3D Printing in Podiatric Medicine

By Seeram Ramakrishna

3D Printing in Podiatric Medicine compiles an interdisciplinary range of scientific literature, laboratory developments, industrial implications and futuristic avenues in this field. The book provides recent developments and research breakthroughs in 3D printing in podiatric medicine, such as functionalized feedstock systems, smart products, process characteristics, modeling and optimization of printed systems and products, and industrial applications. It covers best practices for 3D printing methods to capture, document and validate challenges at the early stage of the design process.  The book's content then goes into mitigating design strategies to address these challenges without compromising the cost, safety and quality of the device.

This book supports new and emerging specializations and provides a comprehensive collection of technical notes, research designs, design methods and processes and case studies.

• Includes coverage of the biomechanical behavior of feet, injuries and injury prevention using 3D printed customized orthosis
• Uses an amalgamation of CAD/CAM, reverse engineering and artificial intelligence with 3D printing in podiatric medicine
• Investigates plantar pressure using gait measurement technologies

• Language: English
• Publisher: Academic Press
• Release date: Nov 15, 2022
• ISBN: 9780323985185

Book preview

Preface

On top of the increasing level of foot injuries, the designers, physiologists, biomedical engineers, ergonomists, and biomechanists know the potential of 3D printing technology in podiatric medicine. This book is intended to cover best practices, 3D printing methods to capture, document, and validate those challenges at the early stage of the design process, and mitigating design strategies to address those challenges without compromising the cost, effort, safety, and quality of the device. As the editorial team, we believe that 3D printing is curious, innovative, and helpful for the end-users. This book aims to support the new and emerging specializations and provide a comprehensive collection of technical notes, research designs, design methods and processes, case studies, and comprehensive literature on the impact of 3D printing methods and processes in podiatric medicine. This book is the first to provide multidisciplinary coverage of the application of 3D printing technology in podiatric medicine. Overall, this book helps designers, clinicians, mainstream healthcare professionals, ergonomists, ancillary healthcare professionals, manufacturing enterprises, and young research scholars understand the real potential of 3D printing. Also, the book provides the most recent developments and research breakthroughs of 3D printing in podiatric medicine, functionalized feedstock systems, smart products, process characteristics, modeling and optimization of printed systems and products, industrial applications, etc. Furthermore, particular emphasis is made on:

• Biomechanical behavior of foot, injuries, and its prevention using 3D printed customized orthosis.

• 3D printed materials for podiatric medicine.

• Use and amalgamation of CAD/CAM, reverse engineering, and artificial intelligence in 3D printing for podiatric medicine.

• 3D printed surgical guides for foot and insoles of rehabilitation.

• Evaluation of 3D printer podiatric products through various techniques.

Chapter One: Role of 3D printing in biomechanics

Mohit Vij ¹ , Neha Dand ² , Supriya Sharma ³ , Nisha Nair ³ , Sanjeev Sahu ¹ , and Pankaj Wadhwa ¹       ¹ School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India      ² Bharati Vidyapeeth's College of Pharmacy, Navi Mumbai, Maharashtra, India      ³ Delhi Pharmaceutical Sciences and Research University, New Delhi, India

Abstract

3D printing has been slowly yet steadily revolutionizing a lot of sectors, but the one arena that has benefitted the most is medicine. The areas where it has found maximum utilization are 3D printed drugs and formulations, organ or tissue fabrication, and biomechanics. Biomechanics firstly involves printing customized wearable devices that help in enhancing the user's ability to function and their overall quality of life. Secondly, in the field of biomechanics, it is used to design anatomical models for planning surgeries. Though it faces multiple challenges, it is still the go-to technique to make patient care specific and widely available. This chapter is going to focus on the biomechanical applications of 3D printing, the types of 3D printing technologies, and materials used thus far. The last segment would highlight the advancements possible to bridge the gap to bring prompt, cost-effective, and user-specific medical devices that would not have design constraints.

Keywords

3D printing; 4D; 5D and 6D printing; Additive manufacturing; Biomechanics; Fused deposition modeling; Orthotics; Prosthetics; Selective laser sintering; Stereolithography

1. Additive manufacturing—what?

1.1. Introduction

Additive manufacturing is hailed as the technology that will usher in the next industrial revolution. It's a process that allows a three-dimensional object of almost any shape to be created from a computer model. This fabrication method can be utilized with a variety of materials, including plastics and metals. It enables the manufacturing of finely designed items with unique geometries in small or big volumes. For the past 30 years, additive manufacturing has been around. Rapid prototyping, direct digital manufacturing, solid free-form fabrication, layered manufacturing, and three-dimensional (3D) printing are some of the umbrella words used to describe it. It has been slowly but steadily transforming a variety of industries, but medicine is one that has benefited greatly from 3D printing [1]. 3D printed pharmaceuticals and formulations, organ or tissue creation, and biomechanics are the areas where it has seen the most use. Biomechanics entails printing bespoke wearable devices that support, correct, restore, protect, and stabilize various sections of the body, hence improving the user's capacity to perform and overall quality of life [2]. Second, 3D printing is utilized in the field of biomechanics to create anatomical models for surgical planning. Despite constraints such as lack of flexibility, high equipment and material costs, the requirement for expert operators, and accurate design, it remains the preferred method for providing patient-specific and broadly available care [3,4]. Customized solutions, enhanced accessibility, cost savings, improved esthetics, and efficient performance make this an appealing and useful technology [5,6]. This technology has the potential to give unrivalled benefits in the field of medical sciences, particularly in the department of biomechanics, which is always on the lookout for better ways to provide patients with tailored treatment alternatives. It was long regarded to be a medical pipe dream, but thanks to the dedicated work and efforts of experts all across the world, it has become a reality [7]. Orthotics and prosthetics are one such area. The demand for orthotics and prosthetics has increased over time due to an increase in the incidence of accidental injuries, sporting injuries, and medical illnesses such as diabetes mellitus, vascular diseases, and osteosarcoma. The market value of the segment was USD 6.39 billion in 2021, and it is predicted to expand at a compound yearly growth rate of 4.2% to USD 8.6 billion in 2028 ("Prosthetics & Orthotics Market Size Report, 2021–28″). According to estimates, 3D printed orthotics and prosthetics will account for more than 35% of this industry. The process of 3D printing orthotics or prosthetics begins with image acquisition using computed tomography (CT) and magnetic resonance imaging (MRI), followed by segmentation, which converts the Digital Imaging and Communications in Medicine (DICOM) file into the Stereo Lithography (STL) format, which is then optimized and printed using the appropriate material and printer. Validation and quality control were also performed on the data [3–6].

1.2. History

Authors such as Murray Leinster in 1945 in his short tale Things Pass By and Raymond F. Jones in 1950 in his science fiction Tool of the Trade depicted 3D printing as a work of fiction. In 1974, David Jones, writing under the moniker Daedalus, published a satirical piece in the New Scientist column about the technique of 3D printing. With the discovery of inkjet technology in the 1960s, the Teletype corporation sowed the seeds for the growth of this approach. Later in 1971, Johannes F. Gottwald was given a patent for his Liquid Metal Recorder, which was designed to layer-by-layer create a liquefied metal item that would subsequently solidify into a specified shape [8,9]. Dr. Hideo Kodama of Nagoya Municipal Industrial Research Institute filed a patent for a rapid prototyping technology that defined layer-by-layer manufacturing a few years later, in 1981. Unfortunately, he was unable to submit the data within the deadline, and the patent was never issued. Raytheon, an electronics and defense company, submitted a patent in 1982 for a method of layering powdered metal to produce an object. Bill Masters submitted a patent for a Computer Automated Manufacturing Process and System in 1984, which was the first time the word 3D printing was referenced [10–12]. Alain Le Méhauté, Olivier de Witte, and Jean-Claude André reported additive manufacturing using stereo lithography in France in 1984, but their work was ignored because it had little practical value. However, Charles Hull was granted the first patent on 3D printing for a stereo lithography apparatus (SLA) machine after a few years [13]. In 1987, he cofounded 3D Systems Corporation and released the first commercial SLA machine. He has filed over 60 patents in this field since then and is widely considered as the founder of the fast prototyping movement, as well as the inventor of the STL file format, which is still in use today. Carl Deckard filed a patent application for the selective laser sintering (SLS) technology in 1987, and it was approved in 1989 [14]. Scott Crump filed a patent for fused deposition modeling (FDM) in 1989 and later co-founded Stratasys Inc, bringing the three key 3D printing technologies together in 5years and revolutionizing the field [15]. The Wake Forest Institute for Regenerative Medicine bioprinted synthetic scaffolds for a human urinary bladder and then coated it with the patient's cells to avoid rejection associated with organ transplants in 1999, which was the first extraordinary achievement in the medical field using 3D printing [16]. By 2002, they had 3D printed a functional human kidney in miniature [17]. Dr. Adrian Bowyer, a senior lecturer at the University of Bath, initiated the RepRap movement in 2004–05, which is arguably the cardinal event in the history of 3D printing. It was an open-source project to develop a 3D printer that could print the majority of its parts, with the goal of making 3D printing more affordable worldwide [18]. The first 3D printed, fully functional, ready-to-wear prosthetic leg was developed in 2008, marking another milestone in medical 3D printing. The patent on FDM expired in 2009, lowering the cost of a 3D printer by approximately tenfold. Organovo, a 3D bioprinting company, generated the first 3D printed blood vessel the same year. Today, 3D printing is used to make everything from children's toys to fashion, food, buildings, cars, and planes. Not only that, but the National Aeronautics and Space Administration (NASA) claimed in 2014 that they had successfully constructed the first 3D printed object in space. Since its inception in the 1980s, the US Patent and Trademark Office has filed over 13,000 patents in this field. Here in Fig. 1.1 is a PRISMA report that shows the publication retrieval technique as well as the inclusion and exclusion of publication reports in a flow