University of Pretoria 3D Prints Prostheses for Rottweilers

A team from the Onderstepoort Veterinary Academic Hospital at the University of Pretoria have performed the first known successful operation on an intraosseous transcutaneous amputation prosthesis (ITAP) in South Africa. A 3D-printed prosthesis was used.

Covid came to the clinic with a severe injury to his right paw. The usual treatment for such an injury would normally have been amputation. However, given the challenges faced by large dogs with only one front leg, the team looked for a solution that would preserve Covid’s quality of life.

Under the guidance of Dr. Klaas-Jan van de Wetering, the decision was made to perform a partial amputation, making Covid an ideal candidate for ITAP surgery. This pioneering surgery involves creating and printing a prosthetic implant that is integrated with the amputated limb to attach an artificial foot. To do this, an implant was inserted into Covid’s bone and passed through the skin, where the prosthetic foot could then be attached. First, however, the wound had to heal.

During the healing phase, a CT scan was performed to plan the implant placement. Orthodesign assisted with images, which were then used to create a customized implant. After an initial fitting in plastic, the final implant was 3D printed in titanium. Eight weeks after the initial surgery, the implant was inserted.

Dr. Van de Wetering said Covid recovered and showed strength during his hospital stay.

“Post-operative  infection was a concern, but fortunately it did not occur. Continuous monitoring for infection is ongoing, and  periodic replacements of the prosthetic foot are performed as needed. We have replaced Covid’s prosthesis twice in four months, but we are busy designing a more robust one that  would hopefully last longer,” Dr Van de Wetering said.

This case is not only a milestone for the ITAP procedure in South Africa, but also provides valuable insight into the feasibility and success of ITAP surgery in veterinary medicine.

He is positive about what the future holds: “The fact that the surgery was a success makes it a possible surgical  treatment for other patients that need amputations but would not cope with an amputation. For instance, a  double amputee and large breed dogs that struggle with only three legs.

“This case marks the first known successful ITAP surgery in South Africa, showcasing the collaborative efforts  of the surgical team, biomechanical engineer, and support staff. The groundbreaking procedure not only saved  Covid’s limb but also provided valuable insights into the feasibility and success of ITAP surgery in veterinary  medicine.”

The success of this operation is the result of the dedicated work of the surgical team. Dr. Van de Wetering planned and performed the operations with the support of his colleagues from the Faculty of Veterinary Sciences, Dr. Elge Bester and Dr. Adriaan Kitshoff, as well as biomechanical engineer Tim Peach from Orthodesign. Theater nurse Adele Rossouw and anesthesiologist Justin Grace also contributed their skills to the success of the operation.