3D-Printed Custom-Made Implants in Complex Revision Total Knee Arthroplasty

Description

This presentation from the ISTA 2024 conference held in Nashville, is by Georg Hettich, an engineer at a German medical device company (Aesculap), focuses on custom knee implants, particularly their design and manufacturing processes using additive manufacturing, or 3D printing.



Georg begins by thanking the audience and explaining the significance of custom knee implants, highlighting their role in cases where standard implants may not fit due to unique patient conditions, such as allergies or severe bone defects. He introduces three categories of personalized implants: patient matched implants, custom made implants, and adaptable implants, with a special emphasis on the benefits of custom made implants, especially when alternative solutions are not viable.



The presentation outlines the intricate process of implant design, emphasizing the collaborative efforts between surgeons and engineers, and the challenges of design validation. A novel method of using finite element method (FEM) simulations to assess implant safety is discussed, followed by a description of the manufacturing process that employs selective laser melting of cobalt-chromium powder, highlighting the efficiency of producing multiple implant types in one job.



Post-processing steps, including heat treatment and surface preparation, are also detailed, underlining the complexity involved in preparing implants for surgical use. Georg provides clinical case studies illustrating the justification and necessity of custom implants in the face of medical needs that standard implants cannot satisfy.



In conclusion, he notes the importance of regulatory compliance, noting that custom implants often require different considerations compared to standard implants, especially regarding testing and documentation post-manufacture. The session ends with an interactive Q&A, where Georg discusses regulations surrounding custom implants in different regions, mechanical testing challenges, and logistical aspects of delivering personalized medical solutions.

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