3D-printed orthopaedic implants are changing joint replacement surgery

The growing field of 3D printing is providing solutions to some of the most challenging problems in orthopaedics. At the Hospital for Special Surgery (HSS), a sophisticated 3D printer produces customized joint replacements for highly complex cases where a standard off-the-shelf implant won’t do. HSS was the first hospital in the US to set up an on-site 3D printing facility for customized implants in partnership with LimaCorporate, which was recently acquired by Enovis.

For most patients who need joint replacement surgery, the traditional implants available in various sizes are sufficient. However, there are cases where these standard solutions do not fit. This is where 3D printing offers a custom-made alternative that has the potential to revolutionize orthopaedic medicine, according to Mathias Bostrom, MD, Deputy Chief Physician at HSS.

“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,” explains Douglas Leach, vice president of Device Innovation at the HSS Innovation Institute.

The Complex Joint Reconstruction Center at HSS treats patients with severe deformities, significant bone loss or failed joint replacement surgeries that need to be redone. For these patients, a customized 3D-printed implant could restore function and mobility or even save limbs. These custom-made implants have already relieved relentless pain and enabled some wheelchair-bound patients to walk again.

The implants are made from fine titanium powder. This is poured onto a platform, carefully leveled and then heated and fused layer by layer by a laser or electron beam.

The technology began over a decade ago with the production of plastic models – exact replicas of patients’ knee, hip, shoulder or elbow joints – in preparation for complex joint replacement operations.

“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,” explains Mark Figgie, MD, 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.”

The technology has developed to such an extent that 3D printers are now producing the titanium implants that are used in patients. These specially designed implants are often the last and best hope for patients who need a complicated hip, shoulder or knee replacement.