Chen Joshua V, Dang Alan B C, Dang Alexis
Department of Orthopaedic Surgery, University of California, San Francisco, USA.
CA Department of Surgery, San Francisco VA Health Center, Orthopaedic Section, San Francisco, USA.
3D Print Med. 2021 Jan 6;7(1):1. doi: 10.1186/s41205-020-00091-4.
3D printed patient-specific anatomical models have been applied clinically to orthopaedic care for surgical planning and patient education. The estimated cost and print time per model for 3D printers have not yet been compared with clinically representative models across multiple printing technologies. This study investigates six commercially-available 3D printers: Prusa i3 MK3S, Formlabs Form 2, Formlabs Form 3, LulzBot TAZ 6, Stratasys F370, and Stratasys J750 Digital Anatomy.
Seven representative orthopaedic standard tessellation models derived from CT scans were imported into the respective slicing software for each 3D printer. For each printer and corresponding print setting, the slicing software provides a print time and material use estimate. Material quantity was used to calculate estimated model cost. Print settings investigated were infill percentage, layer height, and model orientation on the print bed. The slicing software investigated are Cura LulzBot Edition 3.6.20, GrabCAD Print 1.43, PreForm 3.4.6, and PrusaSlicer 2.2.0.
The effect of changing infill between 15% and 20% on estimated print time and material use was negligible. Orientation of the model has considerable impact on time and cost with worst-case differences being as much as 39.30% added print time and 34.56% added costs. Averaged across all investigated settings, horizontal model orientation on the print bed minimizes estimated print time for all 3D printers, while vertical model orientation minimizes cost with the exception of Stratasys J750 Digital Anatomy, in which horizontal orientation also minimized cost. Decreasing layer height for all investigated printers increased estimated print time and decreased estimated cost with the exception of Stratasys F370, in which cost increased. The difference in material cost was two orders of magnitude between the least and most-expensive printers. The difference in build rate (cm/min) was one order of magnitude between the fastest and slowest printers.
All investigated 3D printers in this study have the potential for clinical utility. Print time and print cost are dependent on orientation of anatomy and the printers and settings selected. Cost-effective clinical 3D printing of anatomic models should consider an appropriate printer for the complexity of the anatomy and the experience of the printer technicians.
3D打印的患者特异性解剖模型已在临床上应用于骨科护理，用于手术规划和患者教育。尚未将3D打印机每个模型的估计成本和打印时间与多种打印技术的临床代表性模型进行比较。本研究调查了六种商用3D打印机：普拉斯i3 MK3S、Formlabs Form 2、Formlabs Form 3、LulzBot TAZ 6、Stratasys F370和Stratasys J750数字解剖打印机。
将从CT扫描中获得的七个代表性骨科标准细分模型导入到每台3D打印机各自的切片软件中。对于每台打印机和相应的打印设置，切片软件会提供打印时间和材料使用估计值。使用材料数量来计算估计的模型成本。研究的打印设置包括填充百分比、层高和打印床上的模型方向。研究的切片软件有Cura LulzBot版3.6.20、GrabCAD Print 1.43、PreForm 3.4.6和PrusaSlicer 2.2.0。
将填充率在15%至20%之间变化对估计打印时间和材料使用的影响可忽略不计。模型方向对时间和成本有相当大的影响，最坏情况下打印时间增加多达39.30%，成本增加34.56%。在所有研究设置中取平均值，打印床上水平放置模型可使所有3D打印机的估计打印时间最短，而垂直放置模型可使成本最低，但Stratasys J750数字解剖打印机除外，在该打印机中水平放置也可使成本最低。除Stratasys F370成本增加外，降低所有研究打印机的层高会增加估计打印时间并降低估计成本。最便宜和最昂贵的打印机之间材料成本相差两个数量级。最快和最慢的打印机之间构建速度（厘米/分钟）相差一个数量级。
本研究中所有调查的3D打印机都有临床应用潜力。打印时间和打印成本取决于解剖结构的方向以及所选的打印机和设置。具有成本效益的解剖模型临床3D打印应根据解剖结构的复杂性和打印机技术人员的经验选择合适的打印机。
