3D Printing : Applications Of In Orthopedics by Dr. Raju Vaishya

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The 3D printing technology is penetrating the healthcare field at an astonishing rate. In the clinical settings, 3D printing, as a novel additive manufacturing technique, is mainly applied in orthopedics. A group of 3D printing-based patient-specific osteotomy instruments, orthopedic implants, and dental implants have been for clinical use. The 3D printing technology may provide a chance for the Indian orthopedists and technicians to independently develop innovative medical devices to catch up with their Western counterparts.
Based on imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), the 3D images of the bones can be re-constructed; then, the prototypes of the bones can be obtained using the layered manufacturing technique (LMT) for teaching, presentation, and surgical design. Based on the symmetry of the human anatomy, or by using the human anatomy data in database, we can also reverse or mimic the 3D images of the bones at the missing parts, so as to assist the conventional mechanical processing to manufacture bone prostheses that can be implanted into human body. These two rapid prototyping manufacturing (RPM) techniques have been quite mature and commonly applied in surgery design. Along with the advances in 3D printing technology and the drop of forming equipment prices, an increasing number of doctors began to use 3D printing for the medical education and for the design and presentation of complex surgeries.
The role of patient-specific instrumentation in total knee replacement is becoming popular. It does have some notable advances such as shorter operative time, improved the accuracy of alignment, and simplified complex surgical procedures. All the major international artificial joint companies have marketed their corresponding products for clinical use In addition to the field of artificial joints, the design and application of 3D printing-based instruments in fields including spinal surgery, trauma, and orthopedics have shown special values.
Development of metallic implants and personalized prostheses is the most important and most valuable direction when applying the 3D printing in the field of orthopedics. The preciseness and efficiency of high-energy 3D printing equipment such as electron beam and laser beam can meet the requirements for manufacturing small parts or achieving high-scale production. Under the computer-aided design, the 3D printing can rapidly manufacture shaped implants; meanwhile, it can also produce size-controllable micro-pore structures.
Due to their innate biological inertness, the metal materials can not be easily integrated with the host bones. Currently, one of the hot research topics is the modification in the nature of the porous surfaces of the 3D printing-formed metals.
The application of 3D printing in orthopedics is experiencing a rapid translation from bench to bedside. Only a “real world” clinical translation can reveal the value and future of 3D printing.
3D printing provides a great opportunity for the orthopedic implantable medical devices manufacturing in India to catch up with the advanced countries.

Dr. (Prof.) Raju Vaishya , a surgeon of international repute, is best known for his swift surgical skills in the field of Orthopedic & Joint Replacement. He has been working at Indraprastha Apollo Hospitals, New Delhi as a Professor and Senior consultant. He is the founder president of Arthritis Care Foundation. Apart from his distinguished clinical work in the field of arthroscopic and joint replacement surgery, he is well known for his academic contributions.
He has been awarded for the best paper publication on nu¬merous occasions by Delhi Orthopedic Association and Apollo Hospitals. His work was recognized in the Limca book of records in 2012, 2013 & 2015 for do¬ing bilateral Total Knee Replacement in 93 years old gentleman, bilateral Total Knee Replacement in the oldest couple in a single sitting, ACL reconstruction on oldest man.

Vinod Kumar

Health Journalist & writer. Editor of monthly health magazine "Health Spectrum."

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