3-D Printing - A Revolution in Medicine

From bones to skin, ears, heart valves, and cartilage, 3-D printing is quickly transforming the field of surgery

16 January 2018

3d Printing ARI and AOCMF skull Printing the future – 3D-printed model of a right-sided Zygomatic Complex Fracture (www.usb.ch/3dprintlab)

From bones to skin, ears, heart valves, and cartilage, 3-D printing is quickly transforming the field of surgery. In this article, we investigate how the AO Research Institute in Davos (ARI) and AOCMF are collaborating to improve patient outcomes and explore what 3-D printing could mean for patients in the future.

Creating objects in any shape imaginable

“3-D printing, or additive manufacturing, consists of building a 3-D object by fusing or depositing materials layer-by-layer on top of one another,” shares Dr David Eglin from his office at ARI, where he is working to develop innovative 3-D technologies for the health sector as head of the Polymers team.

“To begin, a “starting” material—which can be anything from a fully-synthetic material, to something of biological origin, or even living tissue—is processed through a printing head and deposited onto a platform. The printer’s speed and resolution, along with the movement of the head and platform, can be programmed to create patterns that can repeat or be changed at each layer, enabling a 3-D object to be made in almost any shape imaginable,” Eglin expands.

“One of our main activities at ARI is to develop non-toxic synthetic and biological materials that are implantable and amenable to the 3-D printing process,” explains Eglin. With ten patents under his belt, a Jean Leray Award from the European Society for Biomaterials, and over 90 peer-reviewed articles and published book chapters to his name, Eglin knows a lot about the interaction of biomaterials and cells in the orthopaedic field.

 

3D Printer ARI ARI

ARI: printing the future


The ARI was already testing stereolithography, one of the first 3-D printing technologies, over twenty years ago. Today, the institute’s fully-customizable, multi-printhead printer enables biofabrication—the printing of living cells and tissues. “We aim to add cells and tissue into the human system with harmless, non-toxic bio-inks (hydrogels containing cells) that can be precisely tuned to resemble the heterogeneous, hierarchical structure of living tissue,” Eglin reveals. The team also uses fuse deposition modelling printers to develop
3-D prototypes, devices, and tools with thermoplastic polymers.

3D printing ARI Hip Printing the future – 3D-printed model of a left-sided pelvic fracture (white) with arteries (red) (www.usb.ch/3dprintlab)

Collaborating to improve trauma and musculoskeletal system disorders

In fulfilling the AO Foundation’s mission to achieve more effective patient care, the ARI is collaborating with AOCMF on multiple printing projects. “One uses off-the-shelf, biopolymer-based products that are extracted from biological tissues like collagen, fibrin, and hyaluronan, to develop a collagen formulation that can be used in humans to enhance one’s repair capacity,” explains Eglin. A further project aims to optimize an osteoconductive calcium phosphate cement product to enable quick printing and setting of patient-specific implants for rapid implementation. “These custom-made implants for bone, disc, and cartilage repair strategies will impact the amount of time required for surgery, patient recovery time, and the overall success of the surgery,” he adds.

From theory to reality: shaping the future of medicine with 3-D printing


In addition to creating implants and regenerative tissues, 3-D technology also supports medical research, by using patient cells to screen drugs or therapies using 3-D tissues for more precise results.

“This form of printing can also convert two-dimensional radiographic images, such as X-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scans into digital 3-D print files, to enable the creation of complex, customized anatomical and medical structures. And this is only what 3-D printing offers today,” expresses Eglin. “Looking further ahead, 3-D printing could also drive down the cost of CMF surgeries. Portability is a feature which might be playing an important role in tomorrow's manufacturing process. 3-D technologies can now be deployed even in poverty-stricken areas or difficult locations in the world, enabling medical teams to print tools and implants they need on-demand, which was never before possible,” Eglin adds.

AOCMF course to help surgeons get started with 3-D printing technology

“This disruptive technology is revolutionizing the approach to handling tissue and regenerative therapies, and how medical research is being conducted,” shares Dr Florian Thieringer, Assistant Medical Director for Cranio-Maxillofacial (CMF) Surgery at the University Hospital Basel in Switzerland, Head of the Medical Additive Manufacturing research group (MAM) at the University of Basel's Department of Biomedical Engineering, and Co-Director of the new transdisciplinary 3-D Print Lab at the University Hospital.

Dr Florian Thieringer Shaping the future of AOCMF - Dr. Florian Thieringer with a 3D Skull model for cranioplasty, University Hospital Basel

Thieringer is chairing the AO Foundation’s first AOCMF 3-D printing course, Advances in Medical 3-D Planning and 3-D Printing, which is taking place in July 2018. “The course will build a comprehensive understanding of medical additive manufacturing processes for clinical applications, so that surgeons and other specialists can start 3-D printing in their own facilities,” Thieringer confirms. The event will include an international faculty of renowned specialists in the field of computer-assisted surgery and medical 3-D printing.

The next frontier: 3-D printing the human body


As 3-D printing continues to progress in the medical field at an astonishing rate, the possibilities it provides become seemingly endless. “In a few years’ time, we can even imagine the reality to print a 3-D living, organ-like implant,” Eglin shares.

For both Eglin and Thieringer, one day, even printing most of the human body could become a concrete reality.

The AOCMF Course—Advances in Medical 3D Planning and 3D Printing will take place in Basel, Switzerland on July 10-11th, 2018