EM12: Biomedical Innovation in Osteoarticular Surgery

The Biomedical Innovation in Osteoarticular Surgery Group was formed out of a desire to foster collaboration among healthcare professionals and experts from other fields in the area of osteoarticular surgery, particularly in the fields of engineering and information technology.

The primary areas of focus are additive manufacturing (3D printing) applied to osteoarticular surgery, organizational innovation in the healthcare sector, and outcomes research in Orthopedic Surgery and Traumatology (COT).

Work has been underway in these areas for about two years, and it has been found that they are of great interest for strengthening the research capabilities of the professionals involved and for developing stable structures for biomedical innovation in the fields of orthopedic surgery, traumatology, and health engineering.

The aim has been for the lines of work to yield results that can be protected through intellectual or industrial property registration, in the form of Patents, utility models, etc., as appropriate in each case. The group is working in collaboration with the OTT-SSPA to coordinate the entire process of valorizing and protecting results, having filed two applications to date for the protection of results, despite not having received any funding support thus far.

The group believes it is necessary to focus its work on commercializing its results through collaboration agreements with companies and the potential licensing of the generated Patents . To this end, INiBICA has signed two confidentiality agreements with companies and a declaration of interest in the results of an innovation project submitted to the 2019 call for proposals by the Regional Ministry of Health and Families.

Responsible researcher

Pablo Andrés Cano:
- E-mail: pablo.andres.sspa@juntadeandalucia.es
- ORCID: 0000-0002-4871-8244

Lines of research

Line 1: Metal additive manufacturing applied to osteoarticular surgery. This line of research, launched in June 2018 thanks to a collaboration between researchers from the TEP231 group at the UCA and the Puerta del Mar University Hospital in Cádiz , and the Virgen del Rocío University Hospital in Seville, focuses on the use of metal additive manufacturing printers based on direct metal laser sintering (DMLS) of metal alloy powders, for the parametric design and fabrication of surgical instruments and devices with improved properties. In the initial phase, the surgical instruments used in spinal surgery were identified as candidates for improvement through DMLS fabrication. Subsequently, the selected instruments were redesigned to reduce their weight, improve their ergonomics, customize their size, and modify their shape to incorporate new functionalities. In a second phase, work is underway on the design and development of customized surgical implants for spinal surgery. To this end, the study proposes initiating a line of research focused on the use of metal additive manufacturing printers based on laser sintering of metal alloy powders, including a process known as Direct Metal Laser Sintering (DMLS). Unlike 3D printing with other materials, DMLS printers are expensive and also require a parallel infrastructure to perform the final finishing tasks on the parts. The Higher School of Engineering (ESI) at the University of Cádiz has a fully equipped metal additive manufacturing laboratory, which is a unique facility among public research centers in Andalusia. Until now, this equipment has been used for industrial purposes; this project aims to make both the existing infrastructure and the expertise of ESI researchers in the use of this technology available to the Andalusian public health system.

Line 2: Applications of additive manufacturing in non-metallic materials at COT. Of the various additive manufacturing technologies available on the market, the one that has achieved the widest adoption in the healthcare sector is FDM (Fused Deposition Modeling). This technology allows parts to be built by melting and feeding a thin plastic filament through a computer-controlled extrusion head. One of the advantages of FDM technology is that it allows for the use of a wide variety of materials with different properties and even enables their combination within a single manufacturing process. Thus, FDM makes it possible to manufacture using different types of plastics, such as ABS, Nylon, PC, ULTEM, PLA, PEEK, or PET. Furthermore, this technology is becoming increasingly widespread, making it possible to get started with very low investment while achieving high-quality results at a very low cost. For this reason, FDM technology has sparked significant interest in the medical sector; in fact, additive manufacturing units are beginning to be established in SSPA hospitals, including the following: HUPM , and HUVR—hospitals from which some of the researchers in this group hail. One of the applications gaining the most traction is the fabrication of anatomical models, which are already being used to complement imaging tests such as computed tomography (CT) and magnetic resonance imaging (MRI). Their use has been proposed for advanced training in orthopedic surgery, surgical planning, and the development of surgical materials and prototypes. The literature includes several studies evaluating the use of 3D printing technology in CT-guided orthopedics for the development of customized surgical guides for shoulder surgery and the treatment of complex fractures in various locations.

Line 3: Organizational Innovation in Healthcare: MQ-AH process management involves a wide range of complex decisions whose outcomes have a significant impact on the quality of care. Through this line of work, we aim to develop Decision Support Systems (DSS) for MQ-AH process management. These DSS seek to integrate the decision models and resolution procedures that are determined, along with the hospital information systems (HIS) available in the Andalusian Public Health System (SSPA). These DSS will not only facilitate the management of demand in the MQ-AH sector but will also provide decision-makers with a tool to visualize and manage resource utilization (how resources are distributed among the different phases within the planning horizon). This tool will also make it possible to evaluate alternative management policies.

Line 4: Outcomes Research in COT. Outcomes research (OR) is the study of the effectiveness of health interventions—that is, the extent to which an intervention achieves its objectives when applied under routine conditions within the health care system. Since the effectiveness of interventions is generally lower than their efficacy, OR studies are necessary, as the effectiveness of an intervention or treatment may sometimes be negligible in routine clinical practice. Among the priority areas of interest for outcomes research in Orthopedic Surgery and Traumatology, we consider the following:

╸Assessment of the impact of health problems (frequency, trends, geographic variation, and identification of at-risk groups).

╸Identification of the determinants of health care utilization and specific interventions.

╸Analysis of the effectiveness and efficiency of health interventions.

Keywords

# Orthopedic Surgery
# Orthopedics
# Osteoarticular Surgery
# Additive Manufacturing
# 3D Printing
# COT

EM12: Biomedical Innovation in Osteoarticular Surgery

Responsible researcher

Pablo Andrés Cano:

Specialist in Orthopedic Surgery and Traumatology in the Department of Orthopedic Surgery and Traumatology. Hospital Universitario Puerta del Mar. Cádiz.

E-mail: pablo.andres.sspa@juntadeandalucia.es
ORCID: 0000-0002-4871-8244
ResearchGate: https://www.researchgate.net/profile/Pablo-Andres-Cano

Members of the Team

Principal Investigators:
- Pablo Andrés Cano (PI).
Researchers:
- Javier Tallón López.
- Juan José Domínguez Amador.
- Tomás Vela Panes.
- Inmaculada Noble Sánchez.
- Magdalena Casas Ruiz.
- Celia Pérez Muñoz.
- Miguel Suffo Pino.
- Jara Orta Chincoa.
- Carlos Revenga Giertych.
- Israel Vázquez Martínez.
- Tamara Santos Pacheco.
- Bárbara Sotelo Sevillano.
- Lidia Delgado Sánchez.
- Daniel Rojas Hernández.

EM12: Biomedical Innovation in Osteoarticular Surgery

Production

Find all of the group's publications ( Projects, Patents , and Publications) on the I+Salud Portal of the Andalusian Public Health System: