目前，金属植入物广泛应用于骨科手术中，包括骨折固定、脊柱融合、关节置换和骨肿瘤缺损修复。然而，传统的植入物难以根据受者的骨骼解剖和缺陷特征进行定制，导致难以满足患者的个体需求。增材制造（Additive manufacturing，简称AM）或三维打印技术（Three-dimensional printing technology），这是一种先进的数字制造技术，能够生产具有复杂和精确结构的零件，提供了个性化的机会。我们对过去10年3D打印骨科金属植入物的文献进行了系统回顾。通过在PubMed和Web of Science上搜索相关的动物、细胞和临床研究。本文介绍了3D打印方法、生物金属特性，并总结了3D打印金属植入物的性质及其在骨科手术中的临床应用。在此基础上，我们讨论了进一步概括和改进的潜在可能性。3D打印技术促进了金属植入物在不同骨科手术中的使用。通过结合CT和MRI等技术的医学影像，3D打印技术可以根据受伤组织的解剖结构精确制造复杂的金属植入物。这种个体化植入物不仅减少了过度的机械强度和应力屏蔽效应，还提高了生物相容性和功能性，增加了细胞和营养物质的渗透性，并促进了血管新生和骨生长。此外，3D打印技术具有成本低、制造周期短和高重复性的优点，可以缩短患者的手术和住院时间。已经进行了许多使用定制植入物的临床试验。然而，建模软件的使用、打印设备的操作、金属植入物材料的高需求以及缺乏相关法律和法规的指导限制了其进一步的应用。3D打印金属植入物在骨科应用中具有个性化、促进骨与植入体的整合、生产周期短和材料利用率高的优势。随着外科医生对建模软件的不断学习、3D打印技术的改进、更好满足临床需求的金属材料的发展以及法律法规的完善，3D打印金属植入物可以应用于更多骨科手术。精确性、智能化和个性化是骨科的未来方向。可以合理地相信，3D打印技术将与人工智能、4D打印和大数据更深入地结合，发挥更大的作用于骨科金属植入物，并最终成为数字经济的重要组成部分。我们旨在为工程师和外科医生总结最新在3D打印金属植入物方面的进展，以设计更贴近与原生骨骼形态和功能的植入物。© 2023 The Authors.

Currently, metal implants are widely used in orthopedic surgeries, including fracture fixation, spinal fusion, joint replacement, and bone tumor defect repair. However, conventional implants are difficult to be customized according to the recipient's skeletal anatomy and defect characteristics, leading to difficulties in meeting the individual needs of patients. Additive manufacturing (AM) or three-dimensional (3D) printing technology, an advanced digital fabrication technique capable of producing components with complex and precise structures, offers opportunities for personalization.We systematically reviewed the literature on 3D printing orthopedic metal implants over the past 10 years. Relevant animal, cellular, and clinical studies were searched in PubMed and Web of Science. In this paper, we introduce the 3D printing method and the characteristics of biometals and summarize the properties of 3D printing metal implants and their clinical applications in orthopedic surgery. On this basis, we discuss potential possibilities for further generalization and improvement.3D printing technology has facilitated the use of metal implants in different orthopedic procedures. By combining medical images from techniques such as CT and MRI, 3D printing technology allows the precise fabrication of complex metal implants based on the anatomy of the injured tissue. Such patient-specific implants not only reduce excessive mechanical strength and eliminate stress-shielding effects, but also improve biocompatibility and functionality, increase cell and nutrient permeability, and promote angiogenesis and bone growth. In addition, 3D printing technology has the advantages of low cost, fast manufacturing cycles, and high reproducibility, which can shorten patients' surgery and hospitalization time. Many clinical trials have been conducted using customized implants. However, the use of modeling software, the operation of printing equipment, the high demand for metal implant materials, and the lack of guidance from relevant laws and regulations have limited its further application.There are advantages of 3D printing metal implants in orthopedic applications such as personalization, promotion of osseointegration, short production cycle, and high material utilization. With the continuous learning of modeling software by surgeons, the improvement of 3D printing technology, the development of metal materials that better meet clinical needs, and the improvement of laws and regulations, 3D printing metal implants can be applied to more orthopedic surgeries.Precision, intelligence, and personalization are the future direction of orthopedics. It is reasonable to believe that 3D printing technology will be more deeply integrated with artificial intelligence, 4D printing, and big data to play a greater role in orthopedic metal implants and eventually become an important part of the digital economy. We aim to summarize the latest developments in 3D printing metal implants for engineers and surgeons to design implants that more closely mimic the morphology and function of native bone.© 2023 The Authors.