The State and Future of Additive Manufacturing in Orthopaedics, a panel discussion, is slated for the lineup at OMTEC 2013 in June. The three panelists started the conversation early, weighing in on the benefits and uses of the process.
Participants (from left to right):
Andy Christensen, President and Owner, Medical Modeling Inc.
Magnus René, Chief Executive Officer, Arcam AB
Stephen Rouse, D.D.S., consultant and chairman of the Society of Manufacturing Engineers RTAM Medical Tech Group
What are the best ways in which to use additive manufacturing for orthopaedic devices? What are the benefits of using this process?
Andy Christensen: Additive manufacturing or AM finds its best application in producing products that are either highly complex, highly customized or where the quantity needed is small and other production techniques are not cost-effective. From a practical standpoint, today’s uses of additive manufacturing in the orthopaedic industry are mostly contained in three main application areas: 1) instrument and implant prototypes (plastic or metal), 2) patient-specific surgical guides/instruments and 3) manufacturing of porous or porous/solid implant constructs.
Prototypes are a “legacy” use of the technology that will continue to grow and do provide value; I think everyone reading this probably has an idea of this application. The production of patient-specific surgical guides and instruments has experienced heavy growth over the last five years with now all main players in total knee arthroplasty (TKA) space providing a system, using AM, for physical guidance (i.e.: with tactile, additively manufactured drilling and cutting guides) of placement of off-the-shelf TKA components. Several very public statements by OEM CEOs have led me to believe that this technology will impact not just three to four percent of the cases, but perhaps 50 percent of the cases performed, at some point. Very interesting opportunities still exist in this space as the technology begins to be applied outside of the TKA procedure.
The most exciting area in AM within orthopaedics for the near future, in my opinion, is with AM of implants. AM has the unique ability to provide “complexity for free,” and the application here is for unique, interesting porous surfaces or volumes. Imagine being able to design your own porous structure, integrating your specific “look,” dialing in pore size, interconnectedness, porous/solid volume, etc. and coming up with something unique. Great, now take that unique porous structure and apply it across your product line, and without secondary machining or manufacturing processes to adhere it to your parts as with some traditional techniques. Now you’ve got a uniform porous structure that can be applied at will to your product line, and the best part is that it’s not a surface; the surface is integral to the part as it is produced as a single, unified body during the construction of the implant via AM. These techniques are used both in Europe and the U.S. today for construction of implants that have been through the appropriate regulatory hurdles, including the FDA 510(k) clearance process.
Magnus René: The best opportunity is for sure to use AM to manufacture advanced trabecular structures.
Stephen Rouse: The greatest benefit to using AM lies in being able to create geometric designs that we’re unable to do with other existing technologies. A good example of that are the hip cups that had the welded beads on them. Those beads came off, and there’s a big lawsuit as a result of that. Being able to integrate that feature into the build for ingrowth of bone makes a phenomenal difference, and really can only be done adequately using this type of technology.
Along with that, the ability to do custom devices for a one-off type manufacturer is something that you can’t do with any of the traditional methods. The biggest part is the design itself—whatever happens to work best for the patients, rather than what is manufacturable.