Objective To demonstrate the advantages of 3D printing as a teaching tool in total knee arthroplasty and the effectiveness of improving the understanding on anatomy and operative skills of young trainee surgeons. Methods 3D printing in TKA provides 3D printing models which could assisted pre-operative training of design and provided surgical rehearsals, 3D printing cutting block which could guided intra-operative osteotomy, and 3D printing software which could reviewed the patient-specific implants results. Results The 3D printing model can show the real anatomical structure to young trainee surgeons more intuitively, and the surgical rehearsal on the model provide the opportunities to operate real cases for the trainees. With the intra-operative usage of cutting block, young trainee surgeons are going to have exercise whilst ensuring there is no detriment to patient safety. At last, 3D printing software will help young trainee surgeons understand the complex cases and the patient-specific implants, as well as used for distance education. Conclusions 3D printing has a valuable role as a training tool to improve young trainee surgeons skills for it have tremendous teaching advantages in total knee arthroplasty.
[1] Schubert C, van Langeveld MC, Donoso LA. Innovations in 3D printing: A 3D overview from optics to organs[J].The British Journal of Ophthalmology, 2014,98(2):159-61.DOI:10.1136/bjophthalmol-2013-304446.
[2] Kostusiak M, Hart M, Barone DG, et al. Methodological shortcomings in the literature evaluating the role and applications of 3D training for surgical trainees[J]. Medical Teacher,2017,39(11):1168-1173.DOI:10.1080/0142159X. 2017.1362102.
[3] Eisenmenger LB, Wiggins RH, Fults DW, et al. Application of 3-dimensional printing in a case of osteogenesis imperfecta for patient education, anatomic understanding, preoperative planning, and intraoperative evaluation[J].World Neurosurgery,2017,107:1049e1-1049e7.DOI:10.1016/j. wneu.2017.08.026.
[4] Bagaria V, Chaudhary K. A paradigm shift in surgical planning and simulation using 3D graphy: Experience of first 50 surgeries done using 3D-printed biomodels[J].Injury,2017,48(11):2501-2508.DOI:10.1016/j.injury.2017.08.058.
[5] 周华,于淼,刘忠军.3D打印模型在脊柱侧凸教学中的辅助作用[J].中国医学教育技术,2017,31(1):67-69.DOI:10.13566/j.cnki.cmet.cn61-1317/g4.201701020.
Zhou H, Yu M, Liu ZJ. Auxiliary role of 3D printing technology applied in the teaching of scoliosis[J].China Medical Education Technology,2017,31 (1):67-69.DOI:10.13566/j.cnki.cmet.cn61-1317/g4.201701020.
[6] 李明,孙亮,马腾,等.3D打印快速成型技术在髋臼骨折分型及年轻医生培养中的应用[J].中华创伤骨科杂志,2017,19(2):140-145.DOI:10.3760/cma.j.issn.1671-7600.2017.02.010.
Li M,Sun L,Ma T,et al. 3D-printing rapid prototyping used in classification of acetabular fractures and education of young surgeons[J]. Chinese Journal of Orthopaedic Trauma,2017,19(2):140-145.DOI:10.3760/cma.j.issn.1671-7600.2017.02.010.
[7] 艾松涛,曲扬,范新东,等.3D打印模具在本科医学影像学教学中的应用[J].中华医学教育探索杂志,2017,16(9):904-908.DOI:10.3760/cma.j.issn.2095-1485.2017.09.010.
Ai ST,Qu Y,Fan XD,et al. Application of 3D printing models in undergraduate medical imaging teaching[J].Chin J Med Edu Res,2017,16(9):904-908.DOI:10.3760/cma.j.issn.2095-1485.2017.09.010.
[8] 施凤伟,付军,郭征.3D打印技术在骨科学肿瘤教学中的应用[J].中华医学教育杂志,2015,35(6):916-917,934.DOI:10.3760/cma.j.issn.1673-677X.2015.06.033.
Shi FW,Fu J,Guo Z.The application of 3D printing technique in the oncology teaching of orthopedics[J].Chin J Med Edu,2015,35(6):916-917,934.DOI:10.3760/cma.j.issn.1673-677X.2015.06.033.
[9] Ventola CL.Medical applications for 3D printing:Current and projected uses[J].P&T,2014,39(10):704-711.
[10] Patra S, Young V. A review of 3D printing techniques and the future in biofabrication of bioprinted tissue[J].Cell Biochemistry and Biophysics,2016,74(2):93-98.DOI:10.1007/s12013-016-0730-0.
[11] Santini AJ, Raut V. Ten-year survival analysis of the PFC total knee arthroplasty: A surgeon's first 99 replacements[J].International Orthopaedics,2008,32(4):459-465.DOI:10.1007/s00264-007-0351-8.
[12] Bathis H,Perlick L,Tingart M,et al.Intraoperative cutting errors in total knee arthroplasty[J].Archives of Orthopaedic and Trauma Surgery,2005, 125(1):16-20.DOI:10.1007/s00402-004-0759-1.
[13] Hodgson A,Helmy N,Masri BA,et al.Comparative repeatability of guide-pin axis positioning in computer-assisted and manual femoral head resurfacing arthroplasty[J].Proc Inst Mech Eng H,2007,221(7):713-724.DOI:10.1243/09544119JEIM284.
[14] Luring C, Tingart M, Beckmann J,et al.Surgical training in orthopaedic and trauma departments in Germany[J].Zeitschrift fur Orthopadie und Unfallchirurgie,2010,148(4):466-470.DOI:10.1055/s-0030-1249792.
[15] Mahaluxmivala J,Bankes MJ,Nicolai P,et al.The effect of surgeon experience on component positioning in 673 press fit condylar posterior cruciate-sacrificing total knee arthroplasties[J].The Journal of Arthroplasty,2001,16(5):635-640.DOI:10.1054/arth.2001.23569.
[16] Ritter MA,Faris PM,Keating EM,et al.Postoperative alignment of total knee replacement.Its effect on survival[J].Clinical Orthopaedics and Related Research,1994(299):153-156.
[17] Hochman JB,Kraut J,Kazmerik K,et al.Generation of a 3D printed temporal bone model with internal fidelity and validation of the mechanical construct[J].Otolaryngology-Head and Neck Surgery,2014,150(3):448-454. DOI:10.1177/0194599813518008.
[18] Jones DB,Sung R,Weinberg C,et al.Three-dimensional modeling may improve surgical education and clinical practice[J].Surgical Innovation,2016,23 (2):189-195.DOI:10.1177/1553350615607641.
[19] 茹江英,时代,徐饶,等.应用个体定制三维打印截骨导板辅助行人工全膝关节置换术[J].中华关节外科杂志(电子版),2017,11(5):484-490.DOI:10.3877/cma.j.issn.1674-134X.2017.05.008.
Ru JY,Shi D,Xu R,et al.Application of three dementional printed positioning guides with patient-specific cutting block technique in total knee arthroplasty[J].Chinese Journal of Joint Surgery (Electronic Edition), 2017,11(5):484-490.DOI:10.3877/cma.j.issn.1674-134X.2017.05.008.
[20] 刘峰,张勇,朱庭标,等.3D打印截骨导板辅助TKA治疗膝外翻畸形[J].中国骨与关节损伤杂志,2017,32(3):329-331.DOI:10.7531/j.issn.1672-9935.2017.03.043.
