4.5 Review

Three-Dimensional Printing of Medical Devices Used Directly to Treat Patients: A Systematic Review

Journal

3D PRINTING AND ADDITIVE MANUFACTURING
Volume 8, Issue 6, Pages 366-408

Publisher

MARY ANN LIEBERT, INC
DOI: 10.1089/3dp.2020.0324

Keywords

3D printing; medical device; medicine; patient; clinical; treatment

Funding

  1. Science Foundation Ireland (SFI) [SFI 16/RC/3918, SFI 20/COV/0031]
  2. European Regional Development Fund

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This study found a significant increase in the use of 3D printing for directly manufacturing medical devices for clinical use in the past 3 years, with a focus on orthopedics and orthopedic oncology. The predominant materials and technologies currently used include titanium alloy/electron beam melting for implants, and polyamide/selective laser sintering or polylactic acid/fused deposition modeling for surgical guides and instruments.
Until recently, three-dimensional (3D) printing/additive manufacturing has not been used extensively to create medical devices intended for actual clinical use, primarily on patient safety and regulatory grounds. However, in recent years there have been advances in materials, printers, and experience, leading to increased clinical use. The aim of this study was to perform a structured systematic review of 3D-printed medical devices used directly in patient treatment. A search of 13 databases was performed to identify studies of 3D-printed medical devices, detailing fabrication technology and materials employed, clinical application, and clinical outcome. One hundred and ten papers describing one hundred and forty medical devices were identified and analyzed. A considerable increase was identified in the use of 3D printing to produce medical devices directly for clinical use in the past 3 years. This is dominated by printing of patient-specific implants and surgical guides for use in orthopedics and orthopedic oncology, but there is a trend of increased use across other clinical specialties. The prevailing material/3D-printing technology used were titanium alloy/electron beam melting for implants, and polyamide/selective laser sintering or polylactic acid/fused deposition modeling for surgical guides and instruments. A detailed analysis across medical applications by technology and materials is provided, as well as a commentary regarding regulatory aspects. In general, there is growing familiarity with, and acceptance of, 3D printing in clinical use.

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