Pediatric Spine and Extremity

Abstract Options for upper extremity arthroplasty especially in the shoulder have proliferated rapidly in recent times. Additive manufacturing technology is at the heart in one of the key areas of advancement in upper extremity arthroplasty: patient specific implants (PSIs). In this chapter we will discuss how 3D printing is influencing modern surgical techniques, implant design, and the future trends in the field. We will start by discussing the goals and challenges of placing the ideal shoulder arthroplasty. We will discuss 3D planning as a means to improve preoperative planning and intraoperative component positioning highlighting different design features that assist in special circumstance. We will discuss the use of 3D planning in the assessment of variations in scapular anatomy and glenoid bone loss and how this affects surgical decision-making. We will move on from preoperative planning to elaborate on how 3D modeling is translated into intraoperative 3D-printed guides that can be used to more accurately achieve glenoid component placement. This section reviews the current literature on patient-specific implants and will discuss the commercially available systems for 3D templating and PSI. Lastly we will discuss emerging concepts in patient-specific implant designs. We will focus primarily on shoulder arthroplasty and touch briefly on elbow arthroplasty in the end.