By Dr. Vikas Gupta
The IT revolution began with the advent of the World Wide Web developed at CERN, France. Since then the world has seen a rapid change in technology. In our lifetime, many technologies and products have become obsolete, replaced by novel, ingenious mechanics across the spectrum. And recent technological developments that have taken the medical world by storm 3D printing.
3D printing is part of a family of manufacturing technologies called additive manufacturing. This object describes the creation of objects by adding content layer by layer. The process of 3D printing begins by creating a graphic model of the object to be printed. These are typically designed using computer-aided design (CAD) software packages, and can be the most labor-intensive part of the process. One of the main advantages of 3D printing is that it allows rapid prototyping of anything. The only real limit to its use is your imagination.
Some objects are too complex to create in more traditional manufacturing or prototyping processes such as CNC milling or molding. It is also much cheaper than many other traditional production methods. After the design, the next stage is to digitally slice the model for printing. The slicing process divides the model into several layers. The design for each layer is then sent to the printer head to be printed or sequenced.
Once the slicer program has worked its magic, the data is sent to the printer for the final stage. From here, the 3D printer takes care of itself. 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, with a brief overview of the process presented, let us examine the use of 3D printing in medical science, with an emphasis on orthopedics.
According to a study published in the Global Health Journal, 3D models produced by 3D printing reduce development costs of medical parts and surgical planning time. Integrating 3D printing with orthopedics helps in pinpointing and understanding the problem and ensures a greater guarantee of success in the operation. This technology can enable doctors/surgeons to design, manufacture, reconstruct and plan operations more accurately, carefully and economically. 3D models can assist specialists with visual understanding of patient-specific pathology and life structures. Innovations in 3D printing launched virtual contours and blueprints for implementing medical procedures.
The most significant opportunity for 3D printing in orthopedics is that it helps to design precise anatomical shapes and suggests that impermeable bone replacement platforms can be incorporated into patient implants. It takes into account the natural bone growth, guaranteeing the stability of the implant over a long distance.
Listed by the author below are some of the ways 3D printing can provide significant assistance:
Injury cases
Orthopedic medical procedures often become obstacles in the case of large essential wounds with various bony discontinuities, and in cases showing bony deformities, radiographs are routinely used for orthopedic surgery, although they lack accurate 3D degree data of bony imperfections. Here, 3D printing can be used successfully in these cases as it uses a 3D model that gives the exact required results/data.
Surgical planning
3D printing models are used to aid in the surgical planning process for restorative osteotomies, to select a more educational outline of the living system with a specific end goal and to increase the detail of the adjustment, especially in the case of minimally invasive medical procedures. It creates an exact duplicate model of the patient’s affected body part/part, which can be seen and felt. Various printed models of the hip, knee and shoulder can be used to create a custom-fit precise design of the injured part and can be used as a patient-specific implant.
Surgery Verification with Reverse Engineering
Another application of 3D printing is the identification of orthoses with the aid of reverse engineering with a 3D scanner. This approach enables consistent fitting into the patient’s lifestyle and streamlines plan selection and content.
Customized tools and parts
The use of physical models for treatment planning and perception, rather than the sole use of computed tomography (CT), magnetic resonance imaging (MRI) data, or virtual remaking, enables the doctor to image different areas of the human body with greater accuracy.
Other benefits
AM reduces advancement time by enabling item corrections to be made ahead of schedule. Rapid prototyping (RP) allows for the engineering, fabrication, and assembly of items in a planned process, with the goal that errors can be corrected and changes made while still being economical. Dr. Vikas Gupta, Consultant, Hand and Upper Extremity Surgery (Orthopaedics) at Max Hospitals, cites the example of a tumor removal procedure to highlight the benefits of using 3D printing: “While removing tumors, conventional methods of using casts take over. The time during which the tumor may increase in size. 3D printing effectively addresses this problem as the process is faster.”
3D printing innovation can be used to precisely improve the system (operative process) performed by specialists. A few printing technologies can also produce mechanical bones, human tissues and organs that can be used to craft directly into the patient’s body. Printing patient-specific customized gadgets can be used to guarantee ideal screw orientation and embed adjustment with minimal presentation.
Procedures such as templating and pre-contouring Recon plates for acetabular fractures are made using 3D printing. Results show improved surgical outcomes and reduced overall surgical time. In another case, 3D printed jigs are used for total knee arthroplasty, which helps improve overall performance.
“In addition to cost-effective, time-saving elements, 3D printing allows for the creation of patient-specific products, allowing for a wide range of modifications to meet the needs of individual patients. Also, 3D printing can be used in remote areas because it requires a printer and materials, eliminating the need to carry expensive, heavy equipment,” explains the author. The benefits promised by 3D printing are numerous. However, like most modern technologies, there are some limitations in its use which are mentioned below:
Cleaning limitations
The shaping opportunity of 3D printing brings some new challenges for implant creators and manufacturers. Designers and manufacturers need to consider equipment cleaning prerequisites and embed them in the planning phase as tremendous geometric flexibility can make cleaning requests more difficult.
Limitation of bio-printable materials
State-of-the-art 3D printing, especially for making implantable biomedical gadgets, is severely constrained by printable materials. Thus, alternative material handling techniques are needed to effectively address non-printable materials.
Government directives, standardization and regulatory constraints
The institutionalization of 3D printing is an ongoing process. Today, administrative offices are becoming comfortable with 3D printing advancements. However, they still likely push for 3D printing—special requirements on established gadget manufacturers until the standards accepted and understood by administrative experts.
Bio-degradability and toxicity limits
Material degradation is an important issue in the 3D phase. Consumption of degraded material can lead to hypoxia and acidosis within the system. Penetration of acidic debasement depends on the level of acidosis, which can damage the seeded cells and the cells that contain them.
Regardless of the limitations of this technology, 3D printing is set to revolutionize surgical procedures. Prominent figures in the medical fraternity have expressed their support for the use of 3D printing. The possibilities promised are staggering and 3D printing can ensure a higher success rate compared to other existing technologies. And if the trajectory of technological advancement is any indication, one can claim that the mechanical limitations of 3D printing will soon be overcome.
Thinking about the future of this technology, Dr. “Biological inks and matrices are becoming increasingly popular,” says Gupta. And cells can be induced to grow in biological matrices, including stem cells. Thus, soon organs can also be printed, which gives a great boost to the medical community. Long waiting times for organ transplants will soon be a relic of the past. Thus, 3D printing offers many advantages and will soon become an indispensable technology in the medical community.
Dr. Vikas Gupta, Director – Orthopedics and Head – Hand and Shoulder Surgery, Max Hospital, Gurgaon and Max Smart Super Specialty Hospital, Saket.
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