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Bio-Design and Manufacturing  2021 Vol.4 No.4 P.818-832

http://doi.org/10.1007/s42242-021-00153-4


3D printing of patient‑specifc implants for osteochondral defects: workfow for an MRI‑guided zonal design


Author(s):  David Kilian, Philipp Sembdner, Henriette Bretschneider, Tilman Ahlfeld, Lydia Mika, Jörg Lützner, Stefan Holtzhausen, Anja Lode, Ralph Stelzer, Michael Gelinsky

Affiliation(s):  Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; more

Corresponding email(s):   michael.gelinsky@tu-dresden.de

Key Words:  Additive manufacturing (AM), Magnetic resonance imaging (MRI), Computer-aided design (CAD), Osteochondritis dissecans (OCD), Bone cement, Hydrogel 


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David Kilian, Philipp Sembdner, Henriette Bretschneider, Tilman Ahlfeld, Lydia Mika, Jörg Lützner, Stefan Holtzhausen, Anja Lode, Ralph Stelzer, Michael Gelinsky. 3D printing of patient‑specifc implants for osteochondral defects: workfow for an MRI‑guided zonal design[J]. Journal of Zhejiang University Science D, 2021, 4(4): 818-832.

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%A Philipp Sembdner
%A Henriette Bretschneider
%A Tilman Ahlfeld
%A Lydia Mika
%A Jörg Lützner
%A Stefan Holtzhausen
%A Anja Lode
%A Ralph Stelzer
%A Michael Gelinsky
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A1 - Tilman Ahlfeld
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A1 - Jörg Lützner
A1 - Stefan Holtzhausen
A1 - Anja Lode
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Abstract: 
magnetic resonance imaging (MRI) is a common clinical practice to visualize defects and to distinguish diferent tissue types and pathologies in the human body. So far, MRI data have not been used to model and generate a patient-specifc design of multilayered tissue substitutes in the case of interfacial defects. For orthopedic cases that require highly individual surgical treatment, implant fabrication by additive manufacturing holds great potential. Extrusion-based techniques like 3D plotting allow the spatially defned application of several materials, as well as implementation of bioprinting strategies. With the example of a typical multi-zonal osteochondral defect in an osteochondritis dissecans (OCD) patient, this study aimed to close the technological gap between MRI analysis and the additive manufacturing process of an implant based on different biomaterial inks. A workfow was developed which covers the processing steps of MRI-based defect identifcation, segmentation, modeling, implant design adjustment, and implant generation. A model implant was fabricated based on two biomaterial inks with clinically relevant properties that would allow for bioprinting, the direct embedding of a patient’s own cells in the printing process. As demonstrated by the geometric compatibility of the designed and fabricated model implant in a stereolithography (SLA) model of lesioned femoral condyles, a novel versatile CAD/CAM workfow was successfully established that opens up new perspectives for the treatment of multi-zonal (osteochondral) defects.

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