Modular design workflow for 3D printable bioresorbable patient-specific bone scaffolds: extended features and clinical validation

Frontiers in Bioengineering and Biotechnology, vol. 12, pp. 1404481

Abstract

A previously in-house developed patient-specific scaffold design workflow was extended with new features to overcome several limitations and to broaden its adaptability to diverse bone defects, thereby enhancing its fit for routine clinical use. It was applied to three clinical cases for further validation. A virtual surgical resection tool was developed to remove regions of the bone defect models. The minor cavity fill module enabled the generation of scaffold designs with smooth external surfaces and the segmental defect fill module allowed a versatile method to fill a segmental defect cavity. The boundary representation method based surgical approach module in the original workflow was redeveloped to use functional representation, eliminating previously seen resolution dependant artefacts. Lastly, a method to overlay the scaffold designs on computed tomography images of the defect for design verification by the surgeon was introduced. The extended workflow was applied to two ongoing clinical case studies of a complex bilateral femoral defect and a humerus defect, and also to a case of a large volume craniomaxillofacial defect. It was able to successfully generate scaffolds without any obstructions to their surgical insertion which was verified by digital examination as well as using physical 3D printed models. All produced surface meshes were free from 3D printing mesh errors. The scaffolds designed for the ongoing cases were 3D printed and successfully surgically implanted, providing confidence in the extended modular workflow's ability to be applied to a broad range of diverse clinical cases.

Authors 10

1. Buddhi Herath

   Australian Research Council · Queensland University of Technology · Metro North Hospital and Health Service

   Affiliation as printed

   Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

   Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

   Jamieson Trauma Institute, Metro North Hospital and Health Service, Brisbane, Australia

   School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia

2. Markus Laubach

   Australian Research Council · Queensland University of Technology · LMU Klinikum · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

   Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

   Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Munich, Germany

   School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia

3. Sinduja Suresh

   Australian Research Council · Queensland University of Technology

   Affiliation as printed

   Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

   Biomechanics and Spine Research Group at the Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia

   Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

   School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia

4. Beat Schmutz

   Australian Research Council · Queensland University of Technology · Metro North Hospital and Health Service

   Affiliation as printed

   Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

   Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

   Jamieson Trauma Institute, Metro North Hospital and Health Service, Brisbane, Australia

   School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia

5. Judith Paige Little

   Australian Research Council · Queensland University of Technology

   Affiliation as printed

   Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

   Biomechanics and Spine Research Group at the Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia

   Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

   School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia

6. Prasad K.D.V. Yarlagadda

   Australian Research Council · Queensland University of Technology

   Affiliation as printed

   Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

   Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

   School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia

7. Heide Delbrück Aachen Department of Orthopaedics, Trauma and Reconstructive Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany

8. Frank Hildebrand Aachen Department of Orthopaedics, Trauma and Reconstructive Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany

9. Dietmar Werner Hutmacher corresponding

   Australian Research Council · Max Planck Society · Queensland University of Technology

   Affiliation as printed

   Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

   Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

   Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, Australia

   School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia

10. Marie‐Luise Wille

    Australian Research Council · Max Planck Society · Queensland University of Technology

    Affiliation as printed

    Australian Research Council Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, Australia

    Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia

    Max Planck Queensland Centre for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, Australia

    School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia