Three-Dimensional Printing Technology in Orthopaedics

Nathan Wm. Skelley, MD; Matthew J. Smith, MD; Richard Ma, MD; James L. Cook, DVM, PhD

Disclosures

J Am Acad Orthop Surg. 2019;27(24):918-925. 

In This Article

Abstract and Introduction

Abstract

Three-dimensional (3-D) printing technology is affecting how orthopaedic surgeries are planned and executed. Like many innovations, 3-D printers are becoming smaller, more affordable, and more accessible. Free access to open-source 3-D imaging software has also made clinical implementation of this technology widely feasible. Within the last decade, 3-D printing advancements have improved the way orthopaedic surgeons can approach both common and complex cases. Advanced imaging studies can be used to create musculoskeletal models, which can then be used to create custom orthopaedic guides and instruments. Similarly, 3-D printing is being applied to improve the field of biologic therapies in orthopaedics. Application of 3-D printing technology has been associated with important improvements in education, preoperative planning, surgical care, and patient-specific devices and treatments. Improvements in cost-effectiveness, access, and usability of 3-D printing technology have made it possible for orthopaedic surgeons to use this powerful tool using desktop 3-D printers in their clinic or office. The types of printers and materials available to print are constantly expanding, but many of the basic 3-D printing principles persist throughout these advances in the field. A clear understanding of this technology is important to the clinical implementation of 3-D printing for current and future practice of orthopaedic care.

Introduction

Conrad Röentgen changed the field of medicine in 1895 with the description of X-ray radiographs. More than 100 years later, the field of orthopaedics continues to be influenced and directed by these two-dimensional images.[1] Imaging technology has developed rapidly in the past century, and advanced imaging modalities including CT and MRI provide intricate two-dimensional anatomic detail.[2] These modalities can be manipulated with unique software to create three-dimensional (3-D) representations of human anatomy using a computer interface.

Along with advances in 3-D imaging, 3-D printing technologies have also rapidly improved in recent years.[3] These printers can transform computer images into tangible and functional objects. Because 3-D printers have become more accurate, affordable, and accessible, the technology is beneficially influencing the field of orthopaedics. Similarly, the types and costs of printing materials along with the time needed to complete prints have made the process more widely available and applicable to orthopaedic surgeons.[4]

The purpose of this article is to review types of 3-D printers readily available to practicing orthopaedic surgeons, how these printers function, regulation regarding orthopaedic 3-D prints, and current and future applications of 3-D printing in orthopaedics. With this article, the clinical orthopaedic surgeon will appreciate how this technology has advanced in recent years and ways that this technology can influence their current and future orthopaedic practice. Understanding 3-D printing technology and concepts is important to the practicing orthopaedic surgeon because, in orthopaedics, as in many fields, 3-D printers and 3-D printing are serving a larger and more impactful role in patient care, and this is likely to continue in the near future.[3,5]

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