2 Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China 3Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China

Corresponding author: Tak Man Wong, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong. Email: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

P. Andrés-Canoa,∗, J.A. Calvo-Haro b,c, F. Fillat-Gomà d, I. Andrés-Cano e, R. Perez-Ma˜nanes b,c

a Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen del Rocío, Sevilla, Spain

b Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Mara˜nón, Madrid, Spain

c Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain

d Unidad de Planificación Quirúrgica 3D, Departamento de Cirugía Ortopédica y Traumatología, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain

e Departamento de Radiodiagnóstico Hospital Universitario Puerta del Mar, Cádiz, Spain

Abstract

      3D printing (I3D) is an additive manufacturing technology with a growing interest in medicine and especially in the specialty of Orthopaedic Surgery and Traumatology. There are numerous applications that add value to the personalised treatment of patients: advanced preoperative planning, surgeries with specific tools for each patient, customised orthotic treatments, personalised implants or prostheses and innovative development in the field of bone and cartilage tissue engineering.

      This paper provides an update on the role that the orthopaedic surgeon and traumatologist plays as a user and prescriber of this technology and a review of the stages required for the correct integration of I3D into the hospital care flow, from the necessary resources to the current legal recommendations.

KEYWORDS

Additive manufacturing; Patient-specific  surgical guide; Custom implants; Bioprinting; Medical 3d printing

PALABRAS CLAVE

Fabricación de aditivos; Guía quirúrgica específica para el paciente; Implantes personalizados; Bioimpresión; Impresión médica en 3D

Resumen

      La impresión 3D (I3D) es una tecnología de fabricación aditiva con un creciente interés en medicina y sobre todo en la especialidad de Cirugía Ortopédica y Traumatología. Hay numerosas aplicaciones que aportan un valor a ˜ nadido al tratamiento personalizado de los pacientes: planificación preoperatoria avanzada, cirugías con herramientas específicas para cada paciente, tratamientos ortésicos a medida, implantes o prótesis personalizadas y un desarrollo innovador en el campo de la ingeniería de tejidos óseos y cartilaginosos.

      En el presente trabajo se realiza una actualización sobre el papel que el cirujano ortopédico y traumatólogo desempe˜ na como usuario y como médico prescriptor de esta tecnología y un repaso a las etapas necesarias para una correcta integración de la I3D en el flujo asistencial hospitalario, desde los recursos necesarios hasta las recomendaciones legales actuales. © 2020 SECOT. Publicado por Elsevier Espa˜na, S.L.U. Este es un art´ıculo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).