Inside3DPrinting_DaveFlynn

Engineering on Human Anatomy

Presented by David Flynn

Materialise USA

Committed to innovations for a

better and healthier world

Inside 3D PrintingSan Jose, CA

09/18/13

About Materialise

• Company

• Established 1990

• Leuven, Belgium

• ±1000 employees

• Worldwide presence

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We are Materialise

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Additive Manufacturing Services

Industrial Prototyping & Mfg Services

Software for Additive Manufacturing

• Magics

• Streamics

• 3-Matic

Biomedical Engineering

Mimics Innovation Suite

Cranio-MaxilloFacial

Clinical Service

RapidFit+

Custom modular fixture development service

i.Materialise

Online 3D Printing Services

.MGX

Additive Manufactured Artwork

Orthopaedics

Clinical Service

PRODUC-

TION

PRODUC-

TION

SOFTWARESOFTWARE

SERVICESSERVICES

Diversity means strength

Courtesy of TotalSim Ltd.

Courtesy of IDEE / Maastricht Instrument

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Mimics Innovation Suite:Our Total Solution

• Mimics®

• Processing software to take 2D image (CT, MRI, etc.) toconstruct 3D models

• 3-matic®

• Design and meshing software ideal for anatomical data

• Services

• Anotomical Models, HeartPrint

• Engineering services5

Medical scanner (CT/MR/US)

Your own PC or laptop

Mimics

3-matic ®

• Design and meshing software ideally suited for use with anatomical data

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Design: custom cranial plate Meshing: vertebrae remeshing

Case Studies

•Visual and Diagnostic Aids:

• Medical Models

• Surgical Intervention

•Engineering Functionality:

• Surgical Guides

• Patient Specific Implants

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MEDICAL MODELS AS

VISUALIZATION AND

DIAGNOSTIC AIDS

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Medical Models

• Separate conjoined twins

• Arteries could not be tracked with X-rays

• Operation time reduced from 97 to 22 hours

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Kenneth E. Salyer, M.D. and Objet Geometries Ltd., 2002

Medical Models

• 3D ultrasound with tomographic output

11Jorge Santos et al. 2009, Royal College of Art, UK

MEDICAL MODELS USED FOR

SURGICAL INTERVENTION

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SURGICAL INTERVENTION CASE

STUDY: AORTIC DISSECTION

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Case Study: Aortic Dissection

• Demographics• Incidence 1-10:100,000

• Rarely < 60

• Mostly male

• Medical emergency• Tear in inner wall of aorta

• Blood flows between layers

• True vs false lumen

• 80% mortality rate if rupture

occurs

Modeling from CT images

Outcomes

• No intervention possible

• Model revealed multiple leakage paths in need of repair

• Location of leakage paths closer to neck arteries than originally thought

• Comorbidity risks too high

• Gave tangible view on leakage paths and relation to connecting anatomy

• Modeling software and 3D printed model helped identify new risks

SURGICAL INTERVENTION CASE

STUDY: CONGENITAL CARDIAC

MALFORMATION

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Case: Congenital Cardiac Malformation

• Irregular Anatomy

• No two cases are the same

• Provides guidance for the surgeon

• Benefits

• Anatomically accurate

• Capture arrangement of chambers and GV

• Model characteristics

• Flexible to mimic soft tissue

• Ability to bend and cut

Emory University Hospital

How was it created?

Emory University Hospital

SURGICAL GUIDES: TOTAL

KNEE REPLACEMENT

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Patient Specific Guides for Total Knee Replacement

Scan

Patient

Construct 3D models

Plan the surgery

Design & build guides

Enter the OR

Scan

Patient

Construct 3D models

Plan the surgery


Enter the OR


Scan

Patient

Construct 3D models

Plan the surgery


Enter the OR


Scan

Patient

Construct 3D models

Plan the surgery


Enter the OR

Laser Sintering (LS)


Scan

Patient

Construct 3D models

Plan the surgery


Enter the OR


SURGICAL GUIDES: CMF

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CMF Software & Surgical Guides

Upload CT data

Perform Planning session online with

Materialise

Printing of planning outcome: Models

and/or guides

Synthes to deliver models, guides and /

or implants

Case presented by Daniel Buchbinder, MD DMD, Beth Israel New York

CMF Software & Surgical Guides

Guide Benefits

• Increase collaboration between doctors

• Reduced cost and complexity of procedure

• Decrease the number of surgical instruments to sterilize

• Potential to decrease OR time

• Expedite patient recovery

• Increase longevity of implants

• Allow surgeon to try different approaches before lifting a scalpel

• Avoid making critical decisions on the spot

Guide Production

• 5 dedicated LS machines in Belgium

• Started USA Production 2010

• Key partners in USA

• Surgeons predominently in USA

• 3 LS Machines � 6 by end of 2011 in Plymouth, MI

• Room to grow to 24 machines!

• Medical Production Focus in USA (growth)

PATIENT SPECIFIC

IMPLANTS

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• Design in 30 minutes

• Design was watertight and ready to print

• Model printed in Ti6Al4V with EBM (Arcam)

Custom Implant Design- 3-matic®

Custom Implant Design

• Cranio-Plate

• Porosity Built In

Patient specific implant design

• Increasing demand for revision total hip arthroplasty

• Growing number primary implants

• 15% require revision

• >50% involve acetabular component

• Extensive bone loss

• Complex defects

• Patient-specific surgical planning

• Custom implant design

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Mechanical loosening

Hip instability

Infection

Fracture

Patient-Specific Acetabular Cup Implant

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Segmentation/reconstruction

of anatomy Custom fit implant designed Automated screw placement

based on bone thickness

Mesh refinement of bone and

implant assembly

Court

esy

of B

art

els

et al. K

U L

euven

CT-derived material properties Patient-specific MSM

Patient specific implant design using FEA

• Model results

• Manufacturing (selective laser melting)

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Implant integrity Bone loading

Custom Implants– Acetabular Cup

• Custom Acetabulum Implant

Where do we go from here?

• Future of healthcare is customization

• Key to better patent care lies in patient specific solutions tailored to individual anatomy

Thank you!

[email protected]

Technology

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