Australia's 3D-printed ribs

Australia has contributed to an international collaboration that has led to a world-first in surgery — the implantation of a 3D-printed titanium sternum and rib cage into a Spanish cancer patient.

Suffering from a chest wall sarcoma (a type of tumour that grows in and around the rib cage), the 54-year-old patient needed his sternum and a portion of his rib cage replaced. However, the use of prosthetic implants would be difficult due to the complex geometry and intricate structures involved in the chest cavity.

“We thought: maybe we could create a new type of implant that we could fully customise to replicate the intricate structures of the sternum and ribs,” said Dr José Aranda from the patient’s surgical team.

Dr Aranda and his colleagues turned to Melbourne-based medical device company Anatomics, which resolved to 3D print the new implant from titanium “because of its complex geometry and design”, explained CEO Andrew Batty.

Through high-resolution CT data, the Anatomics team was able to create a 3D reconstruction of the chest wall and tumour, allowing the surgeons to plan and accurately define resection margins. “From this, we were able to design an implant with a rigid sternal core and semi-flexible titanium rods to act as prosthetic ribs attached to the sternum,” Batty said.

Working with experts at CSIRO’s 3D-printing facility, Lab 22, the team then manufactured the implant out of surgical-grade titanium alloy. Alex Kingsbury, from CSIRO’s manufacturing team, explained how the organisation’s $1.3 million Arcam printer completed the job.

“The printer works by directing an electron beam at a bed of titanium powder in order to melt it,” she said. “This process is then repeated, building the product up layer by layer until you have a complete implant.”

According to Kingsbury, 3D printing has significant advantages over traditional manufacturing methods — particularly for biomedical applications.

“The reason that 3D printing was desired for making this implant was because it needed to be customised exactly to suit the patient,” she said. “No human body is the same, so therefore every implant is going to be different.

“To get to this implant design, Anatomics used the patient’s scan data. And that meant that they were able to make an implant design that exactly matched the patient’s anatomy.”

Once the prosthesis was complete, it was couriered to Spain and implanted into the patient. The patient has since been discharged from hospital, while the procedure has been published in the European Journal of Cardio-Thoracic Surgery.

Image caption: The 3D-printed sternum implant. Image credit: Anatomics.