3D printing "Personal customization"! The Department of Orthopedics of the Second Affiliated Hospital of Soochow University reshapes the patient's joints to help him stand and walk again
2024-08-19
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"3D printing technology can accurately adapt to the specific conditions of different patients. The amount of printing can be determined by the size of the defect. Orthopedic surgery has entered a new era of precise and personalized 'customization'." Recently, the Department of Orthopedics of the Second Affiliated Hospital of Soochow University used 3D printing technology to customize a hip prosthesis for Mr. Liu (pseudonym), who had suffered from a malignant tumor of the femur. The department also successfully completed the extremely difficult hip "revision and reconstruction" surgery, allowing the patient to stand and walk again.
It is reported that Mr. Liu, 55 years old this year, is a construction worker. Ten years ago, due to unbearable pain in his right hip joint, he rushed from his hometown Yancheng to the Orthopedics Department of the Second Affiliated Hospital of Soochow University for treatment and was diagnosed with clear cell chondrosarcoma. The hospital's orthopedics department performed femoral tumor lesion resection surgery and artificial femoral head prosthesis replacement surgery on him. After the surgery, Mr. Liu's pain was eliminated and he returned to normal life.
For ten years, Mr. Liu did not go to the hospital for regular checkups due to work reasons. In the past six months, he felt that the pain in his right hip joint was getting worse, his right lower limb was shortened, and he had difficulty walking, so he came to the Second Affiliated Hospital of Soochow University for treatment again. Chen Hainan, chief physician of the hospital's orthopedics department, said that Mr. Liu often carried heavy objects. Over a long period of time, the artificial femoral head prosthesis made of alloy material continued to rub against the hip joint bone above, causing serious damage to the hip joint. The right hip joint was severely worn, and the prosthesis moved up more than 3 centimeters, causing the patient to have difficulty walking and limping. "The patient's hip joint has many friction defects and the shape of the bone defects is irregular. Under such circumstances, there is no way to perform joint replacement and implant prosthesis according to conventional methods."
Chen Hainan, chief physician of orthopedics at the Second Affiliated Hospital of Soochow University
After careful diagnosis and evaluation, Chen Hainan's team quickly developed a 3D printing technology-customized hip prosthesis treatment plan for the patient. "With the continuous development of science and technology, 3D printing technology has begun to be applied to the field of orthopedics. I plan to use advanced 3D printing technology to remake a hip joint for the patient. The first thing to do is a CT three-dimensional reconstruction examination," said Chen Hainan.
Pre-operative modeling
Chen Hainan's team spent nearly three weeks to reconstruct the CT data in three dimensions, measure the size of the worn bones, and then design a new hip joint defect model based on the results of digital processing, and then send it to the relevant company for 3D printing of hip prostheses and pads, which were then polished and disinfected. "The 3D-printed hip pads are made of special titanium alloy materials with a small gap in the middle, so that after being implanted in the patient's body, the patient's hip bones will quickly merge with it. Not only that, we have to design a variety of 3D-printed hip pads, aiming to make the pads and the patient's hip joints perfectly fit together, to ensure the smooth progress of the operation and the best surgical results." Chen Hainan said.
Then Chen Hainan's team started the nearly 7-hour operation. Referring to the technical difficulties during the operation, Chen Hainan said that on the one hand, it is necessary to be very careful and cautious, clean the patient's soft tissue scars and adhesive tissues, carefully protect blood vessels and nerves, expose fresh tissue wounds, and then separate the original artificial joint prosthesis from its own bones. "In this link, the patient bleeds a lot. We transfused more than 1,000 milliliters of blood to the patient, and we can't slack off at all." On the other hand, in the process of implanting the 3D printed hip joint pad into the patient's body, it is necessary to repeatedly debug and match according to the actual situation, accurately locate the placement of the prosthesis and the direction and angle of the screw fixation, so as to ensure that the patient can walk normally after the operation. The operation was successfully completed. After the operation, the patient recovered quickly after the careful rehabilitation of the nurse rehabilitation team, and was able to walk on the ground when he was discharged from the hospital. Chen Hainan urged the patient to reduce the amount of activity within three months after returning home to avoid excessive activity and incorrect posture causing joint dislocation.
Postoperative X-rays
"3D printing technology is an emerging technology in the world. It has broad application prospects in joint surgery and even the entire medical field. This technology can accurately adapt to the specific conditions of different patients. The amount of defect can be determined by the amount of printing. It is not limited to the hip joint, but also applicable to the knee joint, elbow joint, ankle joint, etc." Chen Hainan expressed the hope that this advanced 3D printing technology can be widely used in more hospitals in the future to benefit more patients.
Intern Wang Gongxu Yangzi Evening News/Ziniu News reporter Zhang Tianyi
Proofread by Xu Heng
