Breaking the Mould: Comparing 3D-Printed and Composite Bone Models in Orthopaedic Training.

Background and aim Synthetic composite bone models (reinforced solid foam) have become the standardised material used in practical orthopaedic education. However, with discussions regarding whether composite foam truly replicates human bone, there has been a drive to explore other available models. Three-dimensional (3D) printing has risen in both popularity and availability, providing a new option in the creation of anatomically accurate bone models. We designed a pilot study to assess whether a new formulation of synthetic bone provides the same tactile feedback that is essential for training purposes. Method Orthopaedic trainees of various grades across two London hospital trusts were invited to participate in a distal radius fixation workshop. As part of the workshop, trainees were asked to complete the following three tasks on the two different models: Kirschner-wire driving, pilot hole drilling and screw insertion. Participants were blinded in this trial and not informed which model was made via 3D printing or the conventional composite bone. Following completion, participants provided feedback on tactile feedback for each task on each model. Results Twenty-three orthopaedic trainees participated in the workshop, with overall majority agreement in all clinical skills that the 3D-printed model provided better tactile feedback. Three-dimensional models were rated superior in K-wire driving (mean score 7.39 vs 4.82; p<0.001) and pilot hole drilling (7.87 vs 4.96; p<0.001), with no significant difference in screw insertion. Qualitative feedback from testers noted a more anatomical representation of the 3D-printed bone, in addition to an overall better representation of the corticomedullary junction. Conclusion Overall, 3D printed models provide a new high-fidelity and sustainable option when seeking bone models for modern-day orthopaedic training. At present composite bone remains the standard for workshops. However, with the growing availability of 3D-printing models, and as supported by this study, they crucially provide the medium for future orthopaedic surgeons to learn and gain confidence.