Abstract
We report on the exemplified realization of a digital to physical process chain for a patient individualized osteosynthesis plate for the tarsal bone area. Anonymized patient-specific data of the right feet were captured by computer tomography, which were then digitally processed to generate a surface file format (standard tessellation language, STL) ready for additive manufacturing. Physical realization by selective laser melting in titanium using optimized parameter settings and post-processing by stress relief annealing results in a customized osteosynthesis plate with superior properties fulfilling medical demands. High fitting accuracy was demonstrated by applying the osteosynthesis plate to an equally good 3D printed bone model, which likewise was generated using the patient-specific computer tomography (CT) data employing selective laser sintering and polyamid 12. Proper fixation has been achieved without any further manipulation of the plate using standard screws, proving that based on CT data, individualized implants well adapted to the anatomical conditions can be accomplished without the need for additional steps, such as bending, cutting and shape trimming of precast bone plates during the surgical intervention. Beyond parameter optimization for selective laser melting, this exemplified digital to physical process chain highlights the potential of additive manufacturing for individualized osteosynthesis.
Highlights
For medical applications, the additive manufacturing (AM) technology of selective laser melting (SLM) offers the distinguished opportunity of extensive customization as per individual patient data.This applies, e.g., for the fabricating of exact-fit, patient-specific orthopedic models, surgery-specific instruments and devices, artificial limbs and prosthetic implants [1,2,3,4]
Though fully integrated process chains may not be conceivable today, the actual adaption of client data from computer tomography (CT) to the manufacturing system with appropriate post-processing is rarely exemplified in the literature for concrete examples [30,31,32,33]. In this contribution we demonstrate the generation of a patient-specific, individualized osteosynthesis plate by selective laser melting as to exemplify, beyond typically published parameter optimization for SLM, the clinical translation along the digital to physical process chain; i.e., the focus of this contribution is the exmeplification of the process chain, rather than optimization of materials or in vivo studies
The physical process chain consists of the following steps: (1) digital construction of the part, (2) data preparation for processing in additive manufacturing—e.g., defining the build orientation and support structures, (3) preparation of the AM system, (4) AM fabrication process, (5) part removal from the AM system—e.g., part cutting from the build plate and thermal treatment, (6) post-processing of the surface—e.g., blasting and (7) final product ready for application [34,35,36]
Summary
The additive manufacturing (AM) technology of selective laser melting (SLM) offers the distinguished opportunity of extensive customization as per individual patient data. This applies, e.g., for the fabricating of exact-fit, patient-specific orthopedic models, surgery-specific instruments and devices, artificial limbs and prosthetic implants [1,2,3,4]. The application of AM offers ideal fit of implants, allowing for fast and efficient production of customized products, thereby saving time and costs [6]. AM may transform innovation and supply chain logistics for the medical device industry. For the acquisition of patient-specific, individualized data, three dimensional imaging methods, such as optical 3D-scanners (laser scanning or stripe line projection), magnetic resonance imaging (MRI)
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