Use of 3D printing in reconstruction of bones of left humerus, clavicle & scapula

Implant Specifications:

• Name of the surgeon : Dr. Pramod Chinder
• Place : The Yellow Ribbon-HCG Hospital, Bangalore
• Surface finish : Matt finished
• Maerial : Patient specific anatomy model, patient specific scapula implant, customized humerus implant & customized cutting guides

Introduction:

Incredible AM Pvt Ltd is India’s 1st & exclusive company working with medical 3D printing in a certified world class facility. The company has built the facility as per FDA norms. It is certified with ISO 13485 and ISO 9001. Key features includes Class 10000 clean room, US-FDA approved software, state of the art equipment and also an excellent team of doctors, engineers, biomedical engineers, CAD designers and medical consultants who are there to deliver outstanding services to doctors, hospitals & patients with complete validation & tests conducted to certify the process & product. Incredible deals with Customized Implants, Standard Implants, Bio models as well as Cutting Guides.

Background :

A male patient of 29 years old hailing from Bangalore, presented with complaint of mass and pain in his left scapula/humerus region. After histopathology, doctor diagnosed with Left side proximal humerus recurrent Chondrosarcoma. Dr. Pramod Chinder, leading Onco Orthopedic surgeon along with Dr. Suraj from The Yellow Ribbon Clinic- HCG Hospital Bangalore decided to go for tumor resection followed by reconstruction using customized implant for scapula, clavicle and humerus bone.

Solution:

Onco Orthopedic Dr. Pramod Chinder surgeon in Bangalore, decided the surgical plan- Considering the extensive extent and size of lesion, the surgery was divided into two parts performed on two different days: day 1 involved wide resection of the tumor in the left proximal humerus encasing the clavicle and scapula. Along with the tumor mass, upper half of scapula, lateral 2/3rd of clavicle and proximal half of the humerus had to be removed. Day 2- involved shoulder reconstruction with the help of 3D printed humerus, scapula, clavicle, and reverse shoulder arthroplasty implants. Incredible team discussed with Surgeon, the designing and entire manufacturing process. It was initially started with surgical planning and case stimulation with the help of US FDA & CE approved Materialise Mimics software by superimposing CT & MRI DICOM data. Once the planning was finalized, the customized implants were designed in such a way that it was complemented/matched with specifications of reverse arthroplasty shoulder joint implants to attend best articulation functionality of arm. Entire construct provides directional movements along with the ease of its attachment to implant and the bone. The design was completed with valuable inputs between the doctor and the Incredible design team together. The benefits of a 3D printed implant were its customization which resembled not only the particular anatomy required but also helped in better fixation. Finite Element Analysis was carried out which to determine the strength, stability and functionality of the implant.

Quote from Doctor :

“3D printed technology helps in designing anatomically and bio mechanically suitable implants that can be perfectly reconstructed in patients, especially in a challenging case like this. 3D printed reconstruction in this patient helped us not only to save the limb, but to also give him a functional arm”

Conclusion:

Implant was manufactured under ISO 13485 guidelines & tested to give an accurate fit & utmost safety. Once the resection was done, customized implant from 3D Incredible was implanted along with standard size shoulder joint prosthesis. Implant was manufactured using Ti6Al4V-ELI as per anatomical requirement, contour and bone thickness which are patient specific. 3D Incredible customized implant helped to reduce OT time as there was no further adaption of standard implant required on OT Table. At Incredible AM Pvt. Ltd. rigorous testing & validation of its plant, equipment and process is carried out to ensure safety and quality of the Implant.