The Application Of3D Printing Technology In The Reconstruction Of Bone Structure

Objectives：To explore the application of the joints and prosthesis aroundthe joint made from3D printing technology in thereconstruction of bone and joints structure.Methods:Selecting four patients who hospitalized in Bethune’ssecond hospital of jilin university during February2014toDecember2014.one patient with severe rheumatoid arthritis onbilateral elbow and thee patients with bone tumor.One of thepatients, female,48years old,rheumatoid arthritis; Anotherpatients, female,62years old,right pelvic metastaticcarcinoma; The third patient,female,50years old, right tibiabone giant cell tumors;The forth patient,male,34yearsold,left radial bone giant cell tumors.Testing the patients’limb with CT scan.The data is saved as a DICOM format,input theMaterialine three-dimensional modeling software,then,inputthe UG6.0software to get three-dimensional model of Digital bone defect.Using Computer aided design software design bonedefect module base on bone defect and physical lines offorce.Save and transmit the results to the3D printer in thelast. With electron beam melting technology at high temperatureand melting titanium alloy,the rapid prototyping make it realto get individual formed and high porosity customizedmodule.During the operation,cutting bone with installationguide of bone cutting according to the designed removal ofplane before the operation.Installate3D printing metalprosthesis accuratly.Results:The3D printing of orthopedic products size andstructure are accord with human body normal anatomical modelof the structure.This is helpful to the doctors making surgicalpre-operative planning facing difficult cases.The reducingoperation steps and the highing accuracy of the operation comefrom the delicate guide tool;The metal implants withmicroporous improve bone integration effectivly and improvethe clinical curative effect of the disease significantly.All of the4patients under general anesthesia got through3D printing metal prosthesis arthroplasty,including oneartificial bilateral elbow arthroplasty,one artificial wrist joint arthroplasty、one artificial knee joint arthroplasty、one artificial half pelvic prosthesis arthroplasty. Thesurgery lasted120minutes to180minutes,140minutes inaverage.The length of hospital stays is7to14days.The3D printing elbow prosthesis can match with the hostbone perfectly,installed directly, fixed firmly.The3Dprinting half pelvic prosthesis can fixes ilium and pubic withacetabulum screw and screw on the wing. The3D printing wristprosthesis implanted in bone cement regular way of radial bonemarrow cavity.The3D printing tibial prosthesis implantedtibial medullary cavity in way of bone cement regular.We do the follow-up after the surgery1to3months. Thepatient with bilateral elbow joint replacement began tofunctioning exercise.The joint function recovered well，thefollow-up results is well3months after the operation,nopostoperative complications, The prosthesis has no loosephenomenon on X ray film; Patients with artificial pelvis ofa good recovery of joint function,can be early functionalexercises on bed,the patients stay on bed before the operation,the Harris score is6.5in the right hip joint. The patientis able to walk after3months of the operation,the Harrisscore is66.5;The patient with artificial knee joint replacement began the function execise after3months of theoperation,gets a better lower limb power line and jointactivity, follow-up visit after3months of the operation,nopostoperative complications, the knee function is good, ROMis0°～110°,KSS score in the knee is85,no tumor and looseis found in the X ray film;We make no check on patient withwrist joint replacement because of the gypsum,the follow-upvisit after1month of the opteration,the function iswell,Cooney score is25before the operation,55after theoperation, no tumor and loose is found in the X ray film.Conclusion:The application of3D printing technology in bonestructure reconstruction make it possible to simulate thesurgery before the operation to solve the complicated jointdiseases and reconstruct anatomical morphology,to designprecise preoperative individualized artificial counterfeitingbody,make the prosthesis matches the host bone very well,thereduceing steps and the more accurate operation benefit fromthe guide, the reduceing steps and the more accurate operationbenefit from the guide, with microporous metal can effectlyimprove the implant bone integration, significantly improvethe clinical curative effect of the disease.