A clinician-run 3D-printing laboratory for orthopaedic preoperative planning: an illustrative case series

BACKGROUND: Orthopaedic surgery often benefits from innovation in biomedical engineering, with 3D printing being one of the latest examples. Proving cost-effectiveness and improved clinical outcomes remains challenging. Because of the reduced cost and increased accessibility, it has been possible to start an orthopaedic 3D-printing laboratory in a South African tertiary hospital, exploring the place for this emergent technology in orthopaedic practice. This case series aims to illustrate the clinical use of 3D-printed anatomical models and investigate the time and cost involved in their manufacture METHODS: The design and manufacturing process is discussed, and a retrospective descriptive case series is presented of all models manufactured from January 2020 to April 2021. Using three illustrative cases, we elaborate on two main usage situations: intraoperative reference models (haptic maps) or rehearsal and templating (simulation models RESULTS: In the study, 3D-printed anatomical models were manufactured for 16 patients. For 12 patients, these were simulation models, and for the other four patients, haptic maps were made. The mean time for manufacture was 33 hours (range 8-62), and the median cost per patient was ZAR 3 257.62 (range ZAR 927.17 to ZAR 7 177.09 CONCLUSION: Considering the decreasing cost and ease of using 3D-printing technology, starting a clinician-run orthopaedic 3D-printing laboratory at a South African training hospital has become possible. In this series we illustrate how 3D printing has been used at our unit for planning and rehearsal of a wide range of orthopaedic cases, and we establish a baseline of time and cost expenditure. The cost-effectiveness of implementing 3D-printing technology in everyday orthopaedic practice warrants further investigation Level of evidence: Level 5