3-D Manufacturing in Orthopedic Surgery

New Implant Designs

Recently, three dimensional (3-D) printing has been considered a potential tool that could be used to produce custom made orthopedic devices, like hip implants.

Man with 3-D printing device and printed objects
Monty Rakusen / Getty Images

Manufacturing of Implants

If you are having orthopedic surgery, you might need an implant inserted for reconstruction, replacement, grafting, or as a brace to hold structures in place. Implants like carbon fiber custom knee braces, for example, can be used for your knee.

Different materials have advantages and disadvantages in terms of durability, healing, and the possible need for a revision down the road.

3-D Printing

A major characteristic of 3-D manufacturing is the additive manufacturing process, in which products are created by adding material layer by layer to create the final product. This differs from a subtractive process, in which a block of material is sculpted into the desired shape. Additive manufacturing has been around for a number of years and is used in many industries, but it is relatively new to the healthcare industry.

Traditionally, orthopedic implants are produced in multiple standard sizes. For example, if you were getting a hip replacement, much like going to a shoe store and trying on different shoe sizes, your orthopedic surgeon would have a variety of hip implant options designed to fit most people. While these implants often work well, the number of sizes is limited, and some people have anatomy that does not conform well to a specific standard size.

In orthopedic surgery, 3-dimensional printing has been used for a number of different applications.

Joint replacement implants: Some of these implants have been used in common surgical procedures, such as hip replacement and knee replacement surgery. In addition, spinal implants have also been designed through 3-dimensional additive manufacturing. 

Patient-specific instrumentation: The instruments that your surgeon uses during your operation can be custom designed to optimize your procedure.

Complex implants: Custom materials can be used to repair severe deformities, for tumor surgery, and in situations when there are no standard implants available for complicated reconstructive surgery.

Custom Implants

You might be interested in getting a custom implant if you want to ensure that an implant used at the time of your surgery is sized perfectly for your body. But, custom joint replacements, where the implants are designed specifically for an individual patient, are available but are not usually needed and are not a standard surgical procedure at this time.

At present, it is not common for a surgeon to implant a custom-made joint replacement. Usually, when people are talking about custom implants, they are having a standard implant inserted, and a custom cut is designed for their specific anatomy.

The potential advantage of a true custom implant, in which the implanted prosthesis is specifically designed for an individual patient, is the ability to replicate the normal mechanics of a joint. There are circumstances where a standard size implant could be a little too long, a little too short, a little too wide, or a little too narrow. In most instances, your surgeon can compensate for slight variations, but there are some situations in which a person has unusual anatomy, and it can be difficult to adapt to standard implants. Custom implant design could allow your surgeon a better ability to control for these variables.

Adhering to Bone

The other aspect of additive manufacturing is the potential to produce an implant that will adhere well to the surrounding bone.

There are different ways for implants to be secured to bone. Screws and wires are typically used to hold healing fractures in place when the implant only needs to last until the fracture is healed. Bone cement can be used as well. but the material can come loose over time.

One of the best ways to secure an implant to the bone is to use implants with a porous coating that the bone can grow into over time.

Porous coated implants are often used in joint replacement surgery, but not all implants can be easily designed with a porous coating. An advantage of 3-D printing is that it has made the process of applying a porous coating to a broad variety of geometric surfaces more possible. 

A Word From Verywell

The future of orthopedic surgery will undoubtedly look very different from the way things are being done today. 3-D printing is a technology that is being used to design custom orthopedic implants that are used for complex reconstructive surgeries. Over time, the use of 3-dimensional printing may become more common and could be used more broadly for standard orthopedic surgical procedures. 

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