3D Printing in Orthopedic Surgery

Several areas of medicine, mainly in surgical areas such as orthopedics are using the additive manufacturing of anatomical models and personalized implants, thus allowing accurate preoperative planning, simulation of surgeries with team training, and better communication with the patient. The first and most important step in printing objects is the acquisition of the image. Usually, it uses medical imaging such as Computer Tomography (CT), Magnetic Resonance Image (MRI), and Ultrasonography (US) in a DICOM format file. During the processing image (modeling and rendering), the 3D object is exported to the Computer-Aided Design (CAD) environment to perform the Virtual Surgical Planning (VSP). CAD programs allow us to visualize and analyze the regions with complex anatomy and simulate surgery. To perform the printing of 3D models is necessary the Computer-Aided Manufacturing (CAM) environment software for generating GCode (machine language of the printers). The Computer-Aided Engineering (CAE) software is an important resource that 3D virtual model volumes (anatomical model and implant) may be discretized and analyzed by simulation in silico using the finite elements method (FEM). According to the literature, the use of 3D printing technology in orthopedic surgery has four important areas: (1) Anatomical model printing (including medical education, pre-operative planning, and pre-operative simulation). (2) Tools, Guides, and Surgical Templates printing. (3) Implants, Prostheses, and Orthoses printing. (4) Scaffolds and Cell printing. The impact of 3D printing technology in orthopedics is rising and leaving definitive changes in the development of customized implants and surgical processes improvement.