LESSONS LEARNED IN THE ROLE OF ADDITIVE        MANUFACTURING IN TRAUMA AND RECONSTRUCTIVE                                 ...
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
 Statements   made during this presentation do  not reflect official policy of the US Army All photos of individuals are...
     Established October 2002 with initial investment of       2.3 million dollars      First model was produced October...
-Complex fractures            -Custom Implants                                              -Facial fixation & reconstruct...
 Design cannot be milled, stamped, or cast Internal geometry Where it reduces cost significantly Variable material pro...
•Mandibular                                                                           discontinuity                       ...
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
   Hand bent in Operating Theater                                            Approximate fit                            ...
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
 Sub-periostealimplants Custom abutments for maxillary prostheses  after hemi-maxillectomy Masterclass: Biomedical appli...
 Complex              fractures Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the ...
•Hemi-pelvectomy repair or                                                          implant                               ...
 Failed   total hip                                                                  implantMasterclass: Biomedical appli...
•   Dec 2003 – June 2008 165 Cranial PMMA implants•   Multi-piece PMMA implants present challenges to    surgeon•    Unkno...
   Methods & Materials:•    Computed Tomography (CT) scans are obtained    relevant bony structures segmented using Mimic...
•PMMA easily modified intraoperatively andinexpensive•Requires EtO sterilization•No tissue ingrowth•Time consuming to proc...
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
Masterclass: Biomedical applications of Additive Manufacturing   Organized by SIRRIS the 12th of March 2013
•   100+ porous mesh implants placed since    November 2007•   First implant – primary, subsequent primary, or    followed...
 Know   the limitations of your material and  equipment Regular factory preventive maintenance and  calibration NEVER n...
 Work  closely with the surgical team Be very comfortable with radiographic  anatomy as well as the anatomy of the area ...
Dr. Stephen RouseIndependent Consultant in Medical Applications  of Additive ManufacturingCell: +1(703) 568-4779Stephen.L....
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2013 03-12-masterclass-biomedical-applications-of-am clinical-support-requirements-rouse

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Additive manufacturing (AM) offers a few major benefits to biomedical applications. To improve the knowledge on AM possibilities, Sirris is organizing two different masterclasses. The first will address the technology, materials used and applications, with experts in the matter explaining all relevant aspects.

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2013 03-12-masterclass-biomedical-applications-of-am clinical-support-requirements-rouse

  1. 1. LESSONS LEARNED IN THE ROLE OF ADDITIVE MANUFACTURING IN TRAUMA AND RECONSTRUCTIVE SURGERYDr. Stephen RouseFormer Director of Operations and Research3D Medical Applications CenterWalter Reed Army Medical Center, Washington, DC
  2. 2. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  3. 3.  Statements made during this presentation do not reflect official policy of the US Army All photos of individuals are shown with the patient’s consent No duplication or publishing of these materials may be made outside of this conference without written permission.Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  4. 4.  Established October 2002 with initial investment of 2.3 million dollars  First model was produced October 2003  Since then produced more than 2600 pre and post- surgical models and 400 cranioplasty plates (PMMA & Ti6Al4V) (2003-2012)Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  5. 5. -Complex fractures -Custom Implants -Facial fixation & reconstructions -Cranioplasties -Aneurysms -post-Cancer prostheses -Implants -HO -Prostheses DesignMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  6. 6.  Design cannot be milled, stamped, or cast Internal geometry Where it reduces cost significantly Variable material properties required No “off-the-shelf” solution exists Custom design reduces surgery time Custom design improves outcome Custom design reduces repetitive surgery to correct same problemMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  7. 7. •Mandibular discontinuity •Substantial Missing bone •Articular surface missing or damagedMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  8. 8. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  9. 9. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  10. 10.  Hand bent in Operating Theater  Approximate fit  Inexpensive & readily availableMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  11. 11. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  12. 12. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  13. 13.  Sub-periostealimplants Custom abutments for maxillary prostheses after hemi-maxillectomy Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  14. 14.  Complex fractures Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  15. 15. •Hemi-pelvectomy repair or implant •Custom Acetabular implant integrationMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  16. 16.  Failed total hip implantMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  17. 17. • Dec 2003 – June 2008 165 Cranial PMMA implants• Multi-piece PMMA implants present challenges to surgeon• Unknown number of PMMA plates removed due to infection• Stimulated search for new material/method• 100+ 3-dimensional EBM built Ti6Al4V cranial plates implanted to replace PMMA• Surgeon driven needMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  18. 18.  Methods & Materials:• Computed Tomography (CT) scans are obtained relevant bony structures segmented using Mimics (Materialise NV).• The implant is designed using 3Matic (Materialise NV) or Freeform Plus (Sensable Technologies)• Built in an ARCAM A-1, using Electron Beam Melting of Ti6Al4V, medical grade titanium alloy.• The resultant three dimensional mesh is 3-4mm in thickness, and has fixation plates integrated.• Sterilizable using standard steam autoclave techniques.Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  19. 19. •PMMA easily modified intraoperatively andinexpensive•Requires EtO sterilization•No tissue ingrowth•Time consuming to process with significantman-hour requirements•Limited contour complexity capable Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  20. 20. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  21. 21. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  22. 22. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  23. 23. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  24. 24. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  25. 25. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  26. 26. Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  27. 27. • 100+ porous mesh implants placed since November 2007• First implant – primary, subsequent primary, or followed multiple PMMA failures• 1 implant removed due to free flap necrosis with infection• 1 Implant removed 12 days post op due to immediate recurrent infection• 1 additional resolved infection• 3 patients tested positive for infection perioperatively.Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  28. 28.  Know the limitations of your material and equipment Regular factory preventive maintenance and calibration NEVER neglect recommended maintenance Keep all records of maintenance, calibration, material batch info, materials testing Document-document-document Participate actively in AMUG and vendor user groupsMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  29. 29.  Work closely with the surgical team Be very comfortable with radiographic anatomy as well as the anatomy of the area where you are working Get feedback from the surgeon Educate—educate—educate both yourself and your customers Every solution doesn’t fit every patient Experiment in house—NOT on the surgeon!Masterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013
  30. 30. Dr. Stephen RouseIndependent Consultant in Medical Applications of Additive ManufacturingCell: +1(703) 568-4779Stephen.L.Rouse@gmail.comMasterclass: Biomedical applications of Additive Manufacturing Organized by SIRRIS the 12th of March 2013

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