3 Boyutlu Yazıcıların Ortopedi ve Travmatolojide Kullanımı

Yazarlar

Bilgehan Ocak
Ramadan Özmanevra
Nihat Demirhan Demirkıran
https://orcid.org/0000-0002-0724-9672

Özet

3 boyutlu yazıcılar, DICOM medikal görüntü verilerini bilgisayar programları yardımıyla stereolitografi formatına dönüştürüp hammaddeleri katmanlar halinde üst üste ekleyerek çalışan yenilikçi bir üretim teknolojisidir. Ortopedi ve travmatoloji alanında hastaya özgü anatomik ve patolojik modellerin oluşturulmasını sağlayarak cerrahlara operasyon öncesinde görsel ve dokunsal açıdan büyük kolaylıklar sunar. Bu teknoloji; cerrahi planlama, preoperatif enstrümentasyon, pediatrik spinal cerrahiler, kişiye özel alçılama uygulamaları, artroplasti ameliyatları ve asistan hekim ile tıp öğrencilerinin eğitim süreçlerinde etkin bir şekilde rol oynamaktadır. Çoğu vakada operasyon sürelerini belirgin şekilde kısalttığı, implant uyumluluğunu artırdığı ve hasta-hekim arasındaki iletişimi güçlendirdiği kanıtlanmıştır. Geleneksel yöntemlerin neden olduğu cilt problemleri ve ağırlık gibi komplikasyonların önüne geçebilen 3 boyutlu yazıcılar, tıbbi alanda devrim niteliğinde avantajlar barındırmaktadır. Ancak yüksek üretim maliyetleri, tedarik sürelerinin uzunluğu ve klinik içi pratik kullanım zorlukları gibi aşılması gereken bazı dezavantajları da bulunmaktadır. Günümüzde plastik materyallerin ötesine geçilerek toz metaller, titanyum ve biyoyumluluğu ile mekanik mukavemeti son derece yüksek olan polieter eter keton (PEEK) gibi gelişmiş hammaddelerin kullanımı yaygınlaşmaktadır. Gelecekte biyomekanik açıdan kemiğe en yakın, sterilize edilebilir ve farmakolojik ajan taşımaya uygun skafoldların üretilmesiyle 3 boyutlu yazıcıların ortopedik cerrahideki etkinliği ve kullanım alanı çok daha üst seviyelere ulaşacaktır.

3D printers are an innovative manufacturing technology that works by converting DICOM medical image data into stereolithography format with the help of computer software and adding raw materials layer by layer. In the field of orthopedics and traumatology, it provides great convenience to surgeons in visual and tactile terms before the operation by enabling the creation of patient-specific anatomical and pathological models. This technology plays an active role in surgical planning, preoperative instrumentation, pediatric spinal surgeries, customized casting applications, arthroplasty surgeries, and the training processes of resident physicians and medical students. It has been proven to significantly shorten operation times in most cases, increase implant compatibility, and strengthen patient-doctor communication. 3D printers, which can prevent complications such as skin problems and weight caused by traditional methods, have revolutionary advantages in the medical field. However, it also has some disadvantages that need to be overcome, such as high production costs, long supply times, and difficulties in practical intraoperative use. Today, going beyond plastic materials, the use of advanced raw materials such as powder metals, titanium, and polyether ether ketone (PEEK), which has extremely high biocompatibility and mechanical strength, is becoming widespread. In the future, with the production of sterilizable scaffolds that are biomechanically closest to bone and suitable for applying pharmacological agents, the efficiency and field of use of 3D printers in orthopedic surgery will reach much higher levels.

Referanslar

WHITAKER, Matthew. The history of 3D printing in healthcare. The Bulletin of the Royal College of Surgeons of England, 2014, 96.7: 228-229.

American Society of Mechanical Engineers. Top 10 materials for 3printing https://www.asme.org/engineering-topics/articles/manufacturing-processing/top-10-materials-3d-printing. Accessed May 29, 2015.

VAISHYA, Raju; VAISH, Abhishek. 3D printing in orthopedics. In: General Principles of Orthopedics and Trauma. Springer, Cham, 2019. p. 583-590.

WONG, Kwok Chuen. 3D-printed patient-specific applications in orthopedics. Orthopedic research and reviews, 2016, 8: 57.

Brown, George A.; Milner, Brenton; Firoozbakhsh, Keikhosrow Application of Computer-Generated Stereolithography and Interpositioning Template in Acetabular Fractures: A Report of Eight Cases, Journal of Orthopaedic Trauma: May 2002 - Volume 16 - Issue 5 - p 347-352

TACK, Philip, et al. 3D-printing techniques in a medical setting: a systematic literature review. Biomedical engineering online, 2016, 15.1: 1-21.

Kunz M, Balaketheeswaran S, Ellis RE, Rudan JF. The influence of osteophyte depiction in CT for patient-specific guided hip resurfacing procedures. Int J Comput Assist Radiol Surg. 2015 Jun;10(6):717-26. doi: 10.1007/s11548-015-1200-7. Epub 2015 Apr 11. PMID: 25861892.

Voleti PB, Hamula MJ, Baldwin KD, Lee GC. Current data do not support routine use of patient-specific instrumentation in total knee arthroplasty. J Arthroplasty. 2014 Sep;29(9):1709-12. doi: 10.1016/j.arth.2014.01.039. Epub 2014 May 27. PMID: 24961893.

GUARINO, Joe, et al. Rapid prototyping technology for surgeries of the pediatric spine and pelvis: benefits analysis. Journal of Pediatric Orthopaedics, 2007, 27.8: 955-960.

Lu S, Xu YQ, Lu WW, Ni GX, Li YB, Shi JH, Li DP, Chen GP, Chen YB, Zhang YZ. A novel patient-specific navigational template for cervical pedicle screw placement. Spine (Phila Pa 1976). 2009 Dec 15;34(26):E959-66. doi: 10.1097/BRS.0b013e3181c09985. PMID: 20010385.

Miyake J, Murase T, Moritomo H, Sugamoto K, Yoshikawa H. Distal radius osteotomy with volar locking plates based on computer simulation. Clin Orthop Relat Res. 2011 Jun;469(6):1766-73. doi: 10.1007/s11999-010-1748-z. Epub 2011 Jan 4. PMID: 21203873; PMCID: PMC3094613.

Hananouchi T, Saito M, Koyama T, Sugano N, Yoshikawa H. Tailor-made Surgical Guide Reduces Incidence of Outliers of Cup Placement. Clin Orthop Relat Res. 2010 Apr;468(4):1088-95. doi: 10.1007/s11999-009-0994-4. Epub 2009 Jul 24. PMID: 19629605; PMCID: PMC2835612.

ELTORAI, Adam EM; NGUYEN, Eric; DANIELS, Alan H. Three-dimensional printing in orthopedic surgery. Orthopedics, 2015, 38.11: 684-687.

VAISHYA, Raju; VAISH, Abhishek. 3D printing in orthopedics. In: General Principles of Orthopedics and Trauma. Springer, Cham, 2019. p. 583-590.

Voleti PB, Hamula MJ, Baldwin KD, Lee GC. Current data do not support routine use of patient-specific instrumentation in total knee arthroplasty. J Arthroplasty. 2014 Sep;29(9):1709-12. doi: 10.1016/j.arth.2014.01.039. Epub 2014 May 27. PMID: 24961893.

Gelecek

8 Haziran 2022

Lisans

Lisans