A novel approach using 3-D printing in the Irish National Centre for pelvic and acetabular surgery

• Published in: Irish journal of medical science 2020-02, Vol.189 (1), p.219-228
• Main Authors: Downey, Colum, McCarrick, Cathleen, Fenelon, Christopher, Murphy, Evelyn P., O’Daly, Brendan J., Leonard, Michael
• Format: Article
• Language: English
• Subjects: Family Medicine; General Practice; Internal Medicine; Medicine; Medicine & Public Health; Original Article
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-019-02055-y

Background Complex pelvic fractures present the orthopaedic surgeon with many challenges. 3-D printed models may provide assistance in pre-operative planning, may lead to improvements in intra-operative (i) decision making and (ii) efficiencies (time reduction, blood loss reduction, screening reduction) and may result in improvements in post-operative outcomes (fracture reduction & quality of life). The models also provide hands-on opportunities for orthopaedic trainees and patients. This may result in improvements in (i) education/training regarding the management of pelvic and acetabular fractures for orthopaedic trainees and (ii) improvements in patient consenting and overall patient satisfaction. Design Single-centre, two orthopaedic surgeons (pelvic and acetabular fellowship trained), prospective observational study. Twenty patients with acute displaced pelvic/acetabular fracture(s); ten 3-D–printed pelvis and ten non-printed cases for comparison. The comparison cohorts were matched for fracture classification, sex and age. Outcome measures Classification assistance, intra-operative time, estimated blood loss, screening amount, post-operative reduction and infection, EQ-5D-5L, teaching/educational assistance and pre-operative counselling. Results The models provided more information regarding fracture pattern, however, this did not result in change of CT-planned approach/procedure or patient outcomes. The models scored highly on surgeon’s questionnaire. The models were found to have a positive impact on trainee education and patient consenting/counselling. With regard to objective comparisons, there was no significant improvements in time-to-surgery, intra-operative time, estimated blood loss, screening amount, fracture reduction or infection rate. There was no significant difference in quality of life questionnaire ~ 12 months post-surgery (statistical tests used; Cohen’s effect size and Fisher’s exact test). Conclusions Whilst the authors recognize the positive subjective findings with respect to the use of 3-D printing in pelvic and acetabular trauma in our National Centre, objective findings were lacking.