Use Of 3D Printed Models Research Articles

3D-printed model is a useful addition in orthopedic resident education for the understanding of tibial plateau fractures

This study aimed to explore the role of the three-dimension (3D) printed models in orthopedic resident training of tibial plateau fractures. A total of 41 residents from our institution were divided into two groups. The intervention group, consisting of 20 residents, had access to 3D-printed models illustrating thirteen tibial plateau fractures. In contrast, the control group, comprising 21 residents, received digital images of thirteen identical tibial plateau fractures. Evaluation of learning outcomes included the accurate identification of tibial plateau fracture patterns, deduction of traumatic mechanisms, preoperative plan, assessment time, and subjective questionnaire responses. The participants with 3D printed models scored significantly higher in both the Schatzker classification and Luo three-column classification compared to those without 3D printed models. Residents in the intervention group performed better in accuracy in deducing traumatic mechanisms compared to the control group. In addition, the sum score of preoperative plan in the intervention group was significantly higher than that in the control group. Specifically, participants with 3D printed models scored higher in surgical approach choice and implants placement than these in the control group. Residents exposed to 3D printed models also spent less time to complete the assessment than those with access only to digital imaging. Subjective assessments indicated that 3D-printed models boosted confidence in fracture identification, improved preoperative plan for fracture management and enhanced the understanding in injury mechanism of tibial plateau fractures. Furthermore, residents agreed that the use of 3D-printed models heightened their interest in learning tibial plateau fractures. Therefore, the addition of 3D printed models significantly contributed to a comprehensive understanding of tibial plateau fractures, the improvement in fracture identification, inferring injury mechanisms and preoperative plan.

Evaluating the Impact of Different Education Methods on Cleft Lip and Palate Anatomy Training.

To compare the effects of different educational methods on short and long-term learning outcomes and to investigate the satisfaction and perception of cleft lip and palate (CLP) education among dental students. The theoretical exam on CLP to determine their baseline level of knowledge was taken by the participants(T0). After the exam, the students were randomly divided into three groups and all students attended a lecture-based traditional education on CLP. Students in the first group (n = 40) received no additional teaching (Group A). Students in the second group (n = 38) received model teaching with 3D-printed models (Group B). The third group (n = 39) was trained in e-learning-supported education (Group C). The theoretical exam was repeated immediately after the education (T1/short-term learning), one week later (T2/early long-term learning), and one month later (T3/late long-term learning), and the effect of the education methods on information level was assessed. In addition, a post-training satisfaction questionnaire was administered to participants of Group B and Group C. Both 3D model-based and e-learning-supported approaches significantly improved immediate knowledge of CLP. However, no significant differences were found in knowledge retention over time between the all methods. A majority of students favored the incorporation of both methods in orthodontic education. While both 3D models and e-learning effectively enhance short-term CLP knowledge among dental students, their long-term educational impacts are comparable. However, student preferences indicated that the use of 3D-printed models and e-learning strategies may be useful augmentations to traditional lecture education.

Systematic Review on the Use of 3D-Printed Models for Planning, Training and Simulation in Vascular Surgery.

The use of 3D-printed models in simulation-based training and planning for vascular surgery is gaining interest. This study aims to provide an overview of the current applications of 3D-printing technologies in vascular surgery. We performed a systematic review by searching four databases: PubMed, Web of Science, Scopus, and Cochrane Library (last search: 1 March 2024). We included studies considering the treatment of vascular stenotic/occlusive or aneurysmal diseases. We included papers that reported the outcome of applications of 3D-printed models, excluding case reports or very limited case series (≤5 printed models or tests/simulations). Finally, 22 studies were included and analyzed. Computed tomography angiography (CTA) was the primary diagnostic method used to obtain the images serving as the basis for generating the 3D-printed models. Processing the CTA data involved the use of medical imaging software; 3DSlicer (Brigham and Women's Hospital, Harvard University, Boston, MA), ITK-Snap, and Mimics (Materialise NV, Leuven, Belgium) were the most frequently used. Autodesk Meshmixer (San Francisco, CA, USA) and 3-matic (Materialise NV, Leuven, Belgium) were the most frequently employed mesh-editing software during the post-processing phase. PolyJet™, fused deposition modeling (FDM), and stereolithography (SLA) were the most frequently employed 3D-printing technologies. Planning and training with 3D-printed models seem to enhance physicians' confidence and performance levels by up to 40% and lead to a reduction in the procedure time and contrast volume usage to varying extents.

Computer Patient-Specific 3D Modeling and Custom-Made Guides for Revision ACL Surgery.

Revision anterior cruciate ligament reconstruction (ACLR) is a challenging surgery occurring in 3 to 24% of primary reconstructions. A meticulous planning to study the precise size and location of both femoral and tibial bone tunnels is mandatory. The aim of the study was to evaluate the intra- and interoperator differences in the decision-making process between experienced surgeons after they were asked to make preoperative planning for ACL revision reconstruction with the use of both the computed tomography (CT) scan and a three-dimensional (3D)-printed model of the knee. Data collected from 23 consecutive patients undergoing revision of ACLR for graft failure at a single institute between September 2018 and February 2020 were prospectively reviewed. The double-blinded collected data were presented to three board-certificate attending surgeons. Surgeons were asked to decide whether to perform one-stage or two-stage revision ACLR based on the evaluation of the CT scan images and the 3D-printed custom-made models at two different rounds, T0 and T1, respectively, 7 days apart one from the other. Interoperator consensus following technical mistake was 52% at T0 and 56% at T1 using the CT scans, meanwhile concordance was 95% at T0 and 94% at T1 using the 3D models. Concordance between surgeons following new knee injury was 66% at T0 and 70% at T1 using CT scans, while concordance was 96% both at T0 and T1 using 3D models. Intraoperative variability using 3D models was extremely low: concordance at T0 and T1 was 98%. McNemar test showed a statistical significance in the use of 3D model for preoperative planning (p < 0.005). 3D-printed model reliability resulted to be higher compared with CT as intraoperator surgery technique selection was not modified throughout time from T0 to T1 (p < 0.005). The use of 3D-printed models had the most impact when evaluating femoral and tibial tunnels, resulting to be a useful instrument during preoperative planning of revision ACLR between attending surgeons with medium-high workflow.

Early Results of a Randomized Trial on the Use of 3D-Printed Models for Endovascular Planning and Simulation in Patients Undergoing Peripheral Angioplasty

Early Results of a Randomized Trial on the Use of 3D-Printed Models for Endovascular Planning and Simulation in Patients Undergoing Peripheral Angioplasty

Accuracy and Sterilizability of In-House Printed Patient-Specific Aortic Model for Surgeon-Modified Stent Grafts-A Workflow Description for Emergency Aortic Endovascular Procedures.

Introduction: The use of 3D-printed aortic models for the creation of surgeon-modified endoprostheses represents a promising avenue in aortic surgery. By focusing on the potential impact of sterilization on model integrity and geometry, this report sheds light on the suitability of these models for creating customized endoprostheses. The study presented here aimed to investigate the safety and viability of 3D-printed aortic models in the context of sterilization processes and subsequent remodeling. Methods: The study involved the fabrication of 3D-printed aortic models using patient-specific imaging data and established additive manufacturing techniques. Five identical aortic models of the same patient were printed. Two models were subjected to sterilization and two to disinfection using commonly employed methods, and one model remained untreated. The models were checked by in-house quality control for deformation (heat map analyses) after the sterilization and disinfection processes. Three models (sterilized, disinfected, and untreated) were sent for ex-house (Lufthansa Technik, AG, Materials Technologies and Central Laboratory Services, Hamburg, Germany) evaluation and subsequent quantification of possible structural changes using advanced imaging and measurement technologies (macroscopic and SEM/EDX examinations). After sterilization and disinfection, each aortic model underwent sterility checks. Results: Based on macroscopic and SEM/EDX examinations, distinct evidence of material alterations attributed to a treatment process, such as a cleaning procedure, was not identified on the three implants. Comparative material analyses conducted via the EDX technique yield consistent results for all three implants. Disinfected and sterilized models tested negative for common pathogens. Conclusions: The evaluation of 3D-printed aortic models' safety after sterilization as well as their suitability for surgeon-modified endoprostheses is a critical step toward their clinical integration. By comprehensively assessing changes in model integrity and geometry after sterilization, this research has contributed to the broader understanding of the use of 3D-printed models for tailor-made endovascular solutions. As medical technologies continue to evolve, research endeavors such as this one can serve as a foundation for harnessing the full potential of 3D printing to advance patient-centered care in aortic surgery.

Use of 3D-printed model of liver by experts and novices

Use of 3D-printed model of liver by experts and novices

Availability and issues of 3D-printed skull models for veterinary anatomy laboratories from students' perspective before and during the COVID-19 pandemic.

Three-dimensional (3D)-printed models of bones are a convenient and durable alternative to real bone specimens, and they have been used in anatomy laboratories. It is necessary to identify the precise advantages of 3D-printed models from all perspectives; not only the improvement in students' knowledge of anatomy but also the students' assessment of such models. Here, students of veterinary medicine and animal science evaluated the reproducibility and effectiveness of 3D-printed models as a learning tool by completing our questionnaires, with a focus on their understanding of the skull-morphological differences among dog breeds. With the COVID-19 pandemic having obliged veterinary universities to provide courses online, we also investigated how the pandemic affected the students' evaluation of the 3D-printed models. The questionnaire results revealed that the animal science students were satisfied with the reproducibility of the 3D-printed models, but the veterinary students were not (they preferred to use real specimens). The skull differences were well understood by both types of students, indicating that 3D-printed models are effective for learning about rare skeletal specimens. The veterinary students who experienced the COVID-19 pandemic tended to choose real specimens more often than those who did not have this experience. Our results suggest that the use of 3D-printed models as an introduction and the use of real specimens in anatomy laboratory courses can be adequate for veterinary students. Together our findings suggest ways to improve the educational performance of 3D-printed models for veterinary students who need to understand the anatomy of many species.

Three-Dimensional Printing and Bioprinting in Renal Transplantation and Regenerative Medicine: Current Perspectives.

For patients with end-stage kidney disease (ESKD), renal transplantation is the treatment of choice, constituting the most common solid organ transplantation. This study aims to provide a comprehensive review regarding the application of three-dimensional (3D) printing and bioprinting in renal transplantation and regenerative medicine. Specifically, we present studies where 3D-printed models were used in the training of surgeons through renal transplantation simulations, in patient education where patients acquire a higher understanding of their disease and the proposed operation, in the preoperative planning to facilitate decision-making, and in fabricating customized, tools and devices. Three-dimensional-printed models could transform how surgeons train by providing surgical rehearsal platforms across all surgical specialties, enabling training with tissue realism and anatomic precision. The use of 3D-printed models in renal transplantations has shown a positive impact on surgical outcomes, including the duration of the operation and the intraoperative blood loss. Regarding 3D bioprinting, the technique has shown promising results, especially in the field of microfluidic devices, with the development of tissue demonstrating proximal tubules, glomerulus, and tubuloinerstitium function, and in renal organoid development. Such models can be applied for renal disease modeling, drug development, and renal regenerative medicine.

3D-Printed models for left atrial appendage occlusion planning: a detailed workflow

PurposeLeft atrial appendage occlusion (LAAO) is a structural interventional cardiology procedure that offers several possibilities for the application of additive manufacturing technologies. The literature shows a growing interest in the use of 3D-printed models for LAAO procedure planning and occlusion device choice. This study aims to describe a full workflow to create a 3D-printed LAA model for LAAO procedure planning.Design/methodology/approachThe workflow starts with the patient’s computed tomography diagnostic image selection. Segmentation in a commercial software provides initial geometrical models in standard tessellation language (STL) format that are then preprocessed for print in dedicated software. Models are printed using a commercial stereolithography machine and postprocessing is performed.FindingsModels produced with the described workflow have been used at the Careggi Hospital of Florence as LAAO auxiliary planning tool in 10 cases of interest, demonstrating a good correlation with state-of-the-art software for device selection and improving the surgeon’s understanding of patient anatomy and device positioning.Originality/value3D-printed models for the LAAO planning are already described in the literature. The novelty of the article lies in the detailed description of a robust workflow for the creation of these models. The robustness of the method is demonstrated by the coherent results obtained for the 10 different cases studied.

Impact of three-dimensional printed planning in Paprosky III acetabular defects: a case-control and cost-comparison analysis.

The main challenges in revision total hip arthroplasty (rTHA) are the treatment of the bone loss and the pre-operative planning. 3D-printed models may enhance pre-operative planning. The aim of the study is to compare the intra- and peri-operative results and costs for Paprosky type 3 rTHAs planned with 3D-printed models to ones accomplished with the conventional imaging techniques (X-rays and CT scan). Seventy-two patients with Paprosky type 3 defect underwent rTHA between 2014 and 2021. Fifty-two patients were treated with standard planning and 20 were planned on 3D-printed models. Surgical time, intra-operative blood loss, number of transfused blood units, number of post-operative days of hospitalization, and use of acetabular rings were compared between the two groups. A costs comparison was also performed. The 3D-printed group showed reduced operative time (101.8min (SD 27.7) vs. 146.1min (SD 49.5), p < 0.001) and total days of hospitalization (9.3days (SD 3.01) vs. 12.3days (SD 6.01), p = 0.009). The cost of the procedures was significantly lower than the control group, with an adjusted difference of4183 euros (p = 0.004).No significant differences were found for the number of total transfused blood units and blood loss and the number of acetabular rings. The use of 3D-printed models led to a meaningful cost saving. The 3D-printed pre-operative planning for complex rTHAs seems to be effective in reducing operating time, hospital stay and overall costs.

Recognition of the pattern of complex fractures of the elbow using 3D-printed models.

This study aimed to answer the following questions: do 3D-printed models lead to a more accurate recognition of the pattern of complex fractures of the elbow?; do 3D-printed models lead to a more reliable recognition of the pattern of these injuries?; and do junior surgeons benefit more from 3D-printed models than senior surgeons? A total of 15 orthopaedic trauma surgeons (seven juniors, eight seniors) evaluated 20 complex elbow fractures for their overall pattern (i.e. varus posterior medial rotational injury, terrible triad injury, radial head fracture with posterolateral dislocation, anterior (trans-)olecranon fracture-dislocation, posterior (trans-)olecranon fracture-dislocation) and their specific characteristics. First, fractures were assessed based on radiographs and 2D and 3D CT scans; and in a subsequent round, one month later, with additional 3D-printed models. Diagnostic accuracy (acc) and inter-surgeon reliability (κ) were determined for each assessment. Accuracy significantly improved with 3D-printed models for the whole group on pattern recognition (acc2D/3D = 0.62 vs acc3Dprint= 0.69; Δacc = 0.07 (95% confidence interval (CI) 0.00 to 0.14); p = 0.025). A significant improvement was also seen in reliability for pattern recognition with the additional 3D-printed models (κ2D/3D = 0.41 (moderate) vs κ3Dprint = 0.59 (moderate); Δκ = 0.18 (95% CI 0.14 to 0.22); p ≤ 0.001). Accuracy was comparable between junior and senior surgeons with the 3D-printed model (accjunior = 0.70 vs accsenior = 0.68; Δacc = -0.02 (95% CI -0.17 to 0.13); p = 0.904). Reliability was also comparable between junior and senior surgeons without the 3D-printed model (κjunior = 0.39 (fair) vs κsenior = 0.43 (moderate); Δκ = 0.03 (95% CI -0.03 to 0.10); p = 0.318). However, junior surgeons showed greater improvement regarding reliability than seniors with 3D-printed models (κjunior = 0.65 (substantial) vs κsenior = 0.54 (moderate); Δκ = 0.11 (95% CI 0.04 to 0.18); p = 0.002). The use of 3D-printed models significantly improved the accuracy and reliability of recognizing the pattern of complex fractures of the elbow. However, the current long printing time and non-reusable materials could limit the usefulness of 3D-printed models in clinical practice. They could be suitable as a reusable tool for teaching residents.Cite this article: Bone Joint J2023;105-B(1):56-63.

3D-printed model for preclinical training in oral and maxillofacial radiology

<h3>Objective</h3> 3D printing is experiencing significant growth in the teaching and learning process. Therefore, this study aimed to present a 3D-printed skull model for preclinical intraoral radiographic practice. <h3>Study Design</h3> Two 3D-printed mannequins were created. The first was created using an STL file of a skull and was edited using two 3D modeling softwares (Meshmixer and Netfabb). The second mannequin was designed directly from segmentation of a patient's CBCT data and then converted into an STL file. Both mannequins were printed using fused deposition modeling (FDM) technology and polylactic acid (PLA) filament. The printed skull bones were attached, and the mandible was articulated to the articular fossa of the temporal bone. The teeth were inserted into the alveoli. Intraoral radiographs of both mannequins were acquired using a digital sensor (Carestream RVG 5100). <h3>Results</h3> Both 3D-printed mannequins showed satisfactory radiographic appearance, allowing geometric representation of each intraoral radiographic projection, regardless of STL file origin. Anatomical structures, such as the periodontal ligament space, zygomatic process of the maxilla, and intermaxillary suture, were represented. The material cost of the printed prototype was $34.00. <h3>Conclusions</h3> The use of 3D-printed models is presented as an alternative to artificial commercial phantoms for the preclinical training of intraoral radiographic techniques, combining the radiographic projection's quality, the possibility of model manipulation, and an affordable price. <b>Statement of Ethical Review</b> Ethical review was sought and study was exempted from ethical review

Three-Dimensional Physical Model in Urologic Cancer

Three-dimensional (3D) printing, as an evolving technology, enables the creation of patient-specific physical models with high precision; thus, it is widely used in various clinical practices, especially urologic cancer. There is an increasing need to clarify the contribution of 3D printing in the practice of urological cancer in order to identify various applications and improve understanding its benefits and challenges in clinical practice. Researches have focused on the use of 3D-printed models in patient and trainee education, surgical simulation, as well as surgical planning and guidance. This mini review will present the most recently published studies on the topic, including the applications of 3D-printed models, feasibility of performed procedures, possible simulated organs, application outcomes, and challenges involved in urologic cancer, to provide potential directions for future research.

Analysis of Quality of Life With 3D-Printed Model vis-á-vis Conventional Procedure in Oral &amp; Maxillofacial Surgery – An Empirical Study

Aims and Objectives 3d-printed models (bio-models) have become a useful tool in the armamentarium of surgeons for improved surgical planning in the recent past. This study directs at reinforcing the incorporation of these bio-models as a handy tool in treatment planning, resident training, patient education and record maintenance. The aim of this empirical study was to compare the outcome in reconstructive maxillofacial surgery when planned using 3d-printed model and without 3d-printed model (conventional). The objectives were to assess and compare the intraoperative time taken during reconstruction, the immediate post-operative experience (pain, mouth opening and incidence of infection) and the quality of life using University of Washington (UW-QOL) questionnaire during follow up. Methods This retrospective comparative study was conducted in Department of Oral &amp; Maxillofacial Surgery, from March 2018 to March 2020. It included 50 cases consisting variety of pathologic and traumatic maxillofacial defects and they were grouped into with 3d-printed model (Group A) and without 3d-printed model (Group B). The groups were further subclassified based on maxillary (MR) and mandibular reconstruction [vascularized flaps (VFFF), non-vascularised grafts (NVG), reconstruction plate alone (RP)]. We compared intra operative time taken along with immediate post-operative parameters (pain, mouth opening and presence of infection) and patient’s quality of life using UW-QOL questionnaire. These values were taken for comparison and statistical analysis was done by unpaired t-test. Result There was 14.75% (35.26 minutes) mean reduction in operative time (* P = .029) and reduction in mean visual analogue score (VAS) (* P = .003) with statistically significant difference. However, increase in immediate post-operative mouth opening was not found to be statistically significant difference ( P =.471). The comparison of the social and functional domain of UW-QOL showed statistically significant P-value in saliva (*0.004) and mood (*0.002) with regard to NVG. In RP group, pain (*0.026), swallowing (*0.041) and taste (*0.008) was found to be statistically significant. In MR group, only pain (*0.037) showed statistically significant difference. Conclusion Use of 3d-printed model to guide and assist in surgical procedures have provided promising results. Based on this study, we found that there is decreased intraoperative time and post-operative pain score when 3d-printed model were used. The patient’s quality of life was also found to be better in terms of reduction in pain, salivary secretion and mood elevation. With increased success rate, the authors are of the strong opinion that it is time to revisit the surgical protocol used for reconstruction and include 3d-printed model as a primary tool or technology across the board for all patients notwithstanding the comparative cost, as the results offset the financial aspect.

Planning the treatment: preoperative 3D reconstruction

: Computed tomography and/or magnetic resonance imaging are commonly used for definite diagnosis of liver tumors, but they furnish only two-dimensional data to the surgeon, which in many cases is difficult to use during surgical treatments because the surgeon must evaluate the three-dimensional (3D) aspect of the lesion to be removed or ablated and understand patients’ hepatic features and vascular structures. The limitations of this imaging techniques mainly are due to the absence to furnish a realistic 3D perception of the anatomical intra-hepatic structures as the relationship of the lesion and the vasculo-biliary anatomy. Furthermore, in recent years, laparoscopic surgery underwent rapid development, but it requires preoperative planning more accurately than open surgery: laparoscopic ultrasound should help the surgeon to identify the position of the lesion, its relationship with Glissonian pedicles and the best resection lines. 3D reconstruction view and 3D printing technologies can clearly demonstrate the precise spatial anatomy of a nodule and can help the surgeons improve their surgical preparations, which can be used for either liver resection or thermoablation. The use of 3D-printed models or holograms in the operative room during the operation increases the surgical accuracy. This article describes all the phases of the hepatic 3D modeling and printing procedure, convenient for improving our preoperative surgical preparation for personalized surgery.

Are 3D-printed Models of Tibial Plateau Fractures a Useful Addition to Understanding Fractures for Junior Surgeons?

Tibial plateau fractures are often complex, and they can be challenging to treat. Classifying fractures is often part of the treatment process, but intra- and interobserver reliability of fracture classification systems often is inadequate to the task, and classifications that lack reliability can mislead providers and result in harm to patients. Three-dimensionally (3D)-printed models might help in this regard, but whether that is the case for the classification of tibial plateau fractures, and whether the utility of such models might vary by the experience of the individual classifying the fractures, is unknown. (1) Does the overall interobserver agreement improve when fractures are classified with 3D-printed models compared with conventional radiology? (2) Does interobserver agreement vary among attending and consultant trauma surgeons, senior surgical residents, and junior surgical residents? (3) Do surgeons' and surgical residents' confidence and accuracy improve when tibial plateau fractures are classified with an additional 3D model compared with conventional radiology? Between 2012 and 2020, 113 patients with tibial plateau fractures were treated at a Level 1 trauma center. Forty-four patients were excluded based on the presence of bone diseases (such as osteoporosis) and the absence of a CT scan. To increase the chance to detect an improvement or deterioration and to prevent observers from losing focus during the classification, we decided to include 40 patients with tibial plateau fractures. Nine trauma surgeons, eight senior surgical residents, and eight junior surgical residents-none of whom underwent any study-specific pretraining-classified these fractures according to three often-used classification systems (Schatzker, OA/OTA, and the Luo three-column concept), with and without 3D-printed models, and they indicated their overall confidence on a 10-point Likert scale, with 0 meaning not confident at all and 10 absolutely certainty. To set the gold standard, a panel of three experienced trauma surgeons who had special expertise in knee surgery and 10 years to 25 years of experience in practice also classified the fractures until consensus was reached. The Fleiss kappa was used to determine interobserver agreement for fracture classification. Differences in confidence in assessing fractures with and without the 3D-printed model were compared using a paired t-test. Accuracy was calculated by comparing the participants' observations with the gold standard. The overall interobserver agreement improved minimally for fracture classification according to two of three classification systems (Schatzker: κconv = 0.514 versus κ3Dprint = 0.539; p = 0.005; AO/OTA:κconv = 0.359 versus κ3Dprint = 0.372; p = 0.03). However, none of the classification systems, even when used by our most experienced group of trauma surgeons, achieved more than moderate interobserver agreement, meaning that a large proportion of fractures were misclassified by at least one observer. Overall, there was no improvement in self-assessed confidence in classifying fractures or accuracy with 3D-printed models; confidence was high (about 7 points on a 10-point scale) as rated by all observers, despite moderate or worse accuracy and interobserver agreement. Although 3D-printed models minimally improved the overall interobserver agreement for two of three classification systems, none of the classification systems achieved more than moderate interobserver agreement. This suggests that even with 3D-printed models, many fractures would be misclassified, which could result in misleading communication, inaccurate prognostic assessments, unclear research, and incorrect treatment choices. Therefore, we cannot recommend the use of 3D-printed models in practice and research for classification of tibial plateau fractures. Level III, diagnostic study.

3D-printed Cutting Guides for Lower Limb Deformity Correction in the Young Population.

Three-dimensional (3D) virtual surgical planning technology has advanced applications in the correction of deformities of long bones by enabling the production of 3D stereolithographic models, patient-specific instruments and surgical-guiding templates. Herein, we describe the implementation of this technology in young patients who required a corrective osteotomy for a complex 3-plane (oblique plane) lower-limb deformity. A total of 17 patients (9 males, average age 14.7 y) participated in this retrospective study. As part of preoperative planning, the patients' computerized tomographic images were imported into a post-processing software, and virtual 3D models were created by a segmentation process. Femoral and tibial models and cutting guides with locking points were designed according to the deformity correction plan. They were used for both planning and as intraoperative guides. Clinical parameters, such as blood loss and operative time were compared with a traditional surgical approach group. All osteotomies in the 3D group were executed with the use intraoperative customized cutting guides which matched the preoperative planning simulation and allowed easy fixation with prechosen plates. Surgical time was 101±6.2 minutes for the 3D group and 126.4±16.1 minutes for the control group. The respective intraoperative hemoglobin blood loss was 2.1±0.2 and 2.5+0.3 g/dL.Clinical and radiographic follow-up findings showed highly satisfactory alignment of the treated extremities in all 3D intervention cases, with an average time-to-bone union (excluding 2 neurofibromatosis 1 patients) of 10.3 weeks (range 6 to 20 wk). The use of 3D-printed models and patient-specific cutting guides with locking points improves the clinical outcomes of osteotomies in young patients with complex bone deformities of the lower limbs. Level III.

Improving Left Atrial Appendage Occlusion Device Size Determination by Three-Dimensional Printing-Based Preprocedural Simulation.

BackgroundThe two-dimensional (2D)-based left atrial appendage (LAA) occluder (LAAO) size determination by using transesophageal echocardiography (TEE) is limited by the structural complexity and wide anatomical variation of the LAA.ObjectiveThis study aimed to assess the accuracy of the LAAO size determination by implantation simulation by using a three-dimensional (3D)-printed model compared with the conventional method based on TEE.MethodsWe retrospectively reviewed patients with anatomically and physiologically properly implanted the Amplatzer Cardiac Plug and Amulet LAAO devices between January 2014 and December 2018 by using the final size of the implanted devices as a standard for size prediction accuracy. The use of 3D-printed model simulations in device sizing was compared with the conventional TEE-based method.ResultsA total of 28 cases with the percutaneous LAA occlusion were reviewed. There was a minimal difference [−0.11 mm; 95% CI (−0.93, 0.72 mm); P = 0.359] between CT-based reconstructed 3D images and 3D-printed left atrium (LA) models. Device size prediction based on TEE measurements showed poor agreement (32.1%), with a mean difference of 2.3 ± 3.2 mm [95% CI (−4.4, 9.0)]. The LAAO sizing by implantation simulation with 3D-printed models showed excellent correlation with the actually implanted LAAO size (r = 0.927; bias = 0.7 ± 2.5). The agreement between the 3D-printed and the implanted size was 67.9%, with a mean difference of 0.6 mm [95% CI (−1.9, 3.2)].ConclusionThe use of 3D-printed LA models in the LAAO size determination showed improvement in comparison with conventional 2D TEE method.

The use of 3D-printed models in patient communication: a scoping review.

3D models have been used as an asset in many clinical applications and a variety of disciplines, and yet the available literature studying the use of 3D models in communication is limited. This scoping review has been conducted to draw conclusions on the current evidence and learn from previous studies, using this knowledge to inform future work. Our search strategy revealed 269 papers, 19 of which were selected for final inclusion and analysis. When assessing the use of 3D models in doctor–patient communication, there is a need for larger studies and studies including a long-term follow up. Furthermore, there are forms of communication that are yet to be researched and provide a niche that may be beneficial to explore.