A qualitative study of ten orthopaedic surgeons describes patient-imaging-derived 3D printed anatomical models as planning interfaces rather than replacements for imaging.
The manufacturing output was a manipulable representation of patient imaging
All participating surgeons reported that access to these models positively influenced preparation.
The most frequent account was that the object acted as an adjunct to imaging interpretation.
Surgeons described haptic exploration as supplementing visual perception from images displayed on a screen.
Some said that physically handling the model gave them additional understanding of the represented pathology or deformity.
One participant used a printed foot-deformity model with a table as a proxy for the floor to assess its relation to the ground.
Planning ranged from tactile mapping to procedural rehearsal
Several participants reported rehearsing procedures on a model more than once before surgery to test strategies and implants.
Other surgeons reported that handling the anatomy without physically rehearsing an osteotomy or other procedure was sufficient to provide the planning insight they needed.
Spine surgeons reportedly used models mainly as haptic maps, whereas arthroplasty surgeons used them to trial intended implants.
Three of the ten surgeons additionally found the models valuable for communicating pathology, deformity, or a surgical plan to team members or patients when verbal explanation was difficult.
Reported theatre effects were perceptions, not measured endpoints
Participants described increased confidence and reassurance in theatre after preparation with a model.
They particularly described a sense of familiarity when an aspect of the operation had been rehearsed beforehand.
Seven of ten surgeons mentioned a perceived reduction in theatre time, and perceived gains in surgical accuracy were also regularly mentioned.
The authors noted that perceived accuracy could be subjective and could be influenced by changes in total cognitive load in theatre.
Participants did not mention intra-operative blood loss, fluoroscopic use, or length of hospital stay.
A plausible interpretation offered in the study is that a model used early in planning may shift critical decisions from the operating theatre to the pre-operative stage.
Methodological limits define the reach of the findings
The researchers used a qualitative exploratory design with a phenomenological approach and conducted in-depth semi-structured interviews with ten surgeons at a training hospital.
Three authors independently performed inductive coding, then compared and iteratively adjusted the coding to refine, merge, or split codes.
The sample was relatively small, covered only a few orthopaedic subspecialties, and came from one centre in a developing country.
The authors therefore state that generalisability is limited.
The central finding is appropriately narrow: these surgeons perceived patient-imaging-derived 3D prints as useful aids for interpretation, planning, selected rehearsal, and sometimes communication.
Whether those perceptions consistently translate into final patient outcomes remains an open research question identified by the authors.
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