French woman suffering from gunshot wound receives 3D printed 'reverse shoulder prosthesis'

Sep 30, 2017 | By Julia

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One lucky patient in France has become one of the first to sport a 3D printed shoulder implant following an almost deadly accident. Nathalie Dufaut Danjon was shot with a hunting rifle a little over two years ago, a near-fatal accident that saw a bullet penetrate her shoulder joint through the front, and exit through the back of her shoulder blade. Needless to say, Danjon’s shoulder anatomy was completely destroyed. The upshot was that her nerves were left intact, yet this meant the subsequent pain proved almost unbearable.

Danjon was hard-pressed to find a solution. Over the course of six months, she visited a total of 12 doctors, only to be greeted with the same response: a traditional implant wouldn’t be possible due to the extreme damage of Danjon’s shoulder, which left very little to work with. In other words, there was not enough bone left to support an implant. Danjon’s inquiries into 3D printed implants were likewise met with resistance. “3D printing is a gadget, a work in progress. It’s not something for you,” the doctors told her.

It was only once she turned to the Centre Hospitalier Universitaire in Dijon that Danjon started making progress. A friend introduced her to the Hospital’s chief of maxillofacial surgery, Professor Narcisse Zwetyenga, who then referred Danjon to orthopedic surgeon Dr. Brice Viard. In a breath of fresh air, Zwetyenga and Viard were optimistic about Danjon’s injury, and confirmed that yes, something could be done.

But that doesn’t mean it was an easy fix. In fact, as Viard explains, it was quite the opposite. “The patient’s humerus had no proximal articular surface and was severely deformed,” he says. The joint destruction was very advanced, with deep lesions in Danjon’s shoulder. 3D scans also showed loose bone fragments stuck to the inner side of the deltoid muscle, and embedded in a fibrous membrane.

It immediately became clear to Viard that current practices wouldn’t be up to the job. “As standard implants are designed for the standard population,” he says, “special cases like this one don’t leave room for good reconstruction. It was impossible to obtain osseous fixation on the scapula.”

A 3D printed implant proved to be the only possible solution. Viard worked closely with engineers and designers at 3D printing company Materialise during his preoperative planning. Together, the team came up with “a reverse shoulder prosthesis”, as Viard calls it, complete with 3D printed implants on both the humeral and glenoid sides of Danjon’s shoulder. It’s an entirely innovative solution to a never-before-seen problem, but that’s exactly where 3D printing is most useful.

Today, almost a year since the surgery, Danjon is doing very well. Viard reports that most of her articular mobility has been regained, and she couldn’t be happier with the results. While it’s still too early to tell whether the bone is growing properly within the implant, Viard says, short and mid-term results are very promising.

Posted in 3D Printing Application

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Australian Scientists Are Behind The World's First 3D Printed Shin Bone Implant

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Queensland University of Technology research and technology is behind the first ever 3D-printed shin bone implant.

The procedure was performed on a Gold Coast man who lost bone lost through an infection.

QUT’s Distinguished Professor Dietmar W Hutmacher is director of the ARC Industrial Transformation Training Centre in Additive Biomanufacturing that is at the frontier of 3D printing in medicine.

“Additive Biomanufacturing is an emerging sector within Advanced Manufacturing and the technology allows us to 3D print scaffolds, customised to the patient, which are then slowly resorbed by the body and guide the new bone formation,” Professor Hutmacher said.

QUT’s research team, including Dr Marie-Luise Wille, Dr Nathan Castro and PhD student Sebastien Eggert, worked closely with Dr Michael Wagels, the Princess Alexandra plastic surgeon who performed the surgery.

The team firstly developed a computer model, 3D printed a series of physical models of the large bone defect from CT scans of the patient’s tibia bone, and then designed a patient-specific implant – in the form of a highly porous scaffold which will guide the regeneration of the new bone.

The QUT team used a 3D printer from the Queensland-based company 3D Industries to print the models. The final scaffold design was sent to Osteopore International, who have been making biodegradable scaffolds for ten years now.

And this is just the beginning for QUT’s 3D printing endeavors.

Professor Hutmacher and Dr Wagels have started an innovative PhD training program which is partially funded by the PA Research Foundation in which young surgeons are trained and perform cutting-edge research in 3D printing in medicine to meet Australia’s need to build capacity in key areas of economic importance.

“Next to the ambition to deliver outstanding fundamental science and engineering, from a business and human capital perspective, my vision for the ARC ITCC in Additive Biomanufacturing is to deliver an exceptionally talented group of entrepreneurs who will start high-impact companies,” he said.

“They will have their roots in globally competitive fundamental and applied STEM research as well as in manufacturing innovation and new medical devices.”

San Diego researchers cut operation times by 25% with 3D printed hip models

Aug 3, 2017 | By Benedict

Bioengineers from the University of California San Diego and physicians from Rady Children’s Hospital are using 3D printed models to improve surgeries for slipped capital femoral epiphysis, the most common hip disorder found in children ages 9 to 16. Use of models cut surgery time by about 25%.

3D printed hip models helped San Diego surgeons cut operation times by around 25 percent

We see 3D printed medical models so frequently these days, it can be easy to accept their existence without questioning them.

But have you ever wondered just how useful such models can be—in numerical terms? While it makes total sense that a 3D printed model could improve a surgeon’s performance by allowing him or her to practice, sometimes it’s hard to gauge just how much improvement there really is.

That’s what makes a recent study at the University of California San Diego and San Diego’s Rady Children’s Hospital so important.

In the study, researchers created 3D printed models of patient hip joints, to allow surgeons to practice their procedure before doing the real thing.

But they also used a control group, letting a few surgeons perform the procedure without a 3D printed aid to see exactly how much difference the 3D printed models were making.

The study was published in a recent issue of the Journal of Children’s Orthopaedics.

In the study, Dr. Vidyadhar Upasani, pediatric orthopedic surgeon at Rady Children’s and UC San Diego and the paper’s senior author, operated on 10 young patients with slipped capital femoral epiphysis, a common hip disorder that affects about 11 in 100,000 children in the United States every year.

Five of Upasani’s operations were assisted with 3D printed hip models; five were not. Two other surgeons also operated on different groups of five patients, without using 3D printed models.

Excitingly, the results of the study showed 3D printing in a positive light. In the group where Upasani used 3D printed models, surgeries were 38-45 minutes shorter compared with the two control groups.

Student Jason Caffrey helped develop the 3D printed models

And according to the study’s researchers, these time savings would translate into at least $2,700 in savings per surgery.

Given that the kind of 3D printer required for the models would only cost around $2,200, such equipment clearly represents a solid investment—so much so, in fact, that Rady Children’s orthopedics department has already acquired its own.

“Being able to practice on these 3D models is crucial,” Upasani concluded. “It’s now hard to plan surgeries without them.”

To make the 3D printed models, two UC San Diego students, Jason Caffrey and Lillia Cherkasskiy, teamed up with Upasani, bioengineering professor Robert Sah, and their colleagues. They took CT scans of each patient’s pelvis, and used this data to make a computerized model of the bone and growth plate for 3D printing.

Printing took between four and 10 hours for each 3D printed hip model.

When completed, the 3D printed models allowed Upasani to visualize in 3D how the growth plate of each patient was deformed. This allowed him to familiarize himself with the patient’s physiology without using radiation-giving X-rays.

Although this study only focused on one kind of procedure, the speed improvement of 25 percent will be music to the ears of medical 3D printing specialists, and may encourage more hospitals to adopt additive technology.

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