Patient – specific solutions for personal healthcare: just press print

Many people who are eagerly waiting for the pain to go away with their new artificial hip, jaw, teeth or even limb can secure a higher quality of life with the help of 3D printing. The personalization of health care, less painful treatment and faster recovery are opened up by personalized prostheses and medical devices.

A revolution of healthcare using 3D printing is already occurring in Lithuania. The CEO of Ortho Baltic, the first company in the Baltic countries to produce 3D printed orthopaedic implants, Gediminas Kostkevičius tells a story of a patient who suffered three endoprosthetic replacements of the same joint in a row. Every time the joint yelped within 3-5 months after surgery. Only when a 3D printed personalized medical device was implanted the patient started enjoying her life – it’s been already three years without complications.

Main challenges, prospects and the latest trends of additive manufacturing, popularly known as 3D printing, in medicine will be discussed at one of the main sessions of Life Sciences Baltics conference on 26-27 of September in Vilnius. 3D printing basically means that an object of any size or shape can be produced by adding successive layers of material in a single continuous run.

Approaching a turning point

“The future of medicine is the transition from standard solutions of medicines, medical devices and procedures to personalized medicine when medicines are created for individual patient based on genetic engineering. As well as personalized implants or single-use surgical guides are designed based on patient-specific anatomical models and manufactured with 3D printing technologies. Personalized medicine changes the way surgeons think and it is very important to continue changing that paradigm of thinking, shifting the centre of surgical treatment from the operation to the pre-surgery planning stage,” Mr Kostkevičius points out.

Instead of letting surgeons continue to twist and turn trying to solve the problem of “how to make do with what we have” now it is possible to ask them to describe the individual structural and functional properties to be implemented in a particular implant for individual patient. For surgeons this signifies greater responsibility for treatment results on one hand but better surgical accuracy and quality on the other.

“3D technology will lead to a global breakthrough in medicine when combining biocompatible materials and living cells artificial parts of the human body are manufactured. This can be expected around 2030. The use of 3D technology in orthopaedics – traumatology, facial-jaw surgery, dentistry, neurosurgery, cardiology and many other areas – is already present,” Mr Kostkevičius says.

The high end 3D printing process is complex and can be accomplished using different technologies, four of them employed by Ortho Baltic. The most common technology is called direct melting laser sintering when medicine titanium powder is spread in ultra thin (30 μm thick – that’s around two times thinner than the thinnest paper) layers and melted by laser. Similar technology – laser sintering – is used to produce disposable surgical guides and anatomical models from processible polymers. Selective laser sintering technology fuses polymers into hardened plastic in a process called photopolymerization. The fourth technology – lithography-based ceramics manufacturing – works by polymerizing ceramic materials in the same process but after forming it the object is also heated into high temperatures like any other pottery.

The CEO of Ortho Baltic marks that the 3D technology is still expensive and application of standard solutions still prevails surgeons’ thinking. Mr Kostkevičius compares situation of 3D printing in medicine to the situation in the beginning of the 20th century when only the privileged members of society drove cars while ordinary persons drove a horse and a cart. Until one well-known brand introduced the “Model T” car – the engineering miracle and the first mass automobile affordable to the working class. “Such developments are on the way to the market in patient-specific implants supply chain as well,” Mr Kostkevičius says.

Bridging business and science

However, Ortho Baltic is so convinced that 3D printing will transform medical practice that it has formed several alliances with interested academic institutions. Together with Lithuanian University of Health Sciences and three other EU universities the company is developing a special study program with focus on training doctors to use the tool for ordering patient-specific implants and do pre-surgery planning in virtual platform. The program will begin in the 2018-2019 academic year at four universities in Lithuania, Belgium, Denmark and Germany.

Last year Ortho Baltic was the first enterprise in Lithuania to introduce the industrial doctoral studies with Kaunas University of Technology. “The PhD student has an opportunity to solve scientific uncertainties and carry out the experimental work with specific products. On the other hand, universities become better at understanding business needs and technology trends“, – Mr Kostkevičius says. Two topics are now being solved by Ortho Baltic’s industrial PhD students: the development of smart implants with diagnostic and therapeutic functionalities and the development of personalized technology for the human jaw biomechanical model.

At Life Sciences Baltics PhD student of Kaunas University of Technology and Ortho Baltic employee Maxime Maugeon will present a topic “Smart patient-specific cranial implants. Combination of 3D printing and sensorics”.

Though a standard Lithuanian business is quite reserved when talking about its investments to research and development, Ortho Baltic is a nice exception devoting around 5% of its income to R&D. “Today Lithuanian scientists seek information about business needs and pursue their research accordingly. But Lithuanian companies should exploit scientific knowledge more. In my opinion, business lacks ambition“, – Mr Kostkevičius says.

At Ortho Baltic every seventh company’s employee works on development of new technologies and products. The multidisciplinary team consists of orthopaedics, biomechanics and mechanics engineers, physicists and medical physicists, mathematicians and IT specialists. Last year the company was awarded a grant worth €1,587 million by Horizon 2020, the European Union Framework Program for Research and Innovation. The company now uses it to develop IT solutions for the optimization of business processes. It is estimated that those new technologies will allow reduce the market price of personalized implants by more than a double.

About the company

Ortho Baltic specializes into medical devices for treatment of complex and rear clinical conditions.  Among its production are patient-specific medical devices, surgical guides, limb prostheses, orthoses for limbs, spine and neck, orthopaedic footwear. 3D printing technologies are also used for prosthetic covers and Pre-preg orthoses.  Almost all its production is exported to Benelux, Scandinavian countries, Germany, Switzerland. Ortho Baltic is one of the biggest companies of this niche market in Europe.

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