Medical AMMetal Additive ManufacturingOrthopedic Implants

HSS leverages 3D printing for patient-specific joint replacements

The hospital was the first in the US to house a 3D printing facility onsite for custom implants - in collaboration with LimaCorporate

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At the Hospital for Special Surgery (HSS), a 3D printer is manufacturing custom-made joint replacements for highly complex cases when a standard ‘off the shelf’ implant won’t work. HSS was the first hospital in the US to house a 3D printing facility onsite for custom implants, in collaboration with LimaCorporate, which was recently acquired by Enovis.

For most people needing joint replacement surgery, traditional implants, which come in a variety of sizes, will fit. However, widely available implants don’t work for everyone, and that’s where the extraordinary capabilities of 3D printing come in. According to Mathias Bostrom, MD, Associate Surgeon-in-Chief at HSS, for problems requiring complicated reconstructive surgery, the ability to customize a joint replacement has been a game-changer.

“Compared to traditional implant manufacturing, the magic of 3D printing is the ability to produce so many more complex shapes and designs in a fraction of the time,” said Douglas Leach, Vice President of Device Innovation at the HSS Innovation Institute.

HSS leverages 3D printing for patient-specific joint replacements - the first hospital in the US to house a facility for custom implants.
One of the EOS printers at HSS.

At the Complex Joint Reconstruction Center at HSS, orthopedic surgeons see patients with severe deformities, massive bone loss, or failed joint replacements that need to be redone. For these patients, a custom-made, 3D printed implant could restore function and mobility or even save their limb. Implants made for specific patients have relieved relentless pain, and they have even enabled wheelchair-bound patients to walk again, according to Dr. Bostrom.

Dr. Bostrom and his colleagues initially began using 3D printing at HSS more than a decade ago to quickly manufacture a plastic model – a replica of a patient’s knee, hip, shoulder, or elbow – before performing a highly complex joint replacement.

“We get a CT scan and from that, we can create an actual model of the patient’s joint to help with planning the surgery before we go into the operating room,” said Mark Figgie, Chief Emeritus of the Surgical Arthritis Service at HSS. “Having the model before surgery has revolutionized the planning process of these difficult cases, helping us make sure we’re doing the right thing and getting the right fit.”

Fast forward 10 years, and the technology has advanced to where 3D printers are now producing the titanium implant that goes into the patient. Often used for complex or re-do hip replacement surgeries, the specially designed implants may also be the last and best hope for patients needing a complicated knee, shoulder, or elbow replacement.

By the time patients come to the Complex Joint Reconstruction Center at HSS, they know they have a complicated problem, according to Dr. Bostrom. “Sometimes HSS is thought of as being the ‘the end of the line’ for these patients,” he said.

Because all new medical devices require approval by the Food and Drug Administration, gaining permission to use a patient-specific 3D printed implant can be a slow process. Under certain circumstances, a waiver known as ‘compassionate use’ can be obtained and, although it may take months, patients reportedly say it is worth the wait.

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Edward Wakefield

Edward is a freelance writer and additive manufacturing enthusiast looking to make AM more accessible and understandable.

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