New York hospital using on-site Additive Manufacturing for custom titanium joint replacements

April 26, 2024

The Hospital for Special Surgery has an on-site Additive Manufacturing facility to produce custom-made joint replacements (Courtesy HSS)
The Hospital for Special Surgery has an on-site Additive Manufacturing facility to produce custom-made joint replacements (Courtesy HSS)

The Hospital for Special Surgery (HSS), based in New York, USA, has reported that it is using Additive Manufacturing to offer custom-made titanium joint replacements for highly complex cases where a standard implant wouldn’t work. HSS was the first hospital to house an Additive Manufacturing facility, which is operated in collaboration with LimaCorporate SpA, Udine, Italy, recently acquired by Enovis.

For most people needing joint replacement surgery, traditional implants, which come in a variety of sizes, will fit. However, widely available implants don’t work for everyone.

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

At the Complex Joint Reconstruction Center at HSS, orthopaedic surgeons see patients with severe deformities, massive bone loss, or failed joint replacements that need to be redone. For these patients, a custom-made additively manufactured implant could restore function and mobility or even save their limb. Implants made for specific patients have reportedly relieved relentless pain and enabled wheelchair-bound patients to walk again, according to Dr Bostrom.

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From model to implant

Dr Bostrom and his colleagues initially began using Additive Manufacturing at HSS more than a decade ago to quickly manufacture a plastic model – an exact replica of a patient’s knee, hip, shoulder or elbow – prior to performing a highly complex joint replacement.

“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,” explained Mark Figgie, MD, chief emeritus of the Surgical Arthritis Service at HSS. “Having the model before surgery has revolutionised the planning process of these difficult cases, helping us make sure we’re doing the right thing and getting the right fit.”

By the time patients come to the Complex Joint Reconstruction Center at HSS, they know that they have a complicated problem, according to Dr Bostrom. “Sometimes HSS is thought of as being the ‘the end of the line’ for these patients,” he shared.

Because all new medical devices require approval by the Food and Drug Administration, however, gaining permission to use patient-specific additively manufactured implants can be a slow process. Additionally, a ‘compassionate use’ waiver must be obtained.

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