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Materials Science in Additive Manufacturing MAM for orthopedic bone plates: An overview

designs display mechanical prowess, their biocompatibility requirements tailored to individual patients or specific
remains a question, underscoring the need for a holistic fracture types. As a result, this traditional approach struggles
evaluation. to truly realize patient-specific solutions, underscoring the
The emergence of patient-specific bone plates through need for innovative manufacturing strategies.
AM, driven by 3D imaging-based models from technologies In the dynamic landscape of orthopedic manufacturing,
such as computed tomography, magnetic resonance AM techniques, especially PBF, have emerged as a
[79]
imaging, and 3D scanners , has marked a transformative transformative force. They offer both design flexibility
era. Such plates promise greater precision in screw and the potential for tailored solutions. For instance, Kim
[47]
placements, decreased surgical durations, and enhanced et al. leveraged a metal laser melting system to craft a
patient outcomes. For instance, studies like those from unique fixation plate tailored for distal radial fractures. In
Steffen et al. and Dobbe et al. testify to the mechanical biomechanical assessments, these AM plates outperformed
[38]
[36]
robustness and superior pain alleviation associated with conventional volar locking plates, showcasing their
these plates. Despite these benefits, challenges persist. potential to better match individual anatomical
Advanced imaging, while improving accuracy, can inflate requirements and reduce stress shielding. A comparative
[84]
[79]
time and financial costs . The manufacturing timeline, as study by Xie et al. revealed the biomechanical edge
highlighted by Teo et al. , could introduce surgical delays. of plates produced through direct metal laser sintering
[37]
Moreover, a conspicuous gap in the literature pertains to (DMLS) over CNC-manufactured plates. Although there
the long-term efficacy and biocompatibility of these plates. was a slight compromise in fatigue performance, DMLS
plates comfortably met clinical standards.
Transitioning from the fully patient-specific
[85]
realm, semi-patient-specific bone plate designs offer From an economic perspective, Ballard et al. shed
a harmonious blend of mechanical optimization and light on the potential cost-efficiencies of AM models.
time and cost efficiency. This approach, which involves Their findings underscored the benefits of reduced
tweaking features of a foundational design, synergizes surgical time and fewer revision surgeries, translating to
well with AM. Jabran et al. exemplify this by optimizing substantial savings for healthcare institutions and patients.
[80]
[37]
features like screw distribution. Yet, many studies in this Yet, as Teo et al. pointed out, the real-world feasibility
domain, such as those by Yan et al. , often eschew clinical of these AM techniques often hinges on the availability of
[81]
validation for mechanical assessments. The introduction both sophisticated infrastructure and skilled personnel.
[34]
of mechanobiological elements, highlighted by works In a bid to innovate further, Vijayavenkataraman et al.
like Subasi et al. , brings added intricacy. While AM has unveiled an orthopedic bone plate incorporating auxetic
[77]
undoubtedly expanded the horizons of bone plate design, structures. This design innovation not only curtails the
realizing its full potential mandates a more integrated stress-shielding effect but also offers the flexibility of
research approach. Holistic studies that amalgamate intraoperative bending.
mechanical, clinical, and biocompatibility aspects are the The realm of bone plate manufacturing is witnessing
need of the hour. transformative changes, particularly with the melding
of additive and subtractive manufacturing techniques.
4.3. Technological innovations in bone plate AM brings to the table its prowess in crafting intricate
fabrication
geometries, although often with subpar surface finishes.
Commercially available bone plates predominantly utilize This necessitates post-manufacturing processes to
subtractive manufacturing techniques. This method enhance surface quality, such as drilling and surface
encompasses various stages, beginning with raw material modifications [86,87] . On the other hand, subtractive methods
formation, and culminating in finishing tasks such as like CNC machining excel in achieving superior surface
hole drilling and surface polishing [82,83] . The integration finishes but grapple with the complexities of detailed
of computer numerical control (CNC) technology into structures.
the machining phase offers notable advantages, including To harness the strengths of both worlds, the fusion of AM
accelerated production, minimized tolerances, and and subtractive manufacturing has gained traction . For
[88]
enhanced repeatability – qualities that align well with mass instance, Da Cruz Gomes et al. employed AM-assisted
[48]
production objectives.
investment casting to fabricate NiTi shape memory
However, the rigidity of subtractive manufacturing alloy bone plates, unveiling notable enhancements in
becomes evident when confronted with the need for mechanical properties and biocompatibility. Another leap
nuanced alterations in bone plate geometry. Specifically, in this hybrid domain is the work by Lu et al. , where the
[89]
it falls short in addressing the diverse and intricate design synergy of laser- DED with laser shock peening was shown

Volume 2 Issue 4 (2023) 8 https://doi.org/10.36922/msam.2113