EM12: Biomedical Innovation in Osteoarticular Surgery

The Biomedical Innovation in Osteoarticular Surgery group arose from an interest in maintaining collaboration between healthcare professionals and professionals from other fields of knowledge in the field of osteoarticular surgery, especially in the fields of engineering and information technology.

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

These areas have been under development for approximately two years, demonstrating significant interest in strengthening the research capabilities of participating professionals and developing stable structures for biomedical innovation in the fields of orthopedic surgery, traumatology, and health engineering.

The aim has been to ensure that the lines of work enable results to 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 valorization and protection of results, having submitted two applications for the protection of results to date, despite not having received any funding assistance so far.

The group considers it necessary to also focus its work on leveraging the results through collaboration agreements with companies and possible licensing of the Patents . To this end, 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 have been signed through INiBICA.

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, launched in June 2018 thanks to collaboration between researchers from the TEP231 group at the University of Cadiz and the Puerta del Mar University Hospital in Cádiz the Virgen del Rocío University Hospital in Seville, focuses on the use of metal additive manufacturing printers based on direct metal laser sintering (DMLS) for the parameterized design and manufacture of surgical instruments and devices with improved properties. In the first phase, the surgical instruments used in orthopedic surgery that could be improved by manufacturing them using DMLS were identified. The selected instruments were then 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 being done on the design and development of customized surgical implants for spinal surgery. To this end, it is proposed to initiate a line of work focused on the use of metal additive manufacturing printers based on laser sintering of metal alloy powders, including Direct Metal Laser Sintering (DMLS). Unlike 3D printing with other materials, DMLS printers are expensive and also require a parallel infrastructure to carry out the final finishing tasks on the parts. The 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, but 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 in COT of additive manufacturing in non-metallic materials. Of the different additive manufacturing technologies available on the market, the one that has achieved the greatest implementation in the healthcare sector is FDM (Fused Deposition Modeling). This technology allows parts to be constructed by melting and advancing a thin plastic filament through a computer-controlled extrusion head. One of the advantages of FDM technology is that it allows a wide variety of materials with different properties to be used and even combined in the same manufacturing process. In this way, 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, which means that it is possible to start using the technology with very low investment, obtaining high-quality results at a very low cost. For this reason, FDM technology has aroused great interest in the medical sector and, in fact, additive manufacturing units are beginning to be created in SSPA hospitals, including the HUPM HUVR hospitals, where some of the researchers in this group come from. One of the applications that is becoming increasingly widespread is the manufacture of anatomical models, which are already 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 trauma, surgical planning, and the development of surgical materials and prototypes. There are several studies in the literature that evaluate the use of 3D printing technology in TOC 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: The management of MQ-AH processes involves a large set of complex decisions whose outcome has a significant impact on the final quality of care. This line of work aims 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, together 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 field, but will also provide decision-makers with a tool to visualize and manage the use of resources (how resources are distributed among the different phases in the planning horizon). With this tool, it will also be possible to evaluate alternative management policies.

Line 4: Outcomes research in COT. Outcomes research (OR) is the study of the effectiveness of healthcare interventions, i.e., the extent to which an intervention achieves its objectives when applied under normal working conditions in the healthcare system. Given that the effectiveness of interventions is generally lower than their efficacy, OR studies are necessary, as sometimes the effectiveness of an intervention or treatment may be null in routine clinical practice. Among the areas of primary interest for outcomes research in Orthopedic Surgery and Traumatology, we consider:

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

Identification of the determinants of healthcare service use and specific interventions.

╸Analysis of the effectiveness and efficiency of health interventions.

Keywords

# Cirugía ortopédica
# Traumatología
# Cirugía osteoarticular
# Fabricación aditiva
# Impresión 3D
# COT

EM12: Biomedical Innovation in Osteoarticular Surgery

Responsible researcher

Pablo Andrés Cano:

Specialist in Orthopedic Surgery and Traumatology at the Orthopedic Surgery and Traumatology Department. 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

Team Members

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

EM12: Biomedical Innovation in Osteoarticular Surgery

Production

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