由聚乳酸(pldla)和β-磷酸三钙(β-TCP)制成的3d打印患者特异性植入物用于桡骨远端矫正截骨。

IF 3.2 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING 3D printing in medicine Pub Date : 2024-12-18 DOI:10.1186/s41205-024-00240-z
Adam Jakimiuk, Michaela Maintz, Magdalena Müller-Gerbl, Florian Markus Thieringer, Marco Keller, Alissa Guebeli, Philipp Honigmann
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引用次数: 0

摘要

治疗骨不愈合最常见的外科手术是矫正截骨术。目前用于截骨后固定骨段的金标准是使用钛板和同种异体移植物,其缺点是可能产生过敏反应,需要进行额外的手术,如从其他部位取出移植物和切除手术。可吸收材料的利用提供了一个机会,以减轻这些缺点,但尚未在文献中进行彻底的研究。本研究评估了使用可生物降解的3d打印患者特异性植入物的可行性,该植入物由聚(- l -丙交酯-co- d, l -丙交酯)(pldla)和β-磷酸三钙(β-TCP)制成,作为体外生物力学研究的替代材料,包括体外生物力学压缩测试、生物降解测试和量热测量。这些植入物具有独特的形状,类似于楔子,并使用可吸收螺钉固定作为截骨骨之间的连接。根据护理点虚拟规划,使用(n = 5)离体半径配备pldla / β-TCP植入物进行生物力学压缩测试,以证明连接具有足够的稳定性。所有pldla / β-TCP植入物都能承受至少1'211 N的压缩力,这超过了文献报道的从一米高处坠落时的最大压力。此外,结果表明,表面化学性质一致,降解速度慢。结果令人鼓舞,为创新桡骨远端矫正截骨手术方法奠定了基础。然而,需要进一步的研究来彻底评估植入物的长期生物降解性和机械功效。
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3D-printed patient-specific implants made of polylactide (PLDLLA) and β-tricalcium phosphate (β-TCP) for corrective osteotomies of the distal radius.

The most common surgical procedure to manage the malunion of the bones is corrective osteotomy. The current gold standard for securing the bone segments after osteotomy is the use of titanium plates and allografts which have disadvantages such as possible allergic reaction, additional operations such as extraction of the graft from other sites and removal operation. The utilization of resorbable materials presents an opportunity to mitigate these drawbacks but has not yet been thoroughly researched in the literature. This study assesses the viability of using biodegradable, 3D-printed patient-specific implants made of Poly(-L-lactide-co-D, L-lactide) (PLDLLA) and β-Tricalcium Phosphate (β-TCP) as an alternative material in an in-vitro biomechanical study involving ex vivo biomechanical compression testing, biodegradation testing, and calorimetric measurements. These implants possess a unique shape, resembling a wedge and are fixated as a connection between the osteotomised bone using resorbable screws. Following point-of-care virtual planning, bio-mechanical compressive tests with (n = 5) ex vivo radii equipped with PLDLLA/ β-TCP implants were performed to prove sufficient stability of the connection. All PLDLLA/ β-TCP implants withstood a compressive force of at least 1'211 N which exceeds the maximum force reported in literature in case of a fall from the height of one meter. Furthermore, the results showed a consistent surface chemistry and slow degradation rate. The outcomes are encouraging, establishing the groundwork for an innovative distal radius corrective osteotomy surgical method. However, further research is necessary to thoroughly evaluate the long-term biodegradability and mechanical efficacy of the implants.

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