Progress in Additive Manufacturing

https://doi.org/10.1007/s40964-020-00109-7

REVIEW ARTICLE

Structural optimisation for medical implants through additive

manufacturing
Abdulsalam Abdulaziz Al‑Tamimi1 · Henrique Almeida3,4 · Paulo Bartolo2

Received: 3 August 2019 / Accepted: 13 January 2020

© Springer Nature Switzerland AG 2020

Abstract
Advanced manufacturing techniques are being explored to fabricate degradable and non-degradable, porous or non-porous
implants for medical applications. These implants have been designed using standard computer-aided design (CAD) and
computer-aided engineering (CAE) tools and produced in a multitude of materials. The recent use of optimisation tech-
niques, mainly topology optimisation, allows the development of additive manufactured medical devices with improved
performance. This review discusses the combined use of optimisation techniques and additive manufacturing to produce
biocompatible and biodegradable scaffolds for tissue engineering with improved mechanical and permeability properties;
metallic lattice structures with reduced weight and minimal stress shielding effect; and lightweight personalised orthopae-
dic implants. Three optimisation routes are considered: topology optimisation; triply periodic minimal surfaces that can be
manipulated by means of the equations parameters to optimise the overall performance; and the use of repetitive structures
that are optimised as unit cells under certain conditions to compose a bulk object. Major limitations and research challenges
are highlighted and discussed.

Keywords Additive manufacturing · Metallic lattice structures · Orthopaedic implants · Topology optimisation · Tissue
engineering scaffolds

1 Introduction optimisation, is being explored to create lightweight medical

The design and fabrication of personalised lightweight
and high-performance implants is a challenge in the medi-
cal field. Structural optimisation, in particular topology
* Abdulsalam Abdulaziz Al‑Tamimi
aaaltamimi@ksu.ed.usa; aaaltamimi@ksu.edu.sa
Henrique Almeida
henrique.almeida@ipleiria.pt
Paulo Bartolo
paulojorge.dasilvabartolo@manchester.ac.uk
1
Industrial Engineering Department, College of Engineering,
King Saud University, Riyadh, Saudi Arabia
2
School of Mechanical, Aerospace and Civil Engineering, The
University of Manchester, Manchester, UK
3
Department of Mechanical Engineering, School
of Technology and Management, Polytechnic Institute
of Leiria, Leiria, Portugal
4
CIIC, Center for Research in Informatics
and Communications, Polytechnic Institute of Leiria, Leiria,
Portugal
implants and, in the case of metallic structures, to improve
the mechanical performance and fatigue behaviour, mini-
mising problems such as stress shielding or tissue bond-
ing. However, the geometric complexity of some of the
obtained designs is difficult to be converted into physical
objects due to the limitations of conventional manufactur-
ing technologies. Emerging additive manufacturing tech-
nologies characterised by freedom of design, elimination
of tooling, reducing assembly requirements by consolidat-
ing parts, elimination of production steps and allowing the
fabrication of complex objects with marginal increase of
costs facilitate the implementation of design tools into the
design and manufacturing process, allowing completely
new approaches for designing novel medical implants. The
combined use of optimisation schemes and additive manu-
facturing is recent [1, 2]. Examples include the design of
internal conformal cooling channels or part orientation in
the fabrication chamber to reduce costs and the volume of
support structures [3–9].
This paper describes the current state-of-the-art of using
optimisation algorithms and additive manufacturing to

13
Vol.:(0123456789)
 Progress in Additive Manufacturing

produce medical implants (biodegradable scaffolds for tissue optimising its layout [18]. Topology optimisation is the most
engineering, metallic lattices and orthopaedic implants) with common method aiming at to determine the material distri-
reduced weight/volume and improved mechanical properties bution to optimise a specific design space considering a set
(not only increasing stiffness to values close to the stiffness of load and boundary conditions [19–24]. In this case, to find
of natural tissues but also minimising bone stress shield- the optimal material distribution, the finite element method
ing and bone loss problems) and medical implant designs is used to divide the design space into a set of discrete ele-
exploiting personalisation approaches enabled by additive ments [16, 18]. After this meshing step, the optimisation
manufacturing. Research challenges and areas for future method is used to determine each element property through
research activities are also presented. the isotropic solid or empty (ISE) optimisation scheme [25].
The density or solid isotropic with microstructure penalisa-
tion (SIMP) method and the homogenisation method are
2 Structural optimisation the two main strategies to solve the ISE topology optimi-
sation [16, 17]. Initially, topology optimisation algorithms
Structural optimisation is a numerical decision-making tool focused on the problem of minimising structural compliance
that defines the material distribution in a defined domain and constraining volume, but new objective and constraint
according to specific constraints and objective functions functions have been proposed to investigate other mechani-
[10–13]. It is a problem focusing on minimising cost func- cal problems such as natural frequencies, yield stresses and
tions subjected to a set of constrains [11, 14, 15]: fatigue behaviour, applied to linear and non-linear materials
and multi-material structures [26–30].
⎧ z1 ⎫ As mentioned, the aim of topology optimisation is to
⎪ z2 ⎪ find the optimal material distribution (Ω*) of a given design
⎪ ⎪
Minimise f (z), where z = ⎨ . ⎬ (1) space (Ω), discretising it into a set of small subspaces (N).
⎪ . ⎪ Usually, topology optimisation focuses on minimising struc-
⎪ ⎪ tural compliance (maximising stiffness) constraining vol-
⎩ zn ⎭
ume, and the problem can be formulated as follows:
{
hi (x) ≤ 0, i = 1, 2, … , m min f T ⋅ u, (6)
subject to
gj (x) = 0, j = 1, 2, … , n (2) 𝜌e ,u

where u is the displacement vectors and f is the load vector

where z is the vector of design parameters and f(z) is the governed by:
cost function. The inequality constraint function gj (x) and
the equality constraint function hi (x) define the constraints ( ) ∑
N
( )
of the problem. This formulation describes a constrained f = K ke ⋅ u = ⋅Ke ke , (7)
optimisation problem. However, in some cases, optimisation
e=1

requires multiple objectives. This corresponds to a multi- where K is the global stiffness matrix and Ke corresponds to
criteria optimisation problem and can be described as fol- the matrices of the element stiffness.
lows [14, 15]: The design stiffness matrix is modified according to the
design variable (density, ρ). This means that the density of
∑
p
min wk fk (x) (3) each element (ρe) defined on Ω through a binary approach
k=1 will result in either ρe = 1 (i.e. keeping the element) or ρe = 0
(i.e. removing the element). Solving this problem requires
where f1,…,fk are the objective functions; or using one func-
rewriting the initial problem as follows:
tion and constraining the others:
( )
min fi (x)
min Z 𝜌e = f T ⋅ u, (8)
x (4)

⎧ ∑
N
subject to fk (x) ≤ 𝜀k , k = 1, … , p, k ≠ j (5) ⎪V = 𝜌e ve ≤ V ∗ ,
subject to ⎨ e=1 (9)
Structural optimisation comprises three main methods: siz- ⎪ 𝜌e = 0 or 1, e = 1, … , N,
ing, shape and topology [16, 17]. Sizing optimisation, in ⎩
which the structure layout is prescribed and the only parame-
where V is the initial volume, ve is the volume of each ele-
ter that can be modified is the size of the object, is commonly
ment and V* is the desired user-defined volume. Figure 1
used to optimise truss-like structures [18]. Shape optimisa-
illustrates a generic topology optimisation scheme.
tion focuses on changing the shape of a considered object by

13
Progress in Additive Manufacturing
Fig. 1  A general topology opti-
misation scheme
3 Tissue engineering scaffolds
Tissue engineering is an emerging research field aiming
at restoring, repairing and regenerating the function of
tissues and organs [31–34]. Three main approaches have
been considered. Cell-based therapies correspond to the
classical approach [35, 36]. It is a simple but less effec-
tive method as it is difficult to keep injected cells in the
right position during clinically relevant times. Most recent
approaches are based on the use of additive manufactur-
ing to produce scaffolds or cell laden constructs [37–42].
The scaffold-based approach is the most commonly used
approach. Scaffolds are three-dimensional, biocompat-
ible and biodegradable porous structures that provide the
physical substrate for cell attachment, proliferation and
differentiation [43–47]. Optimal scaffolds must follow a
multitude of requirements. They must present a degrada-
tion rate similar to the regeneration of a tissue, appro-
priate mechanical properties supporting the loads during
the regeneration process, high porosity, appropriate pore
shape and pore size, and pore interconnectivity to guaran-
tee high permeability allowing oxygen, nutrients and meta-
bolic waste to diffuse promoting tissue ingrowth [48, 49].
Scaffolds must also present proper surface roughness and
surface chemistry to promote cell adhesion, proliferation
and differentiation [50, 51]. Figure 2 presents the main
steps related to the design, fabrication and assessment of
scaffolds. This is a very complex process requiring a mul-
titude of interdependent relationships between material,
rheological properties, fabrication system and process-
ing conditions, scaffold architecture and performance as
shown in Fig. 3.
13

Fig. 2  Main steps for the design
and fabrication of optimal tissue
engineering scaffolds
Fig. 3  Tissue engineering scaffolds as a multi-dimensional optimisa-
tion problem
3.1 Topology optimisation and repeated unit cells
The design of scaffolds presenting high porosity and good
mechanical properties is challenging.
Lin et al. [52] used topology optimisation to design scaf-
fold microstructures meeting specific requirements (stability,
stiffness and porosity) and isotropic elastic constants. The
study was further extended by considering permeability as
part of the optimisation process [53]. However, in this study,
permeability was not coupled with the mechanical proper-
ties and therefore, no correlation between permeability and
mechanical performance was considered. This was solved
by Kang et al. [54], which used a homogenisation topology
optimisation algorithm to design three-dimensional units of
tissue engineering scaffolds. To avoid numerical instabili-
ties, authors considered the Sigmund’s non-linear sensitivity
filter [55]. Target properties were selected based on known
cross-property bounds between mechanical properties and
isotropic diffusivity. Based on the optimisation of scaffolds
unit cells, an interbody fusion cage was also designed. Unit
cells were designed with porosity values ranging between
30% and 60% (Fig. 4a). A correlation between bulk modulus
13
Progress in Additive Manufacturing
and diffusivity for different topologies and 50% of porosity
is presented in Fig. 4b, which clearly shows the effect of the
architecture on both mechanical and permeability properties
of a scaffold.
Almeida and Bártolo [56] proposed a computer tool to
support the design of scaffolds for additive manufacturing.
This tool enables to perform topology optimisation identi-
fying the most appropriate geometries of scaffolds fitting
predefined mechanical properties for a specific material
reduction. Studies were performed considering hydroxyapa-
tite scaffolds and the maximum porosity level achieved was
around 70%, after which a lack of integrity of the scaffolds
structure was observed. Similarly, Poh et al. [57], assuming
a scaffold as a lego-like structure based on repeated single
units, developed a macroscopic optimisation routine to cre-
ate polycaprolactone (PCL) scaffolds. The routine allowed
the optimisation of the volume fraction distribution along
the scaffold. A penalty factor was also considered to control
the scaffold volume fraction avoiding shapes that potentially
could compromise vascularisation. Optimal material distri-
bution allowed to optimise porosity, maximise stiffness and
to reduce the risk of mechanical failure.
Hu et al. [58] used topology optimisation to design a
poly-lactic acid (PLA) customised mandibular porous scaf-
folds using an extrusion-based machine. Computer tomog-
raphy was used to create 3D digital models of the mandible.
Scaffolds were printed using different lay-down patterns and
assessed in terms of ultimate load, failure deflection, yield
deflection, strain distribution and porosity. Results show that
the combination of numerical simulation and topology opti-
misation allows the fabrication of scaffolds with improved
mechanical properties.
3.2 Triply periodic minimal surfaces
Implicit surface modelling using triply periodic minimal sur-
faces (TPMS) has been explored to design scaffolds with
optimal topology considering both mechanical and perme-
ability properties.
Progress in Additive Manufacturing

Fig. 4  a Microstructures obtained for 30%, 50% and 60% of porosity. K1 is the bulk modulus of the void phase, D is the free isotropic dif-
b Effective bulk modulus versus effective diffusivity for microstruc- fusion coefficient of a solute in the fluid phase and D2 is diffusivity of
tures with 50% of porosity. K is the bulk modulus of the solid phase, the solid phase [54]

[ ]
A periodic surface is defined as follows [59]: A = Ak K×1 (12a)
∑
K
[ ( ) ]
�(r) = Ak cos 2𝜋 hk ⋅ r ∕𝜆k + pk = C, (10) [ ]
H = hk K×3 (12b)
k=1

where r is the location vector in the Euclidean space, hk is [ ]

the k th lattice vector in reciprocal space, Ak is the magnitude
P = pk K×1 (12c)
factor, 𝜆k is the wavelength of periods, pk is the phase shift, [ ]
and C is a constant. Specific periodic structures and phases 𝛬 = 𝜆k K×1 (12d)
can be constructed based on this implicit form [59–61].
In the case of TPMS, the Weierstrass formula describes are row concatenations of magnitudes, reciprocal lattice
their parametric form as follows [60, 61]: matrix, phases, and period lengths, respectively. Exam-
ples of TPMS tissue engineering unit cells are presented
� �
⎧ x = Re ∫ 𝜔1 ei𝜃 1 − 𝜔2 R(𝜔)d𝜔 in Fig. 5.
⎪ 𝜔1 i𝜃 � �
𝜔0
Almeida [59, 63, 64] investigated the use of Schwartz
⎨ x = Im ∫𝜔0 e 1 + 𝜔 R(𝜔)d𝜔 ,
2
(11)
⎪ x = −Re ∫ 𝜔1 ei𝜃 (2𝜔)R(𝜔)d𝜔 and Schoen primitives as unit cells to design scaffolds with
⎩ 𝜔 0
improved mechanical and permeability. Two important
parameters can be used as modelling control constraints:
where ω is a complex variable, θ is the so-called Bonnet
thickness and radius. Figure 6 illustrates the effect of these
angle, and R(ω) is the function which varies for different
parameters. These units can be easily manipulated from
surfaces.
a computational point of view through operations such
From a multi-dimensional control parameter space
as union, difference, intersection, modulation and convo-
point of view, the geometric shape of a periodic surface is
lution, allowing the design of scaffolds with a thickness
specified by a periodic vector, such as [59–61]:
gradient. Results show that for both surfaces, the porosity
V = ⟨A, H, P, 𝛬⟩K×6 , (12) decreases by increasing the surface thickness, while the
elastic modulus increases. A linear dependence between
where

13

Fig. 5  Examples of triply periodic minimal surfaces [62]
the scaffold porosity and the elastic modulus was achieved.
For the Schwartz surfaces, it was observed that the poros-
ity decreases by increasing the surface radius till a thresh-
old value, from which it starts to increase (Fig. 7). The
elastic modulus decreases by increasing the surface radius.
The relationship between porosity and surface radius fol-
lows a hyperbolic behaviour and a similar behaviour was
observed regarding the relationship between elastic modu-
lus and porosity; so, it is possible to decrease or increase
the elastic modulus of the scaffold, while maintaining
high porosity values. In the case of Schoen geometries,
the porosity decreases by increasing surface thickness and
the elastic modulus increases with thickness and decreases
with porosity. In the case of Schoen surfaces, the elastic
modulus decreases by increasing either the surface radius
or the porosity. Fluid flow studies were also performed
considering shear strain rate and the wall shear stress on
the surface of the scaffold units. These two parameters
strongly contribute to cell proliferation and differentiation.
For both Schoen and Schwartz unit cells, results show that
the shear strain rate decreases with the thickness of the
unit and increases with the radius. Results also suggest
that the best geometric option is to work with lower thick-
nesses and higher radius. Regarding the variation of the
wall shear stress as a function of the thickness variation,
the author found that the wall shear stress increases with
13
Progress in Additive Manufacturing
Fig. 6  The effect of thickness and radius on the topology of TPMS.
a Schwartz unit cells obtained through thickness variation with con-
stant surface radius; b Schwartz unit cells obtained through radius
variation with constant surface thickness; c Shoen unit cells obtained
through thickness variation with constant surface radius; d Schoen
unit cells obtained through radius variation with constant surface
thickness [59, 64]
thickness in the case of Schwartz units and decreases in
the case of Schoen geometries. A similar behaviour was
observed for the variation of the wall shear stress with
radius variation.
Panesar et al. [65] used TPMS geometries and topology
optimisation to produce functionally graded porous structures
for additive manufacturing. Authors found that functionally
grade structures presented 40–50% superior stiffness than uni-
form porous structures. However, the effect of the gradient
geometry in terms of permeability was not investigated.
Progress in Additive Manufacturing
Fig. 7  Schwartz surfaces a vari-
ation of the scaffold porosity
with the surface radius, b varia-
tion of the elastic modulus with
the porosity [59, 64]
4 Metal lattice structures
Metallic lattice structures, not considered as tissue engi-
neering scaffolds due to their non degradability nature, are
being used for orthopaedic applications. They are light-
weight structures presenting good mechanical properties
and their porous structure facilitates implant fixation and
proper bonding with the surrounding tissues. Rodgers et al.
[66] developed a topology-optimised structural design meth-
odology to obtain lattice structures for orthopaedic applica-
tions with optimised stiffness, porosity, volume fraction and
surface area. A non-linear optimisation algorithm based on
a 3D finite-element beam model was used to determine the
structural properties of the lattice structures. An objective
function considering porosity, material volume and surface
stresses was considered. Porosity described through a non-
linear relationship with pore size determines the permeabil-
ity of the lattice structure. A stress term was considered to
avoid stress shielding. Rahimizadeh et al. [67] developed a
computational methodology combining multi-scale mechan-
ics and topology optimisation to design titanium lattice
structures aiming to reduce the stiffness mismatch between
13

Fig. 8  Computation methodology used to design a lattice structure for tibial-knee applications [67]
the structure and the surrounding bone (Fig. 8). Asymptotic
homogenisation theory was used to characterise the mechan-
ics of individual blocks forming the lattice structure, while
the Soderberg fatigue criterion was used to investigate the
fatigue resistance of the lattice structure under multi-axial
physiological loading conditions. Using this methodology,
authors were able to produce lattice structures reducing in
26% the bone loss in comparison to full dense titanium med-
ical implants. Similarly, Xiao et al. [68] applied topology
optimisation to design titanium scaffolds with 30% volume
fraction and minimum mean pore size of 231 μm fabricated
using selective laser melting (SLM). Challis et al. [69] used
topology optimisation to create TPMS-based lattice struc-
tures for bone applications. By tuning the porosity, it was
possible to produce SLM structures presenting stiffness sim-
ilar to bone. Parts were produced using proprietary materials
(EOSINT M Direct Metal 50 and EOSINT M Direct steel 50
powder). The maximum porosity achieved was 80%.
Significant mandible defects can affect the masticatory
function and lead to loss of speech and facial deformity.
13
Progress in Additive Manufacturing
Luo et al. [70] used an optimisation method based on the
concept of uniform stress to design metallic structures
with minimal weight. Tetrahedral structural titanium lat-
tice structures were successfully designed for repairing
mandibular defects and produced using SLM. The optimi-
sation scheme allows the design of structures presenting
more homogenous stress distribution, eliminating regions
of stress concentration.
Similar to tissue engineering biodegradable scaffolds,
metallic lattice structure can be considered as a lego-like struc-
ture based on repeated single unit elements. Rheme [71] and
Reinhard and Teufelhart [72–74] extensively explored the con-
cept lattice structures and additive manufacturing for metallic
and non-metallic medical and non-medical applications, pro-
viding relevant insights for the design of structures reducing
unfavourable bending and shear forces inside the struts. Xiao
et al. [75] used topology optimisation to design 316L stainless
steel lattice structures to be produced using SLM as shown
in Fig. 9a. Three different unit elements, face centre cube
(FCC), vertex cube (VC) and edge centre cube (ECC), were
Progress in Additive Manufacturing
Fig. 9  a Topology optimisation iterations for lattice structures. b The three different lattice structures considering different percentages of poros-
ity [75]
considered and optimised in terms of mechanical performance
for different levels of porosity (Fig. 9b). The Gibson–Ashby
model was used to predict the performance behaviour of these
units. Results show that the FCC and VC lattice structures pre-
sent better mechanical properties than ECC lattice structures
which present high energy absorption efficiency.
Topology optimisation has been also used to create lattice
structures with negative Poisson’s ratio (NPR) for additive
manufacturing (Fig. 10) [76–81]. These auxetic structures
(expand when stretched and contract when compressed)
present higher flexural bending strength and buckling under
bending, being highly relevant for angioplasty stents or annu-
loplasty rings (Fig. 11) [82]. Soft lattice structures are also
relevant for tendons applications, which present a negative
Poisson behaviour.
5 Orthopaedic implants
Grujicic et al. [85] used finite element analysis and design
optimisation to create a distal femoral fracture fixation
plate with optimal size/thickness ratio as shown in Fig. 12.
13

Fig. 10  Examples of auxetic
structures. a Design of lattice
structures and b EBM produced
auxetic lattice structures [82,
83]
The design was supported by realistic functional require-
ments (strength, bending stiffness and longevity) obtained
through a musculoskeletal multibody inverse dynamics’
analysis considering a human riding a bicycle. Among
the different functional requirements considered in this
research study, it was observed that it is longevity that
controls the fixation plate optimal design.
Fig. 11  Negative Poisson’s ratio stent a design and b assembled
design with vessel [84]
13
Progress in Additive Manufacturing
Fraldi et al. [86] designed hip prosthesis minimising the
risk of implant failure due to stress shielding. The prosthesis
was assessed using a non-linear static finite element analy-
sis on a femur. A maximum stiffness topology optimisation
strategy considering different volume reductions (55%, 65%,
75% and 85%) was implemented. A comparison between the
actual stress level in the intact femur and the stress level in
a femur with optimised implants was estimated. Ti–6Al–4V
alloy was considered for the head of the prothesis and CoCr
alloy for the stem. The results show that it is possible to
design hip prosthesis with reduced stress shielding. Simi-
larly, Al-Tamimi et al. [18, 87, 88] used topology optimisa-
tion to redesign bone fixation plates (locking compression
plates) considering different geometries in terms of number
of screw holes, volume reductions (25%, 45% and 75%) and
loading conditions (bending, compression, torsion and com-
binations of these loads). Optimised plates were printed in
Ti–6Al–4V using electron beam melting. Results showed a
decrease on the equivalent stiffness with an increase of vol-
ume reduction. It was also possible to obtain some designs
where the equivalent Young’s modulus is in the range of
cortical bone. Non-polished plates were biologically tested
showing a significantly high cell attachment and prolifera-
tion compared to commercially available plates.
Peto et al. [89] used topology optimisation and additive
manufacturing to produce a tibia intramedullary implant for
Progress in Additive Manufacturing
Fig. 12  a Fractured femur fixed
with lateral plate and locking
screws assembled with adjoin-
ing bones and b fixation plate
thickness design optimisation
presenting lower and upper
bound [82]
an eight-year-old osteosarcoma patient. Topology optimi-
sation was used to reduce the weight of the implant and
to minimise stress shielding problems. SLM was used to
produce the optimised implant using stainless steel powder.
Figure 13 illustrates the main steps considered to develop
the implant. Iqbal et al. [90] used a multi-objective topology
optimisation to design a personalised pelvic prosthesis mini-
mising weight/volume and maximising stiffness. The design
was obtained considering physiological loading conditions
of different daily routines (e.g. walking, sitting down, stairs
ascending and descending). A pelvic design with minimal
stress concentration regions and strength close to pelvic
bone was achieved. The personalised pelvic prothesis was
designed considering Ti–6Al–4V, produced using EBM and
implanted in a patient suffering from pelvic sarcoma with
satisfactory short-term clinical results (see Fig. 14).
6 Conclusions and research challenges
The use of optimisation techniques and additive manufactur-
ing opens new routes to design and fabricate more effective
medical designs. Different examples related to biocompat-
ible and biodegradable tissue engineering scaffolds, metal-
lic lattice structures and orthopaedic implants are provided
mainly focusing on personalisation, reduce weight/volume
and on improving specific properties (e.g. mechanical prop-
erties and permeability). In the case of metallic implants,
topology optimisation allows to design plates minimising
plate instability and stress shielding.
A wide range of software packages allow to perform
topology optimisation (e.g. Simulia Tosca Structure, Altair
Optistruct, Ansys, Autodesk Netfabb, ParetoWorks, Solid-
Thinking and Simright) [81–97]. However, these tools were
not designed for additive manufacturing and consequently,
they are not able to link the design optimisation of medical
implants with key fabrication issues such as build direction,
minimum wall thickness, overhangs and minimal use of
support structures. Moreover, topology optimisation tools
allow the weight reduction of an implant, but they are not
considering the effect of part redesign in terms of minimis-
ing distortion during the fabrication process and minimising
post-processing steps. Residual stress constraint topology
optimisation, particularly for the fabrication of metallic
implants using powder bed fusion technologies, is also a
challenge.
Topology optimisation has been used mainly to optimise
the porosity of scaffolds to achieve a good balance between
mechanical properties and permeability. However, tissue
engineering scaffolds are made of degradable materials
13
 Progress in Additive Manufacturing

Fig. 13  Strategy to produce a personalised tibia intramedullary implant through the combination of topology optimisation and additive manufac-
turing [89]

Fig. 14  Produced prosthesis using EBM before implementation and the prosthesis radiographic image after implementation [90]

which can degrade through hydrolytic, enzymatic or a com-
bination of both mechanisms [98]. As a consequence of
degradation, the shape of the scaffold changes along time
and, as a consequence, the mechanical performance also
changes. Currently, topology optimisation only considers
the initial design of the scaffold optimised based on the
expected properties after fabrication. The long-term behav-
iour of the scaffold and the effect of the designed topology
on the degradation process and, as a consequence, on the
biomechanical properties must also be considered. Moreo-
ver, topology optimisation of tissue engineering scaffolds
usually assumes each filament as homogenous and isotropic.

13
Progress in Additive Manufacturing
The inherent anisotropy is determined by the layout of the
scaffold. However, recent studies show a significant impact
of processing conditions (e.g. temperature, screw rotation
velocity, deposition velocity) on the crystalline formation,
crystalline size and crystalline orientation. Crystallisation
and crystal orientation influence the mechanical properties,
degradation characteristics and the biological performance
of the scaffolds. Some authors are attempting to establish
correlation models between processing conditions and
morphological development during the fabrication process
allowing to design the anisotropy in each printed filament
[99, 100]. Currently, topology optimisation models are not
able to consider this. Consequently, they are not able to con-
sider the effect of processing conditions on the morphology
and the mechanical properties which may impact the opti-
misation process.
The performance of topology-optimised and additive
manufactured scaffolds, metallic lattice and other ortho-
paedic implants must be assessed against the mechanical
properties of biological tissues (e.g. bone and cartilage).
This requires the existence of a database, which can even-
tually be used as a knowledge-based system that currently
does not exist. A database including mechanical properties
of bones and other tissues considering locations, age and
gender groups is critical.
Additive manufacturing processes often require support
structures to support large overhang areas, to facilitate part
removal after fabrication, or to reduce thermal distortions
[101]. Methods including the sloping wall structures, tree-
like structures or cellular structures, have been proposed
for support slimming, and different topology optimisation
schemes have been developed [9, 101–104]. However, these
methods are computationally expensive and the thermal
performance, which is critical particularly for powder bed
fusion process, was not fully addressed. As an alternative,
several researchers proposed methods to totally remove the
need for support structures [6, 105]. However, these meth-
ods strongly depend on the build direction and limited the
part design optimisation [106]. Therefore, there is a need for
more robust algorithms that are able to minimise the need
of support structures, considering their thermo-mechanical
performance without posing any constraint to the topology
optimisation of the part (no difference regarding conven-
tional topology optimisation).
Acknowledgements Authors are grateful for the support provided by
the Saudi Cultural Bureau and King Saud University, Saudi Arabia.
Compliance with ethical standards
Conflict of interest The authors declare that they have no conflict of
interest.
References
1. Berrocal L, Fernández R, González S, Periñán A, Tudela S,
Vilanova J, Rubio L, Martín Márquez JM, Guerrero J, Lasagni
F (2019) Topology optimization and additive manufacturing for
aerospace components. Prog Additiv Manuf 4:83–95. https:​ //doi.
org/10.1007/s4096​4-018-0061-3
2. Zegard T, Paulino GH (2016) Bridging topology optimization
and additive manufacturing. Struct Multidiscip Optim 53:175–
192. https​://doi.org/10.1007/s0015​8-015-1274-4
3. Jahan SA, Wu T, Zhang Y, El-Mounayri H, Tovar A, Zhang J,
Acheson D, Nalim R, Guo X, Lee WH (2016) Implementation
of conformal cooling & topology optimization in 3D printed
stainless steel porous structure injection molds. Proc Manufac
5:901–915. https​://doi.org/10.1016/j.promf​g.2016.08.077
4. Krol T, Zah M, Seidel C (2012) Optimization of supports in
metal-based additive manufacturing by means of finite element
models. In: Proceedings of the international solid freeform fab-
rication symposium, Austin, USA
5. Langelaar M (2016) Topology optimization of 3D self-supporting
structures for additive manufacturing. Additiv Manuf 12:60–70.
https​://doi.org/10.1016/j.addma​.2016.06.010
6. Leary M, Merli L, Torti F, Mazur M, Brandt M (2014) Optimal
topology for additive manufacture: a method for enabling addi-
tive manufacture of support-free optimal structures. Mater Des
63:678–690. https​://doi.org/10.1016/j.matde​s.2014.06.015
7. Li Z, Wang X, Gu J, Ruan S, Shen C, Lyu Y, Zhao Y (2018)
Topology optimization for the design of conformal cooling sys-
tem in thin-wall injection molding based on BEM. Int J Adv
Manuf Tech 94:1041–1059. https ​ : //doi.org/10.1007/s0017​
0-017-0901-1
8. Mass Y, Amir O (2017) Topology optimization for additive
manufacturing: accounting for overhang limitations using a vir-
tual skeleton. Additiv Manuf 18:58–73. https:​ //doi.org/10.1016/j.
addma​.2017.08.001
9. Strano G, Hao L, Everson RM, Evans KE (2013) A new approach
to the design and optimisation of support structures in additive
manufacturing. Int Adv Manuf Tech 66:1247–1254. https​://doi.
org/10.1007/s0017​0-012-4403-x
10. Christensen P, Klabring A (2009) An introduction to structural
optimization. Springer, Berlin
11. Haftka RT, Sobieszczanski-Sobieski J (2009) Structural optimi-
zation: history. In: Floudas CA, Pardalos PM (eds) Encyclopedia
of optimization. Springer, Boston, pp 3834–3836
12. Rozvany GIN (2001) Aims, scope, methods, history and unified
terminology of computer-aided topology optimization in struc-
tural mechanics. Struct Multidiscip Optim 21:90–108. https​://
doi.org/10.1007/s0015​80050​174
13. Tsavdaridis KD, Kingman JJ, Toropov VV (2015) Application
of structural topology optimisation to perforated steel beams.
Comput Struct 158:108–123. https​://doi.org/10.1016/j.comps​
truc.2015.05.004
14. Spillers WR, MacBain KM (2009) Structural optimization.
Springer, Boston
15. Svanberg K (2009) Structural optimization. In: Floudas CA,
Pardalos PM (eds) Encyclopedia of optimization. Springer, Bos-
ton, pp 3832–3834
16. Bendsøe MP, Sigmund O (2004) Topology optimization: theory,
methods, and applications. Springer, Berlin, Heidelberg
17. Sigmund O, Maute K (2013) Topology optimization approaches.
Struct Multidiscip Optim 48:1031–1055. https:​ //doi.org/10.1007/
s0015​8-013-0978-6
18. Al-Tamimi A, Fernandes PRA, Peach C, Cooper G, Diver C,
Bartolo PJ (2017) Metallic bone fixation implants: a novel
design approach for reducing the stress shielding phenomenon.
13

Virt Phys Prototyp 12:141–151. https​://doi.org/10.1080/17452​
759.2017.13077​69
19. Ansola R, Veguería E, Canales J, Tárrago JA (2007) A simple
evolutionary topology optimization procedure for compliant
mechanism design. Finite Elem Anal Des 44:53–62. https​://doi.
org/10.1016/j.finel​.2007.09.002
20. de Kruijf N, Zhou S, Li Q, Mai Y-W (2007) Topological design
of structures and composite materials with multiobjectives. Int
J Solids Struct 44:7092–7109. https​://doi.org/10.1016/j.ijsol​
str.2007.03.028
21. Deaton JD, Grandhi RV (2014) A survey of structural and
multidisciplinary continuum topology optimization: post 2000.
Struct Multidiscip Optim 49:1–38. https​: //doi.org/10.1007/
s0015​8-013-0956-z
22. Hsu MH, Hsu YL (2005) Generalization of two- and three-
dimensional structural topology optimization. Eng Optim
37:83–102. https​://doi.org/10.1080/03052​15041​23312​71208​
23. Neches L, Cisilino AP (2008) Topology optimization of 2D
elastic structures using boundary elements. Eng Anal Bound
Elem 32:533–544. https ​ : //doi.org/10.1016/j.engan ​ a boun​
d.2007.10.003
24. Sehmi M, Christensen J, Bastien C, Kanarachos S (2018) Review
of topology optimisation refinement processes for sheet metal
manufacturing in the automotive industry. Struct Multidiscip
Optim 58:305–330. https​://doi.org/10.1007/s0015​8-017-1876-0
25. Rodrigues H, Herskovits J, Mota Soares C, Miranda Guedes J,
Araujo A, Folgado J, Moleiro F, Aguilar Madeira J (2014) Engi-
neering optimiztion. CRC Press, London
26. Jung D, Gea HC (2004) Topology optimization of nonlinear
structures. Finite Elem Anal Des 40:1417–1427. https​://doi.
org/10.1016/j.finel​.2003.08.011
27. Ma ZD, Kikuchi N, Hagiwara I (1993) Structural topology and
shape optimization for a frequency response problem. Comput
Mech 13:157–174. https​://doi.org/10.1007/bf003​70133​
28. Nabaki K, Shen J, Huang X (2019) Evolutionary topology
optimization of continuum structures considering fatigue fail-
ure. Mater Des 166:107586. https​://doi.org/10.1016/j.matde​
s.2019.10758​6
29. Suresh K, Takalloozadeh M (2013) Stress-constrained topology
optimization: a topological level-set approach. Struct Multidiscip
Optim 48:295–309. https​://doi.org/10.1007/s0015​8-013-0899-4
30. Wang MY, Wang X (2004) “Color” level sets: a multi-phase
method for structural topology optimization with multiple
materials. Comput Methods Appl M 193:469–496. https​://doi.
org/10.1016/j.cma.2003.10.008
31. Bártolo PJ, Chua CK, Almeida HA, Chou SM, Lim ASC
(2009) Biomanufacturing for tissue engineering: present
and future trends. Virt Phys Prototyp 4:203–216. https​://doi.
org/10.1080/17452​75090​34762​88
32. Melchels FPW, Domingos MAN, Klein TJ, Malda J, Bartolo PJ,
Hutmacher DW (2012) Additive manufacturing of tissues and
organs. Prog Polym Sci 37:1079–1104. https:​ //doi.org/10.1016/j.
progp​olyms​ci.2011.11.007
33. Moreno Madrid AP, Vrech SM, Sanchez MA, Rodriguez AP
(2019) Advances in additive manufacturing for bone tissue engi-
neering scaffolds. Mater Sci Eng C 100:631–644. https​://doi.
org/10.1016/j.msec.2019.03.037
34. Pereira RF, Bártolo PJ (2015) 3D bioprinting of photocrosslink-
able hydrogel constructs. J Appl Polym Sci 132:42458. https​://
doi.org/10.1002/app.42458​
35. Pereira RF, Bártolo PJ (2015) 3D photo-fabrication for tissue
engineering and drug delivery. Eng 1:090–112. https​://doi.
org/10.15302​/J-ENG-20150​15
36. Pereira RF, Sousa A, Barrias CC, Bayat A, Granja PL, Bár-
tolo PJ (2017) Advances in bioprinted cell-laden hydrogels
13
Progress in Additive Manufacturing
for skin tissue engineering. Biomanuf Rev 2:1–26. https​://doi.
org/10.1007/s4089​8-017-0003-8
37. Aguilar I, Smith L, Olivos D, Chu T, Kacena M, Wagner D
(2019) Scaffold-free bioprinting of mesenchymal stem cells
with the regenova printer: optimization of printing parameters.
Bioprint 15:e00048. https​://doi.org/10.1016/j.bprin​t.2019.e0004​
8
38. Koc B, Acar AA, Weightman A, Cooper G, Blunn G, Bartolo
P (2019) Biomanufacturing of customized modular scaffolds
for critical bone defects. CIRP Anal 68:209–212. https​://doi.
org/10.1016/j.cirp.2019.04.106
39. Leberfinger AN, Dinda S, Wu Y, Koduru SV, Ozbolat V,
Ravnic DJ, Ozbolat IT (2019) Bioprinting functional tissues.
Acta Biomater. https​://doi.org/10.1016/j.actbi​o.2019.01.009
40. Miri AK, Khalilpour A, Cecen B, Maharjan S, Shin SR,
Khademhosseini A (2019) Multiscale bioprinting of vas-
cularized models. Biomaterials 198:204–216. https​: //doi.
org/10.1016/j.bioma​teria​ls.2018.08.006
41. Pereira RF, Barrias CC, Bártolo PJ, Granja PL (2018)
Cell-instructive pectin hydrogels crosslinked via thiol-nor-
bornene photo-click chemistry for skin tissue engineering.
Acta Biomater 66:282–293. https​: //doi.org/10.1016/j.actbi​
o.2017.11.016
42. Pereira RF, Sousa A, Barrias CC, Bártolo PJ, Granja PL (2018)
A single-component hydrogel bioink for bioprinting of bioen-
gineered 3D constructs for dermal tissue engineering. Mater
Horizons 5:1100–1111. https:​ //doi.org/10.1039/C8MH0​0525G​
43. Du Y, Guo JL, Wang J, Mikos AG, Zhang S (2019) Hierarchi-
cally designed bone scaffolds: from internal cues to external
stimuli. Biomaterials 218:119334. https​://doi.org/10.1016/j.
bioma​teria​ls.2019.11933​4
44. Huang B, Vyas C, Roberts I, Poutrel Q-A, Chiang W-H, Blaker
JJ, Huang Z, Bártolo P (2019) Fabrication and characterisa-
tion of 3D printed MWCNT composite porous scaffolds for
bone regeneration. Mater Sci Eng C 98:266–278. https​://doi.
org/10.1016/j.msec.2018.12.100
45. Turnbull G, Clarke J, Picard F, Riches P, Jia L, Han F, Li
B, Shu W (2018) 3D bioactive composite scaffolds for bone
tissue engineering. Bioactive Mater 3:278–314. https​: //doi.
org/10.1016/j.bioac​tmat.2017.10.001
46. Wang W, Huang B, Byun JJ, Bártolo P (2019) Assessment of
PCL/carbon material scaffolds for bone regeneration. J Mech
Behav Biomed Mater 93:52–60. https​: //doi.org/10.1016/j.
jmbbm​.2019.01.020
47. Yan Y, Chen H, Zhang H, Guo C, Yang K, Chen K, Cheng
R, Qian N, Sandler N, Zhang YS, Shen H, Qi J, Cui W, Deng
L (2019) Vascularized 3D printed scaffolds for promoting
bone regeneration. Biomater 190–191:97–110. https​: //doi.
org/10.1016/j.bioma​teria​ls.2018.10.033
48. Caetano G, Violante R, Santana AB, Murashima AB, Domin-
gos M, Gibson A, Bártolo P, Frade MA (2016) Cellular-
ized versus decellularized scaffolds for bone regeneration.
Mater Lett 182:318–322. https ​ : //doi.org/10.1016/j.matle​
t.2016.05.152
49. Vyas C, Pereira R, Huang B, Liu F, Wang W, Bartolo P (2017)
Engineering the vasculature with additive manufacturing. Cur-
ren Opin Biomed Eng 2:1–13. https​://doi.org/10.1016/j.cobme​
.2017.05.008
50. Liu F, Vyas C, Poologasundarampillai G, Pape I, Hinduja S,
Mirihanage W, Bartolo PJ (2018) Process-driven microstruc-
ture control in melt-extrusion-based 3D printing for tailorable
mechanical properties in a polycaprolactone filament. Macromol
Mater Eng 303:1800173. https​://doi.org/10.1002/mame.20180​
0173
51. Wang Caetano G, Ambler WS, Blaker JJ, Frade MA, Mandal P,
Diver C, Bártolo P (2016) Enhancing the hydrophilicity and cell
Progress in Additive Manufacturing
attachment of 3D printed PCL/graphene scaffolds for bone tis-
sue engineering. Materials 9:992. https:​ //doi.org/10.3390/ma912​
0992
52. Lin CY, Hsiao CC, Chen PQ, Hollister SJ (2004) Interbody
fusion cage design using integrated global layout and local
microstructure topology optimization. Spine 29:1747–1754.
https​://doi.org/10.1097/01.Brs.00001​34573​.14150​.1a
53. Hollister SJ, Lin CY (2007) Computational design of tissue engi-
neering scaffolds. Comput Methods Appl M 196:2991–2998.
https​://doi.org/10.1016/j.cma.2006.09.023
54. Kang H, Lin CY, Hollister SJ (2010) Topology optimization
of three dimensional tissue engineering scaffold architectures
for prescribed bulk modulus and diffusivity. Struct Multidiscip
Optim 42:633–644. https​://doi.org/10.1007/s0015​8-010-0508-8
55. Sigmund O (1994) Design of Material Structures using Topol-
ogy Optimization. In: PhD Dissertation, Technical University of
Denmark
56. Almeida H, Bártolo P (2010) Virtual topological optimisation of
scaffolds for rapid prototyping. Med Eng Phys 32:775–782. https​
://doi.org/10.1016/j.meden​gphy.2010.05.001
57. Poh PSP, Valainis D, Bhattacharya K, van Griensven M, Dondl P
(2019) Optimization of bone scaffold porosity distributions. Sci
Rep 9:9170. https​://doi.org/10.1038/s4159​8-019-44872​-2
58. Hu J, Wang JH, Wang R, Yu XB, Liu Y, Baur DA (2019)
Analysis of biomechanical behavior of 3D printed mandibular
graft with porous scaffold structure designed by topological
optimization. 3D Print Med 5:5. https​://doi.org/10.1186/s4120​
5-019-0042-2
59. Almeida HA (2013) Smart design of scaffolds obtained by bio-
fabrication for tissue engineering applications. In: PhD Disserta-
tion, Universidade de Aveiro
60. Qi C, Wang Y (2009) Feature-based crystal construction in com-
puter-aided nano-design. Comput-Aid Des 41:792–800. https​://
doi.org/10.1016/j.cad.2008.12.008
61. Wang Y (2007) Periodic surface modeling for computer
aided nano design. Comput-Aid Des 39:179–189. https​ ://doi.
org/10.1016/j.cad.2006.09.005
62. Kapfer SC, Hyde ST, Mecke K, Arns CH, Schröder-Turk GE
(2011) Minimal surface scaffold designs for tissue engineering.
Biomaterials 32:6875–6882. https:​ //doi.org/10.1016/j.biomat​ eria​
ls.2011.06.012
63. Almeida HA, Bártolo PJ (2012) Structural and vascular analysis
of tissue engineering scaffolds, part 1: numerical fluid analysis.
In: Liebschner MAK (ed) Computer-aided tissue engineering.
Humana Press, Totowa, pp 183–207
64. Almeida HA, Bártolo PJ (2012) Structural and vascular analysis
of tissue engineering scaffolds, part 2: topology optimisation.
In: Liebschner MAK (ed) Computer-aided tissue engineering.
Humana Press, Totowa, pp 209–236
65. Panesar A, Abdi M, Hickman D, Ashcroft I (2018) Strategies
for functionally graded lattice structures derived using topol-
ogy optimisation for additive manufacturing. Additiv Manuf
19:81–94. https​://doi.org/10.1016/j.addma​.2017.11.008
66. Rodgers GW, Van Houten EEW, Bianco RJ, Besset R, Woodfield
TBF (2014) Topology optimization of porous lattice structures
for orthopaedic implants. IFAC Proc Vol 47:9907–9912. https​://
doi.org/10.3182/20140​824-6-ZA-1003.00924​
67. Rahimizadeh A, Nourmohammadi Z, Arabnejad S, Tanzer M,
Pasini D (2018) Porous architected biomaterial for a tibial-knee
implant with minimum bone resorption and bone-implant inter-
face micromotion. J Mech Behav Biomed Mater 78:465–479.
https​://doi.org/10.1016/j.jmbbm​.2017.11.041
68. Xiao DM, Yang YQ, Su XB, Wang D, Luo ZY (2012) Topol-
ogy optimization of microstructure and selective laser melting
fabrication for metallic biomaterial scaffolds. Trans Nonferrous
Metal Soci China 22:2554–2561. https​://doi.org/10.1016/S1003​
-6326(11)61500​-8
69. Challis VJ, Roberts AP, Grotowski JF, Zhang LC, Sercombe
TB (2010) Prototypes for bone implant scaffolds designed via
topology optimization and manufactured by solid freeform fab-
rication. Adv Eng Mater 12:1106–1110. https​://doi.org/10.1002/
adem.20100​0154
70. Luo D, Rong Q, Chen Q (2017) Finite-element design and opti-
mization of a three-dimensional tetrahedral porous titanium scaf-
fold for the reconstruction of mandibular defects. Med Eng Phys
47:176–183. https​://doi.org/10.1016/j.meden​gphy.2017.06.015
71. Rehme O (2010) Cellular design for laser freeform fabrication.
In: PhD Dissertation. Technische Universitat Hamburg-Harburg,
Germany
72. Reinhart G, Teufelhart S (2013) Optimization of mechanical
loaded lattice structures by orientating their struts along the flux
of force. Procedia CIRP 12:175–180. https​://doi.org/10.1016/j.
proci​r.2013.09.031
73. Teufelhart S, Reinhart G (2012) Optimization of strut dimeteres
in lattice structures. In: Proceedings of SFF Symposium, Univer-
sity of Texas, US
74. Teufelhart S (2014) Investigation of the capability of flux of
force oriented lattice structures for lightweight design. Adv
Mater Res 907:75–87. https​://doi.org/10.4028/www.scien​tific​
.net/AMR.907.75
75. Xiao Z, Yang Y, Xiao R, Bai Y, Song C, Wang D (2018) Evalu-
ation of topology-optimized lattice structures manufactured
via selective laser melting. Mater Des 143:27–37. https​://doi.
org/10.1016/j.matde​s.2018.01.023
76. Schwerdtfeger J, Wein F, Leugering G, Singer RF, Körner C,
Stingl M, Schury F (2011) Design of auxetic structures via
mathematical optimization. Adv Mater 23:2650–2654. https​://
doi.org/10.1002/adma.20100​4090
77. Souza J, Großmann A, Mittelstedt C (2018) Micromechani-
cal analysis of the effective properties of lattice structures in
additive manufacturing. Additiv Manuf 23:53–69. https​://doi.
org/10.1016/j.addma​.2018.07.007
78. Yang H, Wang B, Ma L (2019) Designing hierarchical meta-
materials by topology analysis with tailored Poisson’s ratio and
Young’s modulus. Compos Struct 214:359–378. https​://doi.
org/10.1016/j.comps​truct​.2019.01.076
79. Yang L, Harrysson O, West H, Cormier D (2015) Mechanical
properties of 3D re-entrant honeycomb auxetic structures real-
ized via additive manufacturing. Int J Solids Struct 69–70:475–
490. https​://doi.org/10.1016/j.ijsol​str.2015.05.005
80. Yuan S, Shen F, Bai J, Chua CK, Wei J, Zhou K (2017) 3D soft
auxetic lattice structures fabricated by selective laser sintering:
TPU powder evaluation and process optimization. Mater Des
120:317–327. https​://doi.org/10.1016/j.matde​s.2017.01.098
81. Zadpoor AA (2019) Mechanical performance of additively manu-
factured meta-biomaterials. Acta Biomater 85:41–59. https:​ //doi.
org/10.1016/j.actbi​o.2018.12.038
82. Eldesouky I, Harrysson O, West H, Elhofy H (2017) Electron
beam melted scaffolds for orthopedic applications. Additiv
Manuf 17:169–175. https:​ //doi.org/10.1016/j.addma.​ 2017.08.005
83. Gao J, Xue H, Gao L, Luo Z (2019) Topology optimization for
auxetic metamaterials based on isogeometric analysis. Com-
put Methods Appl M 352:211–236. https​://doi.org/10.1016/j.
cma.2019.04.021
84. Wu W, Song X, Liang J, Xia R, Qian G, Fang D (2018) Mechani-
cal properties of anti-tetrachiral auxetic stents. Compos Struct
185:381–392. https​://doi.org/10.1016/j.comps​truct​.2017.11.048
85. Grujicic M, Arakere G, Xie X, LaBerge M, Grujicic A, Wag-
ner DW, Vallejo A (2010) Design-optimization and material
13

selection for a femoral-fracture fixation-plate implant. Mater Des
31:3463–3473. https​://doi.org/10.1016/j.matde​s.2010.01.036
86. Fraldi M, Esposito L, Perrella G, Cutolo A, Cowin SC (2010)
Topological optimization in hip prosthesis design. Biomech
Model Mechanobiol 9:389–402. https​://doi.org/10.1007/s1023​
7-009-0183-0
87. Al-Tamimi A, Fernandes P, Peach C, Bartolo P (2019) Topology
optimization of bone plates to reduce stress shielding. In: Bartolo
P et al (eds) Industry 4.0—shaping the future of the digital world.
Taylor and Francis, Routledge
88. Al-Tamimi A, Huang B, Vyas C, Hernandez M, Peach C, Bartolo
P (2019) Topology optimised metallic bone plates produced by
electron beam melting: a mechanical and biological study. Int J
Adv Manuf Technol. https​://doi.org/10.1007/s0017​0-019-03866​-0
89. Peto M, Ramírez-Cedillo E, Hernández A, Siller HR (2019)
Structural design optimization of knee replacement implants for
additive manufacturing. Proc Manufac 34:574–583. https​://doi.
org/10.1016/j.promf​g.2019.06.222
90. Iqbal T, Wang L, Li D, Dong E, Fan H, Fu J, Hu C (2019) A
general multi-objective topology optimization methodology
developed for customized design of pelvic prostheses. Med Eng
Phys 69:8–16. https:​ //doi.org/10.1016/j.medeng​ phy.2019.06.008
91. Dessault Systemes: simulia tosca structure (2018) https​: //
www.3ds.com/produ​ctsse​r vice​s/simul​ia/produ​cts/tosca​/struc​
ture/topol​ogy-optim​izati​on/. Accessed 8 Sep 2018
92. Altair Optistruct (2018) https​://www.altai​r.com/optis​truct​/.
Accessed 12 Sep 2018
93. Ansys (2018) https​://www.ansys​.com/engb/produ​cts/struc​tures​/
topol​ogy-optim​izati​on. Accessed 12 Sep 2018
94. Autodesk Netfabb (2018) https​://www.autod​esk.co.uk/produ​cts/
netfa​bb/overv​iew. Accessed 12 Sep 2018
95. ParetoWorks SciArt, Inc (2018) https​://www.solid​works​.com/
partn​er-produ​ct/paret​owork​s. Accessed 22 Aug 2018
96. SolidThinking (2018) https​://solid​think​ing.com/. Accessed 22
Aug 2018
97. Simright (2018) https​://www.simri​ght.com/. Accessed 07 Sep
2018
98. Azevedo H, Reis R (2004) Understanding the enzymatic deg-
radation of biodegradable polymers and strategies to control
13
Progress in Additive Manufacturing
their degradation rate. In: Reis R, Roman J (eds) Biodegradable
systems in tissue engineering and regenerative medicine. CRC
Press, Boca Raton, pp 177–201. https​://doi.org/10.1201/97802​
03491​232
99. Liu F, Vyas C, Poologasundarampillai G, Pape I, Hinduja S, Mir-
ihanage W, Bartolo P (2018) Structural evolution of PCL during
melt extrusion 3D printing. Macromol Mater Eng 303:1700494.
https​://doi.org/10.1002/mame.20170​0494
100. Liu F, Wang W, Mirihanage W, Hinduja S, Bartolo PJ (2018) A
plasma-assisted bioextrusion system for tissue engineering. CIRP
Anal 67:229–232. https​://doi.org/10.1016/j.cirp.2018.04.077
101. Jiang J, Xu X, Stringer J (2018) Support structures for additive
manufacturing: a review. J Manuf Mater Process 2:64. https​://
doi.org/10.3390/jmmp2​04006​4
102. Gan MX, Wong CH (2016) Practical support structures for selec-
tive laser melting. J Mater Process Tech 238:474–484. https​://
doi.org/10.1016/j.jmatp​rotec​.2016.08.006
103. Huang X, Ye C, Wu S, Guo K, Mo J (2008) Sloping wall struc-
ture support generation for fused deposition modeling. Int J
Adv Manuf Tech 42:1074–1081. https​://doi.org/10.1007/s0017​
0-008-1675-2
104. Mirzendehdel AM, Suresh K (2016) Support structure con-
strained topology optimization for additive manufacturing. Com-
put-Aid Des 81:1–13. https​://doi.org/10.1016/j.cad.2016.08.006
105. Gaynor AT, Guest JK (2016) Topology optimization considering
overhang constraints: eliminating sacrificial support material in
additive manufacturing through design. Struct Multidiscip Optim
54:1157–1172. https​://doi.org/10.1007/s0015​8-016-1551-x
106. Liu J, Gaynor AT, Chen S, Kang Z, Suresh K, Takezawa A, Li
L, Kato J, Tang J, Wang CCL, Cheng L, Liang X, To AC (2018)
Current and future trends in topology optimization for additive
manufacturing. Struct Multidiscip Optim 57:2457–2483. https:​ //
doi.org/10.1007/s0015​8-018-1994-3
Publisher’s Note Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.