Point-of-Care 3D Printing: A Feasibility Study of Using 3D Printing for Orthopaedic Trauma

Aim: The aim of this study was to assess the feasibility of 3D printing a customised implant at the point of care from a manufacturing and logistics perspective. We hypothesised that customised plate production would be possible within a clinically relevant time frame of 72 hours using currently available technology. Materials and methods: This study uses 6 cadaveric lower limbs to simulate real-life surgical patients. Split-depressed lateral tibial plateau fractures were created in an identical fashion in the cadaveric lower limbs. CT scans of the fractures were obtained and digital reconstructions were used to design customised patient and fracture-specific 3D-printed plates. These were subsequently printed in medical grade stainless steel 316L and post-processed at a local additive manufacturing centre. Surgical fixation of the fractures was then carried out using these plates, following which post-operative X-rays were obtained. The time taken for each step in plate production from the initiation of pre-operative CT scan to the completion of the post-operative X-ray was recorded. Results: Six customised proximal tibia locking plates were produced with accompanying surgical drill guides. The mean total time taken for plate fabrication from completion of CT scan was approximately 24 hours and 7 minutes, with a maximum of 28 hours and 46 minutes. Conclusion: Production of patient-specific 3D printed plates for fixation of proximal tibia fractures at the point of care is achievable within a clinically acceptable time frame provided adequate manufacturing facilities and skilled manpower are in place. (C) 2021 Elsevier Ltd. All rights reserved.