Case StudiesMedical Additive ManufacturingOrthopedic Implants

Arcam Systems Produced Over 100,000 3D Printed Hip Cups Since 2007

Implanting 3D printed parts into a human body was a rarity back in 2007, until Italian surgeon Dr. Guido Grappiolo implanted the world’s first 3D-printed hip cup, the Delta-TT Cup, in a patient with advanced arthritis who needed a hip replacement. The surgeon joined forces with orthopedic implant maker LimaCorporate and 3D printer manufacturer Arcam, now part of GE Additive, for the landmark operation. Since then its estimated that more than 100,000 hip cups have been made in Arcam printers and implanted in patients.
With their help, he implanted the world’s first 3D printed hip cup, the Delta-TT Cup. The TT stands for “Trabecular Titanium” a biomaterial “characterized by a regular, three-dimensional, hexagonal cell structure that imitates trabecular bone morphology,” according to LimaCorporate.

A few months after the operation, Grappiolo looked at a CT scan of the patient and saw that her bone tissue had already started to grow into the 3D-printed hexagonal cells of the implant. “From a technical point of view, we immediately got a good feeling of stability,” he said in a recent video interview, when asked to recall how the surgery went.

Grappiolo, who caught up with his female patient from 10 years ago to record the video, asked her to bend her leg back toward her chest. Then, he helped her rotate it.

“The first patient is doing extremely well,” he said.

How long will a 3D printed hip last? As yet there’s no frame of reference. But signs are good, considering Grappiolo’s patient is still going strong, as are many others. The surgeon has since implanted close to 600 hip cups — his group has implanted over 1,500 — that were created by 3D printers made by the likes of Arcam. He believes the devices could last “a lifetime.” Many other doctors worldwide use the 3D-printed Delta-TT cup for their daily practice, resulting in thousands of implants used in patients since the first implant. That promises an improvement on conventionally manufactured implants.

It wouldn’t be unusual for someone with a traditional hip operation to get their implant replaced after 10 to 15 years, says Maria Pettersson, an orthopedic industry specialist with Arcam. Commonly, they could stretch that to well over 20 years, she says.

Orthopedic implant makers like LimaCorporate can also customize the design of the final implant according to the patient’s and surgeon’s needs, keeping the same features of the original structure, including the complex 3-dimensional hexagonal cells on the surface.

This level of design freedom and the ability to potentially tailor implants to different patient’s necessities is why 3D printing also increasingly is being used for dental implants, hearing aids, prosthetics and even surgical tools. Pettersson estimates that overall more than 100,000 hip cups have been made in Arcam printers and implanted in patients. There are likely hundreds of thousands more that have been made in printers from other companies.

While that is still a minor proportion of the overall number of hip replacements that hospitals are carrying out today, the demand from surgeons and manufacturers is growing, says Pettersson.

“If you’re not in it, you realize you’re behind.”

 A decade later, the patient is still doing extremely well. Since this first patient, Grappiolo has implanted close to 600 3D-printed hip cups, and his group has implanted over 1,500. While it wouldn’t be unusual for someone with a traditional hip operation to get their implant replaced after 10 to 15 years, specialists believe their 3D-printed parts could stretch that to well over 20 years. Grappiolo believes the devices could last “a lifetime.”

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