Desktop 3D Printing Is an Aid to Limb Salvage at UF Health
Three-dimensional (3D) printing technology is steadily gaining popularity in medicine, especially in orthopedics. At the UF Health Orthopaedics and Sports Medicine Institute, it is being used routinely as an aid to limb salvage surgery during cancer treatment.
“We are using the new technology of 3D printing to help guide both resection and reconstruction,” says Mark Scarborough, MD, a professor of orthopedic oncology and chair of the UF department of orthopaedics and rehabilitation.
Scarborough explains that two principal uses of 3D printing in his field are to:
- Print a model of the tumor by feeding computed tomography data into a specialized software program. The model can be used as a guide to plan both the resection and the subsequent reconstruction.
- Print a cutting jig designed to fit the individual patient’s 3D anatomic data — this guides the surgeon in making complicated bone cuts rather than having to do them freehand.
“The second method is more technically challenging but it increases the accuracy of the cuts,” Scarborough says. “When you take out a tumor and have to replace the defect with a section of allograft, it’s like having to cut a piece of jigsaw puzzle and then fit it back in. With 3D printing, after you cut out the tumor, you can cut out an identical piece of bone for transplant.” Figure 1 shows a model of a tumor and its matching allograft.
3D printing can also help the surgeon plan the procedure. “Building a model gives you a 3D spatial representation of what you’ll need to do,” Scarborough notes. “It’s a lot easier to understand when you have a model that you can hold in your hands, rather than just looking at images and trying to translate them into your brain.” These highly accurate models can even help the surgeon anticipate complications.
An additional advantage of preoperative planning may be the identification of inadequate tools or instruments, particularly for rare or complex cases for which standard surgical equipment may not be suitable. 3D printing allows the surgeon to design and produce their own tools to overcome anticipated challenges, reducing the risks of errors or additional complications.
“All of these benefits improve the quality of the surgery and help the surgeon understand what needs to be accomplished,” Scarborough notes.
Scarborough says he and his colleagues do about one surgery per month that makes use of 3D printing. “It’s become cheap and easy,” he adds. “We can get a model done with a desktop printer for about $20.”
Custom commercial models and jigs are also available, although they are more expensive. Figure 2 shows an allograft resting in a commercially produced custom 3D printed holder with cutting jigs.
Whatever method chosen, Scarborough says, 3D printing “allows more conservative limb salvage surgery — we don’t have to take as much bone out — and it improves outcomes.”