Review Article Three-dimensional Printing in Orthopaedic Surgery: Current Applications and Future Developments ABSTRACT Three-dimensional (3D) printing is an exciting form of manufacturing technology that has transformed the way we can treat various medical pathologies. Also known as additive manufacturing, 3D printing fuses materials together in a layer-by-layer fashion to construct a final 3D product. This technology allows flexibility in the design process and enables efficient production of both off-the-shelf and personalized medical products that accommodate patient needs better than traditional manufacturing processes. In the field of orthopaedic surgery, 3D printing implants and instrumentation can be used to address a variety of pathologies that would otherwise be challenging to manage with products made from traditional subtractive manufacturing. Furthermore, 3D bioprinting has significantly impacted bone and cartilage restoration procedures and has the potential to completely transform how we treat patients with debilitating musculoskeletal injuries. Although costs can be high, as technology advances, the economics of 3D printing will improve, especially as the benefits of this technology have clearly been demonstrated in both orthopaedic surgery and medicine as a whole. This review outlines the basics of 3D printing technology and its current applications in orthopaedic surgery and ends with a brief summary of 3D bioprinting and its potential future impact. Three-dimensional (3D) printing (additive manufacturing) has revolutionized the design theory and manufacturing processes behind a wide range of products in all major industries, providing substantial opportunity for easy prototyping, small production runs with opportunity for real-time refinement, and customizability. Creating geometrically complex and heavily detailed designs and even one-off manufacturing that would not be feasible with traditional production methods has been made possible with this powerful technology. In addition, traditional manufacturing tends to require a central manufacturing site with space to store large inventories. Ondemand manufacturing, made possible with 3D printing, has changed this workflow and eliminated the need for a large production and storage space. The technology has become an integral component to commercial Journal of the AAOS Global Research & Reviews® ----- April 2021, Vol 5, No 4 ----- © American Academy of Orthopaedic Surgeons 1 Colleen M. Wixted, BS Jonathan R. Peterson, MD Rishin J. Kadakia, MD Samuel B. Adams, MD From the Department of Orthopaedic Surgery, Duke University, Durham, NC. Dr. Adams or an immediate family member has stock options in Restor3D and 4Web. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Ms. Wixted, Dr. Peterson, and Dr. Kadakia. JAAOS Glob Res Rev 2021;5:1-11 DOI: 10.5435/JAAOSGlobal-D-20-00230 Copyright 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. This is an open access article distributed under the Creative Commons Attribution License 4. 0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. APRIL 2022 | The Surgical Technologist | 161
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