Applied Sciences

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Prof. Dr. Paolo Domenico Parchi

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Guest Editor

1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
Interests: computer assisted orthopedic and spine surgery

Dr. Marina Carbone

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Guest Editor

Information Engineering Department, University of Pisa, 56126 Pisa, Italy
Interests: biomedical imaging elaboration; augmented reality; surgical navigation; surgical simulation; physical and hybrid simulation for rehabilitation specialists
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Dr. Sara Condino

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Guest Editor

Information Engineering Department, University of Pisa, 56126 Pisa, Italy
Interests: computer-assisted surgery; design of innovative instrumentation for surgical navigation; design of virtual and augmented reality applications for surgical navigation and simulation; design of innovative technologies based on virtual reality; physical and hybrid simulation for rehabilitation specialists
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Computer-assisted systems were introduced in orthopedic surgery in the 1990s to guide and improve surgical accuracy. From their first applications, the evolution of computer-assisted systems has led to robot platforms, next-generation surgical navigation systems with intraoperative CT scans, augmented reality systems, 3D printing solutions, custom implants, and the first applications of artificial intelligence. These solutions have developed rapidly in recent years, and are changing the face of orthopedic surgery rooms as the presence of the engineers and their interaction with the surgeon becomes increasingly relevant. The surgeons should understand the technologies that they will use during the surgery (including their advantages and limitations) and improve their interaction with the engineers and the technical aspects. Computer-assisted systems also play an important role in young surgeons' education. Although results have been encouraging, further studies are still needed to investigate long-term outcomes, implant survival, and revision rates and causes.

Prof. Dr. Paolo Domenico Parchi
Dr. Marina Carbone
Dr. Sara Condino
Guest Editors

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Keywords

computer-assisted systems
robot platforms
next-generation surgical navigation systems
intraoperative CT scans
augmented reality systems
3D printing solutions
custom implants
first applications of artificial intelligence
orthopedic surgery rooms

Published Papers (2 papers)

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Research

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13 pages, 4815 KiB

Open AccessArticle

An Osteocartilaginous 3D Printing Implant Using a Biocompatible Polymer and Pre-Differentiated Mesenchymal Stem Cells in Sheep

by Carlos Landa-Solís, Clemente Ibarra, Andrea Salinas-Rojas, Carmina Ortega-Sánchez, Alexandra Berenice Luna-Angulo, María del Rocío Aguilar-Gaytán and Eric Joseph Hazan-Lasri

Appl. Sci. 2023, 13(18), 10177; https://doi.org/10.3390/app131810177 - 10 Sep 2023

Viewed by 1035

Abstract

(1) Background: Currently, there are no pharmacological treatments that can modify the course of osteoarthritis (OA). For this reason, the present work is focused on generating knowledge for the development of new therapeutic alternatives for the treatment of OA. The objective of this work was to develop an articular hybrid implant with mesenchymal stem cells (MSCs) from sheep. The cells were differentiated into cartilage and bone using a bioabsorbable polymer with 3D printing Technology. (2) Methods: MSCs pre-differentiated to chondrocytes and osteoblasts were seeded on the 3D-printed scaffolds using polylactic acid (PLA). These were later implanted for 3 months in the thoracic ribs area and for 6 months inside the femoral head and outside of the joint capsule. After recovery, we analyzed the expressions of specific markers for bone and cartilage in the implants (3) Results: After 3 months, in lateral implants, the expression for bone markers (OPN, RUNX2) was similar to that of the control; at 6 months, we obtained a higher expression of bone markers in the implants with pre-differentiated MCS to osteoblasts outside and inside the joint. For cartilage markers, three months after the placement of the lateral implant, the expressions of Aggrecan and SOX9 COL2A1 were similar to those of the control, but the expression of COL2A1 was less; at 6 months, the three cartilage markers SOX9, Aggrecan, and COL2A1 showed significant expressions in the implant inside joint with pre-differentiated MCS to chondrocytes. (4) Conclusions: In this study, we demonstrated that the presence of pre-differentiated MSCs in the implants was a determinant factor for the expression of bone- and cartilage-specific markers at three and six months. We managed to generate a practical and easy-to-implement articular surface repair model. Full article

(This article belongs to the Special Issue Computer-Assisted Methods and 3D Printing in Orthopedics)

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Other

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12 pages, 3821 KiB

Open AccessCase Report

3D Printing in Surgical Planning and Intra-Operative Assistance: A Case Report on Cervical Deformity Correction Surgery

by Claudio Belvedere, Maurizio Ortolani, Alberto Leardini, Michele Cappuccio, Luca Amendola and Federico De Iure

Appl. Sci. 2022, 12(22), 11564; https://doi.org/10.3390/app122211564 - 14 Nov 2022

Cited by 1 | Viewed by 1392

Abstract

Three-dimensional (3D)-printed anatomical models of the bones play a key role in complex surgical procedures. These subject-specific physical models are valuable in pre-operative planning and may also offer assistance during surgery by improving the visibility of inaccessible anatomical structures, particularly in spine surgery. Starting from medical imaging, virtual 3D bone models are reconstructed, and these can also be used for quantifying original, planned, and achieved bone-to-bone alignments. The purpose of this study is to report on an original exploitation of these techniques on a patient with a severe cervical deformity to undergo corrective and stabilizing surgery. A virtual anatomical model of the cervical spine before surgery was obtained from computer tomography to assess the original deformity and for surgical planning. The corresponding 3D model was printed in acrylonitrile-butadiene-styrene and used to simulate the surgery by performing bone cuts, implanting the screws, and placing and shaping the fixation elements. During surgery, this physical 3D-printed model was used as a reference for each surgical action. The comparisons between pre- and post-operative virtual models confirmed that the planned correction was achieved. Virtual and 3D-printed anatomical models of the cervical spine offer advantages in the planning and execution of personalized complex surgeries, in addition to improving surgical safety. Full article

(This article belongs to the Special Issue Computer-Assisted Methods and 3D Printing in Orthopedics)

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