Dimensional Printing Technology Research Articles

Custom Triflange Acetabular Implants for Complex Hip Revisions: A Case Series.

Revision total hip arthroplasty (THA) presents a formidable challenge when addressing extensive acetabular defects, particularly in severe cases classified under Paprosky types 3A and 3B and American Academy of Orthopaedic Surgeons types 3 and 4. Traditional methods often fall short, prompting the potential use of custom triflange acetabular components or patient-specific acetabular implants (PSAIs). These implants are specifically designed to conform to an individual's anatomy, aiming to enhance defect reconstruction and pelvic stabilization. This case series describes the utilization of advanced 3-dimensional printing and rapid prototyping technologies to construct customized acetabular components, which can be instrumental in enabling precise preoperative planning and surgical execution for these difficult acetabular cases and potentially leading to improved surgical outcomes.

Application of 3D Printing in Cleft Lip and Palate Repair.

This manuscript reviews the transformative impact of 3-dimensional (3D) printing technologies in the treatment and management of cleft lip and palate (CLP), highlighting its application across presurgical planning, surgical training, implantable scaffolds, and postoperative care. By integrating patient-specific data through computer-aided design and manufacturing, 3D printing offers tailored solutions that improve surgical outcomes, reduce operation times, and enhance patient care. The review synthesizes current research findings, technical advancements, and clinical applications, illustrating the potential of 3D printing to revolutionize CLP treatment. Further, it discusses the future directions of combining 3D printing with other innovative technologies like artificial intelligence, 4D printing, and in situ bioprinting for more comprehensive care strategies. This paper underscores the necessity for multidisciplinary collaboration and further research to overcome existing challenges and fully utilize the capabilities of 3D printing in CLP repair.

The uses of 3-dimensional printing technology in orthodontic offices in North America

The purpose of this study was to examine the use of orthodontic 3-dimensional (3D) printing technology in North America and to understand why orthodontists are, or are not, incorporating 3D printing technology in their practices. A survey questionnaire was delivered on a secure online platform, RedCap (Case Western Reserve University Clinical and Translational Science Award; no. UL1TR002548). The survey consisted of 14-34 items with branching logic. The association between participant demographics and in-house 3D printing was assessed using a chi-square test of independence. A total of 518 responses were recorded. The highest number of responses came from respondents in the 36-45-year age group. Most of the respondents were practice owners; 46.9% had 3D printers in their office. Chi-square tests of independence were performed on the data to see which associations existed. The strongest statistical associations with using an in-house 3D printer are seen with patient load, practice type, years since residency, and orthodontist's position. Approximately 75% of orthodontists use 3D printing technology in some capacity in North America. Major factors that influenced orthodontists to incorporate 3D printing technology into their office were self-interest and research. Major factors that have prevented orthodontists from not incorporating 3D printing technology into their office were space for equipment/ventilation and digital workflow training deficit. Orthodontists use their 3D printers mostly to make plastic retainers from printed models. The strongest associations with using in-house 3D printers are seen in patient load, practice type, years since residency, and orthodontist position. Increasing patient load and being in private practice increases the likelihood of having a 3D printer.

Development of a patient specific cartilage graft using magnetic resonance imaging and 3D printing

ObjectivesThe goal of this project was to develop and validate a patient-specific, anatomically correct graft for cartilage restoration using magnetic resonance imaging (MRI) data and 3-dimensional (3D) printing technology. The specific aim was to test the accuracy of a novel method for 3D printing and implanting individualized, anatomically shaped bio-scaffolds to treat cartilage defects in a human cadaveric model. We hypothesized that an individualized, anatomic 3D-printed scaffold designed from MRI data would provide a more optimal fill for a large cartilage defect compared to a generic flat scaffold. MethodsFour focal cartilage defects (FCDs) were created in paired human cadaver knees, age <40 years, in the weight-bearing surfaces of the medial femoral condyle (MFC), lateral femoral condyle (LFC), patella, and trochlea of each knee. MRIs were obtained, anatomic grafts were designed and 3D printed for the left knee as an experimental group, and generic flat grafts for the right knee as a control group. Grafts were implanted into corresponding defects and fixed using tissue adhesive. Repeat post-implant MRIs were obtained. Graft step-off was measured as the distance in mm between the surface of the graft and the native cartilage surface in a direction perpendicular to the subchondral bone. Graft contour was measured as the gap between the undersurface of the graft and the subchondral bone in a direction perpendicular to the joint surface. ResultsGraft step-off was statistically significantly better for the anatomic grafts compared to the generic grafts in the MFC (0.0 ​± ​0.2 ​mm vs. 0.7 ​± ​0.5 ​mm, p ​< ​0.001), LFC (0.1 ​± ​0.3 ​mm vs. 1.0 ​± ​0.2 ​mm, p ​< ​0.001), patella (−0.2 ​± ​0.3 ​mm vs. −1.2 ​± ​0.4 ​mm, p ​< ​0.001), and trochlea (−0.4 ​± ​0.3 vs. 0.4 ​± ​0.7, p ​= ​0.003). Graft contour was statistically significantly better for the anatomic grafts in the LFC (0.0 ​± ​0.0 ​mm vs. 0.2 ​± ​0.4 ​mm, p ​= ​0.022) and trochlea (0.0 ​± ​0.0 ​mm vs. 1.4 ​± ​0.7 ​mm, p ​< ​0.001). The anatomic grafts had an observed maximum step-off of −0.9 ​mm and a maximum contour mismatch of 0.8 ​mm. ConclusionThis study validates a process designed to fabricate anatomically accurate cartilage grafts using MRI and 3D printing technology. Anatomic grafts demonstrated superior fit compared to generic flat grafts. Level of evidenceLevel IV.

Tracheal intubation in patients with Pierre Robin sequence: development, application, and clinical value based on a 3-dimensional printed simulator.

Background: The main clinical manifestations of patients with Pierre Robin sequence (PRS) include micrognathia, the glossoptosis and dyspnoea. The difficulty of tracheal intubation (TI) in such patients is increased. Objective: The purpose of the study was to evaluate the reliability and efficacy of the PRS simulator. Methods: A PRS simulator was developed by using 3-dimensional (3D) printing technology under computer-aided design. A total of 12 anaesthesiologists each trained 5 times for TI on the PRS Training Simulator-1 and recorded the simulation time. After the training, they were randomly divided into three groups with a total of 12 nontrained anaesthesiologists, and the simulation was completed on PRS Simulator-2, 3 and 4. The simulation time was recorded, and the performance was evaluated by three chief anaesthesiologists. Then, all 24 anaesthesiologists completed the questionnaire. Results: A PRS simulator developed by 3D printing was used to simulate the important aspects of TI. The average number of years worked was 6.3 ± 3.1years, and 66.7% were female. The time for the 12 anaesthesiologists to complete the training gradually decreased (p < 0.01). Compared with the trained anaesthesiologists, the simulation time of TI in the nontrained anaesthesiologists was much longer (all p < 0.01). In addition, the simulation performance of the trained anaesthesiologists was relatively better (all p < 0.01). Conclusion: The reliability and efficacy of the PRS simulator is herein preliminarily validated, and it has potential to become a teaching and training tool for anaesthesiologists.

Three-dimensional printed exoskeletons and orthoses for the upper limb-A systematic review.

This systematic review aims to assess and summarize the current landscape in exoskeletons and orthotic solutions developed for upper limb medical assistance, which are partly or fully produced using 3-dimensional printing technologies and contain at least the elbow or the shoulder joints. The initial search was conducted on Web of Science, PubMed, and IEEEXplore, resulting in 92 papers, which were reduced to 72 after removal of duplicates. From the application of the inclusion and exclusion criteria and selection questionnaire, 33 papers were included in the review, being divided according to the analyzed joints. The analysis of the selected papers allowed for the identification of different solutions that vary in terms of their target application, actuation type, 3-dimensional printing techniques, and material selection, among others. The results show that there has been far more research on the elbow joint than on the shoulder joint, which can be explained by the relative complexity of the latter. Moreover, the findings of this study also indicate that there is still a gap between the research conducted on these devices and their practical use in real-world conditions. Based on current trends, it is anticipated that the future of 3-dimensional printed exoskeletons will revolve around the use of flexible and high-performance materials, coupled with actuated devices. These advances have the potential to replace the conventional fabrication methods of exoskeletons with technologies based on additive manufacturing.

Cost-effective office 3D printing process in orthopaedics and its benefits: A case presentation and literature review

Background and objectives The advent of 3-Dimensional (3D) printing technology is one of the most revolutionising breakthroughs of the generation. Its benefits in surgical practice are undeniable, however a steep learning curve and concerns regarding costs may pose a barrier to large scale implementation. Methods We set up an in-house 3D printing facility in our institution and described our workflow. Using the described workflow, we 3D printed models which were used in the surgical management of three patients with differing conditions. Results We present three case examples to display the uses that 3D printing technology is able to provide in our experience, and show how 3D printing technology can be beneficial in the field of orthopaedic oncology and surgically complex cases. 3D printing has proven to be useful and improved quality of care in these case examples. The processes for each case were described individually. The benefits of our in-house 3D printing facility were discussed in detail. Conclusion An in-house office 3D printing facility is advantageous and cost-efficient. Its benefits can be maximised if implemented on a larger scale and has the potential to be standard of care in many institutions.

Facile fabrication of an extended-release tablet of Ticagrelor using three dimensional printing technology.

The objective of the study was to fabricate tailored extended-release tablets of blood thinner Ticagrelor as once-daily dosing using additive manufacturing for better compliance in heart failure therapy. The solid work design of the tablet was printed using hot melt extrusion (HME) based 3D printing by optimized mixture of Eudragit RS-100, plasticizer and drug for producing extrudable and printable filaments. FTIR and TGA results showed no covalent interaction among ingredients and no decomposition during HME process, respectively. Friability, weight variation, assay and content uniformity tests met USP requirements, while the mean hardness of the tablets was calculated in a value between 40 and 50 kg. According to DSC and XRD results, the crystallinity state of the Ticagrelor was converted to an amorphous one in the tablet matrix. Smooth surfaces with multiple deposited layers were observed using SEM. In comparison, the maximum Ticagrelor release of 100% after 120 min from Brilinta® tablets was decreased to 97% in 400 min from the 3D tablet at infill of 90%. Korsmeyer-Peppas kinetic model showed the drug release mechanism is affected by diffusion and swelling. In general, fabrication of the extended-release 3D printed tablet of Ticagrelor using HME-based-additive manufacturing has the potential to provide specific doses with tailored kinetic release for personalized medicine, improving adherence at point-of-care.

Thermoluminescence Dosimeters Holder Cassette Design and 3D Printing

3-dimensional (3D) printing technology has been used in many fields and has taken a significant place in several applications. The ease of production, cheap cost, being able to produce the product most suitable for your needs, and easy accessibility of the 3D printer have enabled it to be used in many areas.&#x0D; This study emerged from the need for an apparatus to place thermoluminescence dosimeters (TLD) during the calibration of TLDs to be used to determine organ doses in fluoroscopy applications. In the study, the TLD holder cassette that specially designed in the SolidWorks program was printed from PLA material using the fused deposition modeling (FDM) technique with Creality Ender 3 S1 printer.&#x0D; With this 3D TLD holder cassette that designed and printed in accordance with the needs, we aimed to show the usability of the 3D printing technique in almost every field of applied sciences.

The influence of structural topology of additively manufactured PEGDA monolith on adsorption performance for textile wastewater treatment

AbstractWith the rapid advancement of three dimensional (3D) printing technology that offers flexibility to achieve desired surface area and permeability for wastewater applications, structural topology design has the potential to significantly improve the adsorption performance. This present work involves fabricating the green water technology with four different complex monolithic structural designs (Kagome, gyroid, Fischer, and body‐centered cubic [BCC]) with specific surface areas varied from 19.4 to 39.84 mm2 via digital light processing (DLP) technique. All the monolithic structures with different structural topologies were grafted with chitosan to evaluate their adsorption performance in a batch process. The influence of different structural topology on the adsorption performance and efficiency was evaluated at an optimal temperature of 60°C with optimum pH of 6.3 for a reaction time of 2 h using synthetic methyl orange (MO) dye and textile wastewater. Results indicated that the body‐centered cubic (BCC) design exhibited the highest MO adsorption capacity (12.71 mg/g), with the highest permeability (2.57 10−7 m2) and surface area (39.84 mm2). Additionally, a direct relationship was found between the surface area and the permeability of the adsorbent as well as adsorption strength. Fifty percent of color and 2.46% of chemical oxygen demand (COD) removal efficiencies were achieved to verify the adsorbent feasibility in actual application. The present work mainly establishes the feasibility of 3D printing in fabricating different monolithic structures, which enables future topology optimization for improved wastewater management.

The effect of layer thıckness on the accuracy of the dıfferent ın-house clear alıgner attachments.

The accuracy of the attachments, one of the key components of clear aligner therapy, is important for obtaining more precise tooth movement. The aim of this study was to evaluate the accuracy of the ovoid, hemi-ellipsoid, and vertical rectangular attachments produced by the digital light-processing(DLP) 3-dimensional printing technologies with 25µm, 75µm, and 125µm layer thickness. The ovoid, hemi-ellipsoid, and vertical rectangular attachments were positioned onto the convex surface of the central incisor by the software. The printing process was carried out by a DLP printer using a commercially printed resin with 25µm, 75µm, and 125µm layer thickness (n = 30, for each group). All test models' digital data was exported into the reverse engineering software for the superimposition. After selecting the 5 comparison points for the ovoid and vertical rectangular attachments, and 6 comparison points for the hemi-ellipsoid attachment, the Root Mean Square (RMS) was evaluated for each group. There is a statistically significant difference between the 25µm and 125µm layer thickness of total RMS values in the ovoid, hemi-ellipsoid, and vertical rectangular attachment groups (p = 0.001, p = 0.03, and p = 0.00 respectively). The printing time with the 25µm layer thickness was 4 times longer than with the 125µm layer thickness. This study revealed that the accuracy of the attachments used for in-house clear aligner therapy is affected by the layer thickness of the 3D printer. The layer thickness of the 3D printer is a crucial factor in determining attachment accuracy, but its clinical significance is minimal. Clinicians should make informed decisions about the appropriate layer thickness, taking into account their workflow preferences, time constraints, and other practical considerations specific to their clinical practice.

Effects of novel microimplant-assisted rapid palatal expanders manufactured by 3-dimensional printing technology: A finite element study

The expansion effects of several new microimplant-assisted rapid palatal expanders (MARPEs) manufactured by 3-dimensional printing technology were evaluated by finite element analysis (FEA). The aim was to identify a novel MARPE suitable for treating maxillary transverse deficiency. The finite element model was established using MIMICS software (version 19.0; Materialise, Leuven, Belgium). First, the appropriate microimplant insertion characteristics were identified via FEA, and several MARPEs with the above insertion patterns were manufactured by 3-dimensional printing technology. Then, the stress distribution and displacement prediction of the 4 MARPEs and hyrax expander (model E) were evaluated via FEA: bone-borne (model A), bone-tooth-borne (model B), bone-mucous-borne (model C), bone-tooth-mucous-borne (model D). Monocortical microimplants perpendicular to the cortical bone on the coronal plane resulted in better expansion effects. Compared with a conventional hyrax expander, the orthopedic expansion of each of the 4 MARPEs was far larger, the parallelism was greater, and the posterior teeth tipping rate was lower. Among them, the expansion effects of models C and D were the best; the von Mises peak values on the surfaces of the microimplants were smaller than those of models A and B. This study may demonstrate that the 4 MARPEs obtained more advantageous orthopedic expansion effects than a hyrax expander. Models C and D obtained better biomechanical effects and had better primary stability. Overall, model D is the recommended expander for treating maxillary transverse deficiency because its structure acts like an implant guide and is beneficial for the accurate insertion of the microimplant.

Evaluation of marginal accuracy of nickel chromium copings fabricated from three different fabrication techniques: an in vitro study

The purpose of the study was to compare the marginal accuracy of Ni-Cr copings made by four different pattern forming methods, using inlay casting wax and pattern resin in the conventional manner, inlay wax patterns by CAD &amp; milling and resin patterns made by a 3 dimensional printing (3DP) technology a total of 40 test samples of Ni-Cr cast copings were made out of 10 patterns of each group using inlay casting wax, pattern resin, inlay wax by CAD and milling and from pattern resin by 3D printing technology. Each cast coping was seated on the stainless steel die and was evaluated for both vertical and horizontal marginal gaps using a translating tool makers microscope. The vertical marginal gap data was analyzed by use of Kruskal Wallis Test followed by Mann Whitney U Test and the horizontal marginal gap data was analyzed by using ANOVA followed by Tukey honestly significantly different (HSD) tests. 3D printed resin pattern copings showed better results of marginal adaptability. marginal fit of the Ni-Cr cast copings fabricated from the patterns prepared from inlay casting wax, pattern resin, CAD milling and 3 dimensional printing (3DP) technology were in the clinically acceptable range for longevity of restorations.

Three-Dimensional Printing Applications in Pediatric Spinal Surgery: A Systematic Review.

Systematic Review. 3DP technology use has become increasingly more common in the field of medicine and is notable for its growing utility in spine surgery applications. Many studies have evaluated the use of pedicle screw placement guides and spine models in adult spine patients, but there is little evidence assessing its efficacy in pediatric spine patient populations. This systematic review identifies and evaluates the current applications and surgical outcomes of 3-Dimensional Printing (3DP) technology in pediatric spinal surgery. A search of publications was conducted using literature databases and relevant keywords in concordance with PRISMA guidelines. Inclusion criteria consisted of original studies, and studies focusing on the use of 3DP technology in pediatric spinal surgery. Studies with a focus on adult populations, non-deformity surgery, animal subjects, systematic or literature reviews, editorials, or non-English studies were excluded from further analysis. After application of inclusion/exclusion criteria, we identified 25 studies with 3DP applications in pediatric spinal surgery. Overall, the studies found significantly improved screw placement accuracy using 3DP pedicle screw placement guides but did not identify significant differences in operative time or blood loss. All studies that utilized 3D spine models in preoperative planning found it helpful and noted an increased screw placement accuracy rate of 89.9%. 3DP applications and techniques are currently used in pre-operative planning using pedicle screw drill guides and spine models to improve patient outcomes in pediatric spinal deformity patients.

The use of a 3D printed titanium implant for arthrodesis in the management of large osseous defects in the ankle

BackgroundLarge osseous defects (LOD) in the ankle occur because of multiple aetiologies. Advancement in 3-dimensional (3D) printing technologies has led to the use of custom implants and instrumentation their management. A 3D printed patient-specific porous titanium cage which allows for peripheral osteo-integration and autogenous bone-grafting could be an ideal implant in these cases. MethodsRetrospective review of a multi-centre, multi-surgeon consecutive cohort of patients requiring either TTC or AA for a large osseous defect between June 2019 – August 2020. A custom titanium prosthesis was 3D-printed according to CT measurements for implantation. ResultsMean follow up was 19.5 months (range 12–24 months). Plain radiographs and CT scans at 12 months confirmed osseointegration (stability) in 11of 13 patients (84%). Two patients developed late infection, one requiring revision surgery. Conclusions3D-Printed titanium implants in the management of LODs in the ankle offer a comparable success rate to other reported procedures, with unlimited geometric possibilities in the design allowing for accurate length correction. Their structural stability may offer an advantage over conventional bone graft techniques and limits the amount of bone-graft required. Levels of evidenceLOE III

Application of 3-dimensional printing technology in the treatment of postoperative nonunion of femoral neck fracture: A case report.

Nonunion of the femoral neck represents the main complication following fractures at this location. Few studies have documented the application of 3-dimensional printing technology for the surgical treatment of postoperative nonunion of femoral neck fractures. The present manuscript describes a case of a particular 3-dimensional printing technology method for designing a custom-made guide plate for revision surgery. A 46-year-old man suffered a nonunion of the femoral neck following an internal fracture fixation. Using 3-dimensional printing technology, we preoperatively printed a femur model and a custom-made guide plate. Using the model, we performed a simulated operation before the surgery, and the guide plate was used for accurate osteotomy during the operation. With this method, we achieved the desired results: the fracture healed, the operation time was shortened, and there was no femoral head necrosis. Our case suggests that 3-dimensional printing technology provides an effective aid in the treatment of patients with nonunion following a femoral neck fracture and recommends 3-dimensional printing technology for such cases.

Influence of preoperative simulation on the reduction quality and clinical outcomes of open reduction and internal fixation for complex proximal humerus fractures

PurposeProximal humerus fractures (PHFs) are common. With the development of locking plates, open reduction and internal fixation (ORIF) of the proximal humerus can provide excellent clinical outcomes. The quality of fracture reduction is crucial in the locking plate fixation of proximal humeral fractures. The purpose of this study was to determine the impact of 3-dimensional (3D) printing technology and computer virtual technology assisted preoperative simulation on the reduction quality and clinical outcomes of 3-part and 4-part proximal humeral fractures.MethodA retrospective comparative analysis of 3-part and 4-part PHFs undergoing open reduction internal fixation was performed. Patients were divided into 2 groups according to whether computer virtual technology and 3D printed technology were used for preoperative simulation: the simulation group and the conventional group. Operative time, intraoperative bleeding, hospital stay, quality of fracture reduction, Constant scores, American Society for Shoulder and Elbow Surgery (ASES) scores, shoulder range of motion, complications, and revision surgeries were assessed.ResultsThis study included 67 patients (58.3%) in the conventional group and 48 patients (41.7%) in the simulation group. The patient demographics and fracture characteristics were comparable in these groups. Compared with the conventional group, the simulation group had shorter operation time and less intraoperative bleeding (P < 0.001, both). Immediate postoperative assessment of fracture reduction showed a higher incidence of greater tuberosity cranialization of < 5 mm, neck-shaft angle of 120° to 150°, and head shaft displacement of < 5 mm in the simulation group. The incidence of good reduction was 2.6 times higher in the simulation group than in the conventional group (95% CI, 1.2–5.8). At the final follow-up, the chance of forward flexion > 120° (OR 5.8, 95% CI 1.8–18.0) and mean constant score of > 65 (OR 3.4, 95% CI 1.5–7.4) was higher in the simulation group than the conventional group, as well as a lower incidence of complications in the simulation group was obtained (OR 0.2, 95% CI 0.1–0.6).ConclusionsThis study identified that preoperative simulation assisted by computer virtual technology and 3D printed technology can improve reduction quality and clinical outcomes in treatment of 3-part and 4-part PHFs.

Individualized medicine using 3D printing technology in gynecology: a scoping review

ObjectiveDevelopments in 3-dimensional (3D) printing technology has made it possible to produce high quality, affordable 3D printed models for use in medicine. As a result, there is a growing assessment of this approach being published in the medical literature. The objective of this study was to outline the clinical applications of individualized 3D printing in gynecology through a scoping review.Data sourcesFour medical databases (Medline, Embase, Cochrane CENTRAL, Scopus) and grey literature were searched for publications meeting eligibility criteria up to 31 May 2021.Study eligibility criteriaPublications were included if they were published in English, had a gynecologic context, and involved production of patient specific 3D printed product(s).Study appraisal and synthesis methodsStudies were manually screened and assessed for eligibility by two independent reviewers and data were extracted using pre-established criteria using Covidence software.ResultsOverall, 32 studies (15 abstracts,17 full text articles) were included in the scoping review. Most studies were either case reports (12/32,38%) or case series (15/32,47%). Gynecologic sub-specialties in which the 3D printed models were intended for use included: gynecologic oncology (21/32,66%), benign gynecology (6/32,19%), pediatrics (2/32,6%), urogynecology (2/32,6%) and reproductive endocrinology and infertility (1/32,3%). Twenty studies (63%) printed 5 or less models, 6/32 studies (19%) printed greater than 5 (up to 50 models). Types of 3D models printed included: anatomical models (11/32,34%), medical devices, (2/32,6%) and template/guide/cylindrical applicators for brachytherapy (19/32,59%).ConclusionsOur scoping review has outlined novel clinical applications for individualized 3D printed models in gynecology. To date, they have mainly been used for production of patient specific 3D printed brachytherapy guides/applicators in patients with gynecologic cancer. However, individualized 3D printing shows great promise for utility in surgical planning, surgical education, and production of patient specific devices, across gynecologic subspecialties. Evidence supporting the clinical value of individualized 3D printing in gynecology is limited by studies with small sample size and non-standardized reporting, which should be the focus of future studies.

Treatment of Comminuted Radial Head Fractures with Personalized Radial Head Prosthesis Produced with 3D Printing Technology.

The radial head is the forearm's pivot point for supination-pronation motions. Although radial head resection can be performed in comminuted radial head fractures, radial head prosthesis has gained popularity in order to prevent possible complications such as progressive valgus instability in the elbow and secondary ulnocarpal impaction that may develop due to proximal displacement of the radius. As for radial head prostheses, standard prosthetic designs do not provide the same results in everyone, and the alignment of the radial head and radial neck angle cannot be fully achieved. We believe that the radial head, considered the pivot point of the elbow joint, must be reconstructed with a complete anatomical implant. We designed and applied personalized prostheses to our patients, and in this study, we wished to share the 2-year results of these patients. In this study, 23 patients who had comminuted radial head fractures were applied personalized radial head prostheses. Preoperative variables such as type of injury, age, side, additional ligament injury, operation time, number of radial head parts, neck angle of individual prosthesis, stem length, and stem diameter were noted. Mean operating time was 26 ± 9 minutes. One month postoperatively, after physical therapy, elbow ROM, loss of strength compared to the opposite joint, Mayo elbow scores, QuickDASH scores, and patient satisfaction were evaluated. Patients were summoned two years postoperatively. QuickDASH and Mayo elbow scores were satisfactorily good (mean QuickDASH score: 9.091, mean Mayo score: 91.08). According to the results of the patient satisfaction questionnaire, 16 of the 23 patients reported excellent satisfaction, 5 patients good satisfaction, and 2 patients moderate satisfaction. None of the patients reported poor results. Since a personalized radial head prosthesis consists of a single monoblock, its surgical application consists of a single step and has a short operating time. As the applications in the literature increase and more studies are conducted, this subject will be better understood. Our study demonstrated that these patients, whose anatomy were individually replicated, achieved good range of motion and patient satisfaction. In fact, none of the patients reported negative results. In comminuted radial head fractures, surgical implantation of personalized radial head prosthesis is a treatment modality with easy application, short operating time, and good functional results due to nearly complete preservation.

Application of and Prospects for 3-Dimensional Printing in Transcatheter Mitral Valve Interventions

Mitral valve (MV) disease is one of the most common valvular diseases that endangers health status. A variety of catheter-based interventions have been developed to treat MV disease. The special anatomical structures of the MV complex increase the difficulty of interventional surgery, and the incidence of perioperative complications remains high. With the continuous development of cardiovascular 3-dimensional (3D) printing technology and of multidisciplinary cooperation, 3D printing for transcatheter mitral valve interventions (TMVI) has become a revolutionary technology to promote innovation and improve the success rate. Patient-specific 3D printed models have been used in measuring sizes and predicting perioperative complications before TMVI. By simulating a bench test and using multi-material printing, surgeons may learn how the device interacts with the specific anatomical structures of the MV. This review summarizes relevant cutting-edge publications in this field and illustrates the application of 3D printing in TMVI with examples. In addition, we discuss the limitations and future directions of 3D printing in TMVI. Clinical Trial Registration: ClinicalTrials.gov Protocol Registration System (NCT02917980).