Need an Implant? Just Print It Out

Patients who need a life-saving implant may soon be able to get a customized one from a 3D printer. In the first procedure of its kind, surgeons replaced the sternum and a portion of the rib cage with a 3D-printed titanium sternum and rib implant. The procedure, performed in a 54-year-old Spanish man with a chest wall sarcoma, was reported in a recent issue of the European Journal of Cardio-Thoracic Surgery.

The surgical team at Salamanca University Hospital predicted that the surgery to remove the tumor would be difficult due to the complicated geometry of the chest cavity. They consulted the medical device company Anatomics, who proposed metallic 3D printing of a titanium implant to accommodate the geometry and design of the chest cavity. The team at Anatomics used high-resolution computed tomography data to create a 3D reconstruction of the chest wall and tumor. From these data, the surgeons planned and defined the resection margins needed for the procedure, and the Anatomics team designed an implant with a rigid sternal core and prosthetic ribs composed of semi-flexible titanium rods.

Lab 22, the 3D printing facility at Commonwealth Scientific and Industrial Research Organisation (CSIRO) located in Melbourne, Australia, manufactured the implant out of surgical grade titanium alloy. An electron beam was repeatedly directed at a bed of titanium powder to melt it and construct the product one layer at a time. The finished product was shipped to Spain, where it was successfully implanted into the patient.

Although long-term outcomes and durability have yet to be established, the authors indicate that this 3D printing offers several advantages over traditional manufacturing methods for customized reproduction of complex bony structures, including precise setting of resection margins, development of novel prosthetic designs, and safer fixation of the bones.

Read more: Aranda JL, et al. Tridimensional titanium-printed custom-made prosthesis for sternocostal reconstruction. European Journal of Cardio-Thoracic Surgery, 2015; ezv265