The world's first 3D printed elbow replacement surgery successfully completed

Sep 4, 2014 | By Alec

A new medical application for 3D printing technology was recently successfully implemented in the academic hospital of the Jilin University in Changchun, Northern China. In this case, a specifically developed 3D printed elbow was surgically implemented in the arm of a 48-year-old woman suffering from rheumatoid arthritis. This is the first case ever where 3D printing technology has been successfully used in elbow replacement surgery.

The 48-year-old Leng Cai Feng, a farm worker, had been living from this condition for more than twenty-five years. She explained that this did not bother her at all when it was first diagnosed. 'It is common for farm workers to have rheumatoid arthritis, and I did not really care about it in at the beginning. It was not a serious handicap, and while I always had sore joints during spring and autumn, it did not affect my work.'

However, her condition worsened considerably three years ago. Leng explained that she suddenly became completely unable to move her knee and elbow, while her entire right her arm became stiff and almost impossible to move. Her left side, meanwhile, became only capable of performing very simple movements and activities. Furthermore, her left elbow and knee became covered in lesions. All this severely affected the quality of her life, as it left her almost entirely paralyzed and unable to take care of herself. She spent her days lying bed, relying on her family to feed her.

Having ran of options, she was admitted to the orthopaedic department of Changchun's academic hospital of Jilin University. There, doctor Chen Bingpeng diagnosed her and arranged for her to undergo bilateral knee replacement surgery. While this several elevated her walking difficulties –she was able to walk again within twenty days – her arms seemed like a hopeless case. Damage to her elbows and bone structure was severe, which made it virtually impossible to properly implement conventional prosthetic joints.

As Leng explained, she thought it was simply 'game over' for her arms. However, she came into contact with Orthopaedic Hospital Professor Wang JinCheng soon afterwards, who convinced her to cooperate in a 3D printing experiment. He explained to her that '3D printing technology can achieve the positive postoperative results for a bilateral elbow replacement surgery that conventional prosthetics can't.'

After repeated testing with prostheses in practise scenarios, her bilateral elbow replacement surgery was successfully completed in early May of this year. The 3D printed elbow prosthesis exactly matched Leng Cai Feng's bone structure, and all the steps the surgeons practised were a success.

Surgery began in the patient's right arm, with an incision of approximately 10 cms across her elbow. Professor Wang Jincheng carefully separated the patient's anconeus and triceps muscles, before removing the distal end of her humurus and the upper end of her ulna. The surgeon explained that these parts of the elbow were seriously deformed due to the patient's condition. These where then replaced with the 3D printed prosthesis. After some stitching, the surgery was complete.

Her recovery was also quick. 'Just five days after the surgery, I could drink from the cup I could hold myself.' Leng said. She has since recovered completely and the quality of her life has severely been improved. As she excitedly explained, 'I can freely move my arms, I can work and cook!'

Ms. Leng after the surgery

This successful surgery is another pioneering step that 3D printing technology has brought to the medical profession. We already reported on various success stories in the medical field, like the recent skull cap, pelvic and facial implants, but this particular application is entirely new. As Professor Wang explained, 'The success of the operation was not only the first time 3D printing technology was used in this academic hospital, but also the first time this technology was every used for artificial joint elbow replacement surgery. It's a world record.'

Here you can see the differences in bone structure before (left scans) and after the surgery (right scans).

The successful surgeon went on to emphasize the many positive aspects attached to 3D printing technology. 'Bilateral elbow 3D printing is a customized order. Just like tailor-made cloths are a better fit than store-bought mass productions, prosthetics are the best match.' To achieve this, they made a three-dimensional CT scan of the patients limbs, and sent that data to a Beijing-based prosthesis production factory. There, the data was entered into the computer and titanium powder was precisely crafted to fit the patient's bone structure.

Professor Wang JinCheng

'Another advantage of 3D printed joints is that we can use a skeletal model of the 3D printed joint to examine all stages of the surgery. We effectively carried out the operation in vitro. This greatly shortens the operation time, and reduces patient pain and the number risks involved', Wang said.

However, he goes on to emphasize that using 3D printing technology is still quite expensive to use in medical situations. 'because it is a new technology, pricing will be involved in all aspects of the process, such as machine costs, production time, design, etc. In general, it is still more expensive that the traditional technologies that are used for prostheses.'

The professor nonetheless feels that this technology very useful and will be extensively used in the future, as it is very suitable for diseased joints that are usually uniquely shaped in every particular situation. Furthermore, Wang believes that surgery costs for operations that involve 3D printing will likely be reduced as the technology matures.

Posted in 3D Printing Applications

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