Abstract

ObjectiveThis study reports on a new method for the development of multi-color and multi-material realistic Knee Joint anatomical models with unique features. In particular, the design of a fibers matrix structure that mimics the soft tissue anatomy.MethodsVarious Computer-Aided Design (CAD) systems and the PolyJet 3D printing were used in the fabrication of three anatomical models wherein fibers matrix structure is mimicked: (i) Anterior cruciate ligament reconstruction (ACL-R) model used in the previous study. (ii) ACL-R model, incorporating orientations, directions, locations, and dimensions of the tunnels, as well as a custom-made surgical guide (SG) for avoiding graft tunnel length mismatch. (iii) Total knee arthroplasty (TKA) model, including custom-made implants. Before models 3D printing, uni-axial tensile tests were conducted to obtain the mechanical behaviors for individual No. 1 (A60-A50), No. 2 (A50-A50), No. 3 (A50-A40), and No. 4 (A70-A60) soft tissue-mimicking polymers. Each material combination represents different shore-hardness values between fiber and matrix respectively.ResultsWe correlated the pattern of stress-strain curves in the elastic region, stiffness, and elastic modulus of proposed combinations with published literature. Accordingly, material combinations No. 1 and No. 4 with elastic modules of 0.76-1.82 MPa were chosen for the soft tissues 3D printing. Finally, 3D printing Knee Joint models were tested manually simulating 50 flexo-extension cycles without presenting ruptures.ConclusionThe proposed anatomical models offer a diverse range of applications. These may be considered as an alternative to replacing cadaver specimens for medical training, pre-operative planning, research and education purposes, and predictive models validation. The soft tissue anatomy-mimicking materials are strong enough to withstand the stretching during the flexo-extension. The methodology reported for the design of the fiber-matrix structure might be considered as a start to develop new patterns and typologies that may mimic soft tissues.

Highlights

  • Three-dimensional (3D) printing is an emerging technology that is getting substantial interest over the past years in several key areas such as the automotive, aerospace, and especially medicine

  • The stiffness comparison was based on the linear regressions, reported in Fig. 11. as well as values calculated from dimensions and elastic modulus, and values published in the literature

  • We found that The Knee Joint soft tissues with higher elastic modulus were Patellar Tendon (PT), Medial collateral ligament (MCL), Lateral collateral ligament (LCL), Quadriceps tendon (QT), and cruciate ligaments had higher stiffness

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Summary

Introduction

Three-dimensional (3D) printing is an emerging technology that is getting substantial interest over the past years in several key areas such as the automotive, aerospace, and especially medicine. Current research applications are classified into the following five main areas of focus: (i) Anatomical models derived from medical images, (ii) Custom-made prosthetics and implants, (iii) Local bioactive and biodegradable scaffolds, (iv) Pharmaceutical research platforms, and (v) Research on directly printing tissues and organs with complete life functions. Such applications remain far from widespread in clinical use due to several technical and scientific issues that are currently under study [6]. This statement does not consider other important studies and contributions about surgical and numerical simulations based on 3D computer-generated anatomical models

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