Currently available fracture fixation devices that were originally developed for healthy bone are often not effective for patients with osteoporosis. Resulting outcomes are unsatisfactory, with longer recovery times, often requiring re-surgery for failed cases. One major issue is the design of bone screws, which can loosen or pull-out from osteoporotic bone. Design improvements are possible, but the development of new screws is a lengthy and expensive process due to the manufacture of the complex geometry involved. The aim of this research was to validate our currently available 3D printing technology in the design, manufacture and testing of screws.

Three standard wood screw designs were reverse-engineered using computational modelling and then fabricated in polymeric resin using 3D rapid prototyping on a Stereolithography (SLA) machine. The original metal screws and the 3D screws (n=5 of each) were then inserted into a synthetic bone block (Sawbones, PCF5) representing the mechanical properties of severely osteoporotic cancellous bone. Pull-out tests were conducted in accordance with ASTM 543-13.

The three metal screws exhibited pull-out strengths of 125, 74 and 118 N respectively. The 3D printed screws by comparison showed pull-out strengths approximately 15–20 % lower than their metal counterparts. However, when the results were normalised to the material tested, showing the relative changes to the first design, the pattern of results in the metal and 3D printed groups were almost identical (within 3 % of each other), showing excellent correlation.

This study is the first to show that 3D Rapid Prototyping can be used in the pre-clinical testing of orthopaedic screws. The methodology provides a cheaper, faster development process for screws, allowing huge scope for development and improvement. Future work will include expanding the study to include more screw configurations as well as testing in higher density foams to compare performance in healthier bone.