Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Hamot Hospital, Erie, PA, USA.
Department of Robotics and Production Systems, University Politehnica of Bucharest, Bucharest, Romania.
Expert Rev Med Devices. 2023 Mar;20(3):233-244. doi: 10.1080/17434440.2023.2183839. Epub 2023 Mar 1.
While 3D printing of bone models for preoperative planning or customized surgical templating has been successfully implemented, the use of patient-specific additively manufactured (AM) implants is a newer application not yet well established. To fully evaluate the advantages and shortcomings of such implants, their follow-up results need to be evaluated.
This systematic review provides a survey of the reported follow-ups on AM implants used for oncologic reconstruction, total hip arthroplasty both primary and revision, acetabular fracture, and sacrum defects.
The review shows that Titanium alloy (Ti4AL6V) is the most common type of material system used due to its excellent biomechanical properties. Electron beam melting (EBM) is the predominant AM process for manufacturing implants. In almost all cases, porosity at the contact surface is implemented through the design of lattice or porous structures to enhance osseointegration. The follow-up evaluations show promising results, with only a small number of patients suffering from aseptic loosening, wear, or malalignment. The longest reported follow-up length was 120 months for acetabular cages and 96 months for acetabular cups. The AM implants have proven to serve as an excellent option to restore premorbid skeletal anatomy of the pelvis.
虽然 3D 打印骨骼模型已成功用于术前规划或定制手术模板,但患者特异性增材制造(AM)植入物的使用是一种较新的应用,尚未得到充分确立。为了充分评估此类植入物的优缺点,需要对其随访结果进行评估。
本系统评价对用于肿瘤重建、初次和翻修全髋关节置换、髋臼骨折和骶骨缺损的 AM 植入物的随访报告进行了综述。
综述表明,由于钛合金(Ti4AL6V)具有优异的生物力学性能,因此是最常见的材料系统类型。电子束熔化(EBM)是制造植入物的主要增材制造工艺。在几乎所有情况下,通过设计晶格或多孔结构来实现接触表面的多孔性,以增强骨整合。随访评估结果表明,只有少数患者出现无菌性松动、磨损或错位。报道的最长随访时间为髋臼笼 120 个月,髋臼杯 96 个月。AM 植入物已被证明是恢复骨盆病前骨骼解剖结构的绝佳选择。