3D-printed implant tech – transforming lives

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3D-printed implant technology developed with EPSRC support has transformed the life of Peter Maggs (pictured centre), a 71-year-old man who had been operated on to remove a large cancerous sarcoma that required surgeons to remove three ribs and part of his breastbone.

  • 3D-printed titanium implants developed using a new system could transform lives globally
  • Technology makes it easier to order patient-specific titanium implants
  • Method is significantly more efficient and lower cost than current technologies

The operation was performed at Morriston Hospital in Swansea and was led by thoracic surgeon, Ira Goldsmith (pictured right). He says: “Mr Maggs’ growth was very extensive and needed to be removed. However, this would have left a large defect that could have destabilised the entire chest wall. Reconstructing it was going to be a very complex procedure.”

Instead of a traditional acrylic cement prosthesis, Goldsmith and fellow consultant surgeon Thomas Bragg (pictured left), with the support of the Morriston surgical team, implanted a custom 3D-printed titanium prosthesis that fit perfectly into the gap left by the removal of Maggs’ ribs and breastbone. The prosthesis was an exact match thanks to collaborative 3D-design between a multidisciplinary team at the hospital and PDR International Centre for Design & Research at Cardiff Metropolitan University.

Computer-aided design and 3D-printing in titanium resulted in an implant that was a better shape, stronger and more stable than acrylic cement. It also reduced the risk of complications, cutting surgery time by about two hours, which was important because Mr Maggs has heart problems amongst other health issues, so the surgeons wanted the surgery to be as quick as possible.

Dr Goldsmith says: “We are very pleased with the outcome. The implant is a perfect fit. Titanium is very strong and any problems like dislocation are reduced or even eliminated because the implant is anchored securely to the ribs and breastbone.”

The implant was designed by Morriston’s Biomedical 3D Technician, Heather Goodrum, and Peter Llewellyn Evans at Morriston and Hayley Hanson at PDR, using Mr Maggs’ CT scans to create a perfect fit. It was 3D-printed by one of the world’s leading engineering and scientific technology companies, Renishaw at its Healthcare Centre of Excellence and fabrication facility in South Wales. It was the first time such an implant has been 3D-printed in the UK, and followed a previous three-year project funded by EPSRC and Innovate UK, the NHS and industry partners.

The award-winning project, called ADEPT (Additive-manufacture for Design-led Efficient Patient Treatment), focused on the development of pioneering software to automate the design of patient-specific facial implants. The research now informs the wider use of 3D printing to produce titanium implants.

Peter Llewelyn Evans, Maxillofacial Laboratory Services manager at Morriston Hospital, says: “Until recently, surgeons would have to take off-the-shelf implants and bend them to roughly the right shape.

“Even if they do have access to conventional CT data/3D-printing systems, this technology still requires expensive software costing tens of thousands of pounds. ADEPT costs substantially less and is a single solution, providing surgeons with everything they need to design and print tailor-made maxillofacial implants for their patients.

“They will be able to sit at their desk, design an implant for a patient on-screen within minutes and e-mail it to be printed in 3D. It will then come back as a custom titanium implant.

Research developed during the ADEPT project has enabled Renishaw to launch the software commercially, helping to transform the lives of patients and improve NHS service efficiency. The ambition is to use the same design automation and 3D printing production methods to improve efficiency for other implant types, then deploy the solution globally.

Peter Llewelyn Evans says: “Surgeons anywhere in the UK, and indeed the world, will have the facility to design a custom implant that is far more likely to give better results because it fits the patient’s original anatomy.”

In 2017, ADEPT won the Health & Wellbeing category at The Engineer magazine’s inaugural Collaborate to Innovate Awards, launched to celebrate the role collaboration plays in developing new ground-breaking engineering solutions. EPSRC-supported projects won three of the remaining five categories.

Mr Maggs, a grandfather from Abergavenny, is living proof of the effectiveness of both the surgery and the technology. He says: “Before I went in for my operation the tumour was growing like hell. Now, I feel all right. And Mr Goldsmith… He’s a saint.”

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Mr Maggs’ operation was part of a multidisciplinary between the maxillofacial team at Morriston Hospital, Swansea, a surgical and prosthetic design team at Cardiff Metropolitan University, led by Dr Dominic Eggbeer, technology company Renishaw and industry partner LPW Technology Ltd.

The implant was covered with a section of latissimus dorsi muscle, which had been harvested from Maggs’ upper back. The entire procedure took about eight hours.