Nicum Arya, Hothi Harry, Henckel Johann, di Laura Anna, Schlueter-Brust Klaus, Hart Alister
Institute of Orthopaedics and Musculoskeletal Science, University College London, UK.
Royal National Orthopaedic Hospital, Stanmore, UK.
EFORT Open Rev. 2024 Sep 2;9(9):862-872. doi: 10.1530/EOR-23-0182.
Three-dimensional printing is a rapidly growing manufacturing method for orthopaedic implants and it is currently thriving in several other engineering industries. It enables the variation of implant design and the construction of complex structures which can be exploited in orthopaedics and other medical sectors. In this review, we develop the vocabulary to characterise 3D printing in orthopaedics from terms defined by industries employing 3D printing, and by fully examining a 3D-printed off-the-shelf acetabular cup (Fig. 1). This is a commonly used 3D-printed implant in orthopaedics, and it exhibits a range of prominent features brought about by 3D printing. The key features and defects of the porous and dense regions of the implant are clarified and discussed in depth to determine reliable definitions and a common understanding of characteristics of 3D printing between engineers and medical experts in orthopaedics. Despite the extensive list of terminology derived here, it is clear significant gaps exist in the knowledge of this field. Therefore, it is necessary for continued investigations of unused implants, but perhaps more significantly, examining those in vivo and retrieved to understand their long-term impact on patients and the effects of certain features (e.g. surface-adhered particles). Analyses of this kind will establish an understanding of 3D printing in orthopaedics and additionally it will help to update the regulatory approach to this new technology.
三维打印是一种在骨科植入物制造领域迅速发展的制造方法,目前在其他一些工程行业也蓬勃发展。它能够实现植入物设计的多样化,并构建复杂结构,这些结构可应用于骨科及其他医疗领域。在本综述中,我们从采用三维打印的行业所定义的术语出发,并通过全面研究一个三维打印的现成髋臼杯(图1),来开发用于描述骨科三维打印的词汇。这是骨科常用的三维打印植入物,它展现出了一系列由三维打印带来的显著特征。对植入物多孔和致密区域的关键特征及缺陷进行了深入阐明和讨论,以确定可靠的定义,并使骨科工程师和医学专家对三维打印的特征达成共识。尽管在此得出了大量术语,但显然该领域的知识仍存在重大空白。因此,有必要继续研究未使用的植入物,但或许更重要的是,检查体内使用的及回收的植入物,以了解它们对患者的长期影响以及某些特征(如表面附着颗粒)的作用。此类分析将有助于理解骨科中的三维打印,此外还将有助于更新对这项新技术的监管方法。