A hip arthroplasty surgery involving the use of a custom-made titanium endoprosthesis was performed in the clinic of Samara State Medical University in Samara, Russia. The implant was 3D printed using locally manufactured materials.
According to the press-center of Samara State Medical University, the doctors had to perform the revision of an older endoprosthesis, change all of its parts and then place a new titanium joint. The alternative methods were deemed too risky, so the custom-made endoprosthesis was the best choice.
“We will change the hip part of the prosthesis, its femoral head. And our main goal will be to get the work on the femur done, since the patient’s acetabular component is rotated by 90 degrees. It is unstable and the problem is that a bone defect has been formed. To put it simply: she has a hole in her hip bone. It’s difficult to solve this with traditional tools. We could use the femoral head for replacement but it’s already removed since the patient had a surgery, so there is no femoral head to use. Moreover, such big defects are considered to be a bad choice for autoimplantation, since it’s ineffective and there are high risks of infection and other things. So a special custom endoprosthesis was made based on the 3D reconstruction of her CT scan. The prosthesis is designed to fill in the whole defect and fixate the femur,” explained Dmitry Kudashev, head of orthopedic surgery and trauma department, assistant professor of the orthopedics, trauma and extremal surgery department at the university. It was said in an interview prior to the surgery.
The endoprosthesis manufacturing technology was refined by an inter-university consortium that included Samara State Medical University, Samara National Research University and Togliatti State University.
The 3D printed implants are made from finely dispersed titanium powder and are based on individual 3D models that are designed around CT scan results. Titanium joints are exclusively made of domestically produced materials.
Anton Agapovichev, assistant professor of the department of engine production technology at Samara National Research University, explained: “Our laboratory conducted the tests covering mechanical properties and structure analysis of the material that was the result of the Selective Laser Sintering of BT6 titanium alloy powder. We are currently developing a method to design open lattice structures and forms with a set porosity gradient for bionic implant production.”
The advantages of the technology are high levels of safety and biocompatibility: each implant is personalized and is coated with a material that reduces the risk of rejection. The researchers of Togliatti State University participated in development of the coating technology.
Sergey Peteraitis, Vice-rector for Scientific and Innovative Development of Togliatti State University, explained: “Our university has been working with coating technologies for more than 40 years. We’ve been working on various projects with the doctors for more than a decade. The coatings for titanium joints showed great results at the preclinical studies. We applied for a patent and are preparing a special production area for this technology.”
“A complex technological cycle is among the main reasons why it is difficult to get such developments delivered to the patients. Similar prostheses can be designed in one region, manufactured in another city and the patient will be waiting for a surgery at another place. Thanks to the doctors, researchers and manufacturing workers, the design, production and packaging of such prostheses will now be done at one production site in the Samara region. The launch of production is expected soon,” explained Andrey Nikolaenko, director of the Research Institute "Bionics and Personalized Medicine" at Samara State Medical University.
The additive technologies laboratory at Samara National Research university, a place where the endoprostheses and implants are produced, will be soon equipped with a new domestic additive manufacturing system for 3D printing with metal powders.
