A systematic review of three dimensional (3-D) printing applications in hip and knee arthroplasty

Abstract

Three dimensional (3D) printing, a form of rapid prototyping (RP) which is based on computer aided design (CAD) has been around for decades. Its use in orthopaedic surgery is still under development. Specific indications of 3D printing include complex hip and knee procedures, deformities particularly in malignancy and infection, as well as complex trauma. The aim of this paper is to review the literature on the clinical application of 3D printing in orthopaedic surgery.

A literature search was carried out on MEDLINE using search terms ‘three dimensional printing”, “rapid prototyping”, AND “hip surgery” and “knee surgery”. The database search was conducted in December 2016. Sixteen papers (547 patients) were reviewed and these described the clinical application of RP in hip and knee surgery, particularly used in revision surgery and malignant conditions where bone structure had been severely deformed. Eight studies reported reduced surgical time during hip and knee elective surgery. There was reduced intraoperative blood loss during hip arthroplasty in two studies and the post-operative alignment of the lower limb was reported as significantly more accurate in five studies compared to the conventional surgery.

Current literature suggests good outcomes to date based on the small number of clinical studies on 3D printing in orthopaedic hip and knee arthroplasty. Assessment of cost-benefit analysis as well as scoping exercises for wider clinical applications required to gauge the usefulness of this relatively new technique are lacking.