The orthopaedics industry has long been driven by innovation, aiming to improve patient outcomes and quality of life.
Over 30 years ago, 3D printing emerged as a transformative technology, opening up opportunities to reshape how orthopaedic professionals approach challenges in diagnosis, treatment, and recovery. From enhancing surgical precision to enabling personalized care, 3D printing and, even more evident, 3D planning are revolutionizing the field in ways once thought impossible.
This article will examine this innovative 3D journey and explore its applications, benefits, and potential to set new benchmarks in patient care.
A legacy of innovation: The birth of 3D printing in medicine
The foundation of medical 3D printing was laid in the early 1990s with the EU-funded PHIDIAS project. This groundbreaking initiative introduced 3D printing to healthcare by creating accurate, tangible models of human anatomy based on medical imaging. At the time, medical imaging was limited by the “salami method,” where CT scans were taken in slices, creating distortions whenever a patient moved. The PHIDIAS team revolutionized this process by introducing spiral CT scanning, which allowed for continuous imaging and produced far more accurate representations of the body.
These improved scan images, combined with the launch of the first medical engineering software, Materialise Mimics, enabled the creation of 3D virtual images and 3D-printed anatomical models of bones and organs. By converting CT scans into 3D models, surgeons gained an unparalleled understanding of the patient’s anatomy. These models provided a new way to plan and rehearse surgeries, giving surgeons a tangible representation of what they would encounter during procedures.
The PHIDIAS project demonstrated the transformative potential of this technology in healthcare, laying the groundwork for future advancements in surgical planning, tools, and implants.
3D printing enters the operating room
Building on this legacy, 3D technology evolved to revolutionise intraoperative procedures in orthopaedics. The first breakthrough came with the development of 3D-printed surgical guides, which enabled surgeons to transfer preoperative planning directly into the operating room with unmatched precision.
The earliest 3D-printed guides were developed for osteotomy surgeries—fully personalized tools designed for highly complex cases. Over the past 20 years, these guides have proven to be life-changing for patients with challenging limb deformities that are difficult to assess using standard imaging techniques. The personalized treatment approach assists surgeons at multiple stages: enabling digital visualization of complex pathology, 3D printing of anatomical models for planning, virtual surgical procedure design, and creation of personalized cutting guides. These guides are created through detailed planning by clinical engineers, allowing surgeons to execute intricate bone realignments with exceptional accuracy. While transformative, their implementation requires substantial engineering expertise because of the uniqueness and complexity of each case.
In 2009, the launch of the first 3D-printed personalised guides for knee arthroplasty marked a turning point. Developed by Materialise in partnership with Zimmer Biomet, the knee guides allowed surgeons to plan and order personalized surgical guides themselves, directly from the planning software. This innovation represented the first case of mass personalization in orthopaedics, combining 3D surgical planning with 3D-printed devices on a large scale.
These knee guides enable surgeons to create patient-specific plans and execute them with precision in the operating room, helping surgeons to perform accurate cuts and implant positioning. Over time, this technology expanded to other anatomies, including hips, shoulders, and other joints, enabling personalised care across a broad range of procedures.
While robotics, navigation systems, and augmented reality (AR) have emerged as alternatives, 3D-printed guides have maintained their unique value due to their reliability, cost-effectiveness, and ease of use. More importantly, these guides validated the power of 3D planning, which has become the cornerstone of many orthopaedic procedures, enabling better outcomes regardless of the intraoperative technology used.
Paradigm shift: From standardised to p