Abstract

Background3D 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.MethodsSeven 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.ResultsThe 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 (cm3/min) was one order of magnitude between the fastest and slowest printers.ConclusionsAll 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.

Highlights

  • 3D printed patient-specific anatomical models have been applied clinically to orthopaedic care for surgical planning and patient education

  • Literature supports significant cost savings due to reduced operating room time associated with the use of 3D printed patient anatomical models in surgical applications [11]. 3D printing has become especially relevant due to the COVID-19 pandemic in 2020, where 3D printing was employed to combat shortages in essential medical equipment including ventilator components, N95 respirators, nasopharyngeal collection swabs, and splash-proof face shields [12,13,14,15,16,17,18,19]

  • fused deposition modeling (FDM) printing is based on the continuous extrusion of a heated thermoplastic from a nozzle, SLA printing is based on the polymerization of resin from a resin vat using ultraviolet (UV) light, and PolyJet is based on the UV light mediated polymerization of liquid photopolymer material administered from an ink-jet, all three of which occur in a layer by layer process [1, 9, 22]

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Summary

Introduction

3D printed patient-specific anatomical models have been applied clinically to orthopaedic care for surgical planning and patient education. As 3D printing technologies integrate into medical care, it becomes important to understand and optimize the time and cost needed to produce clinically relevant 3D prints. This knowledge may potentially be applied to timesensitive fracture care [20, 21]. The three common 3D printing techniques investigated in this study are material extrusion, vat polymerization, and material jetting. These are alternatively known as fused deposition modeling (FDM), stereolithography (SLA), and PolyJet, respectively. FDM printing is based on the continuous extrusion of a heated thermoplastic from a nozzle, SLA printing is based on the polymerization of resin from a resin vat using ultraviolet (UV) light, and PolyJet is based on the UV light mediated polymerization of liquid photopolymer material administered from an ink-jet, all three of which occur in a layer by layer process [1, 9, 22]

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