Sep 8, 2017 | By Benedict

Surgeons at Princess Alexandra Hospital in Brisbane have performed world-first surgery by implanting a 3D printed shinbone scaffold into the leg of Reuben Lichter, a patient suffering from a severe bone infection.

What would you choose: amputation above the knee, or an experimental surgery—never before tried on a human patient—that may or may not work to save your infected leg? For Reuben Lichter, a 27-year-old resident of Mudgeeraba, Queensland, the choice was obvious.

The Australian recently became the first person in the world to receive a complete 3D printed shinbone scaffold, after a serious infection started rotting away the bone in his leg.

Worse still, the seriousness of the condition only came to light two days after Lichter’s son William was born, which meant that fiancee Caity Bell, fresh out of labor, had to care for their new baby alone.

Now, however, Lichter hopes he might be able to not only care for William, but carry out all the activities he wants to share with the child: walking, running, and—most of all—skiing.

“Reuben has never been able to pick his son up and carry him…or throw him up in the air, making Will squeal with excitement,” Bell said. “They seem like such small things in everyday life, but missing out on the little things like that always hits the hardest.”

At one point, before the possibility of a 3D printed shinbone scaffold was discussed, those things seemed like an impossibility. So when Lichter was presented with the option of the experimental surgery, he accepted immediately.

“It was not frightening at all,” Lichter recalls. “If there was a chance for me to save my leg and do the things I want to do with my son, then I was going to take it. I wasn't going to lose my leg without having a fight.”

Although Lichter is now the first human patient to have surgery of this kind, the procedure had in fact been trialled on sheep, a process that encouraged doctors to try the same thing on Lichter.

To carry out the world-first surgery, staff designed the 3D tibia scaffold at the Queensland University of Technology, before sending it to Singapore, where the 36-centimeter scaffold could be 3D printed in a special biodegradable, biologically safe polymer.

A total of five operations were needed to get the 3D printed shin into Lichter, one of which involved draining pus from his infected leg.

The 3D printed scaffold is wrapped in blood vessels and tissue taken from the patient’s two tibia bones and left knee, and that tissue is already starting to grow around the scaffold. Eventually, and if all goes to plan, the growing tissue will eventually form a complete new shinbone.

Overall, doctors are pleased with how the novel procedure went, but think Australia needs to try harder to perfect procedures like this one.

"We see this operation as an opportunity to make this happen here, locally," said reconstructive surgeon Michael Wagels.

It’s not yet certain that the operation will give Lichter a long-term solution to his problems, but early signs are good, meaning the patient can keep dreaming about that ski holiday with his son.

In the meantime, Bell has set up a GoFundMe page asking for any donations that can help get the family back on its feet after these testing times.

Doctors say Lichter, who has been out of work for a year because of his condition, will not be able to walk for another 18 months.



Posted in 3D Printing Application



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