ArticleArchives of orthopaedic and trauma surgery2026
Comparative evaluation of additively manufactured PLA models as cost-effective, non-inferior alternatives to composite bones for pull-out testing.
Article in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe purpose of this study was to perform biomechanical pull-out comparisons between composite bone blocks and additively manufactured bone models using locked plate and screw systems. The hypothesis posited that the mean pull-out force of the 3D-printed models would demonstrate non-inferior pull-out strength compared to standard composite bones within a clinically acceptable 15% margin. A standardized pull-out mechanism was developed to evaluate its biomechanical reliability and its potential as a customizable alternative. MATERIALS AND
methodsThe study compared three groups: standard composite (Sawbones) blocks and two types of additively manufactured polylactic acid (PLA) blocks (grid and gyroid infill pattern), each measuring the same dimensions with 30% infill and mimicking a Sawbones block with 2 mm cortical thickness. A 6-hole LC-DCP titanium plate was fixed onto bone block models with dimensions of 29 × 170 × 42 mm using four screws, each measuring 36 mm in length, which were inserted perpendicularly and tightened to the same torque levels. Steel cables placed under the plate were connected to a mechanical testing setup, and pull-out tests were conducted to evaluate fixation strength. Seven replicate specimens were fabricated to ensure repeatability and reliability of the results.
resultsMean pull-out forces were 1784.4 ± 79.9 N for Sawbones, 1698.5 ± 134.3 N for Grid PLA (n = 7), and 1908.7 ± 335.2 N for Gyroid PLA (n = 7). Statistical analysis using a one-sample t-test showed that both 3D-printed models were non-inferior to the standard Sawbones model within a clinical acceptance margin of 15% (p < 0.05).
conclusionsAdditively manufactured models exhibit mechanical pull-out performance that is statistically non-inferior to traditional composite bone block models. These findings confirm that 3D-printed PLA-based grid and gyroid structures serve as reliable, cost-effective alternatives for orthopaedic mechanical research without compromising mechanical integrity.
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