We often talk about the potential of additive manufacturing to revolutionize the medical industry through implants, but there is one healthcare area where 3D printed implants are already having very real impacts: in the veterinary field.
UK-based vets Dr. Kevin Parsons and Tom Shaw, for instance, have been using the technology since 2016 to create anatomical guides, surgical guides and even titanium implants to treat small dogs who suffer from genetically prone conditions.
Dr. Parsons, an orthopaedic vet at Langford Vets in Bristol, has been working closely with CBM Wales, a Swansea-based service for advanced manufacturing and reverse-engineering solutions. Founded by the University of Wales Trinity Saint David, CBM Wales houses a range of AM technologies, including GE Additive’s Arcam EBM Q10plus, which are suitable for producing titanium implants for the animal patients.
Dr. Shaw, for his part, is a neurosurgeon who once worked with Dr. Parsons at Langford Vets but who now practices at Willows Veterinary Centre and Referral Service in Solihull. In his time at Langford Vets, Dr. Shaw helped pioneer the use of AM for bespoke implants.
Some small dog breeds are particularly prone to developing abnormal bone growth problems. For instance, dachshunds and Shih Tzu’s can often be affected by bone growth than causes their front paws to point outwards, while pugs and other corkscrew tail breeds are prone to spinal problems caused by misshapen bones. Fortunately, if diagnosed in time, many of these problems can be remedied with surgery.
Additive manufacturing, in its ability to produce surgical guides, anatomical models and even implants tailored to the patient (even if said patient is a dog), has proved very useful to veterinary surgeons, as it enables them to better navigate the intricate operations with more precision.
“Taking this approach with additive has resulted in a improved preoperative planning, reduced surgical time and more predictable outcomes,” explained Dr. Kevin Parsons.
In manufacturing the dog implants, CT or MRI imaging data is sent from the Langford Vets’ surgical team to the specialists at CBM (overseen by Dr. Ffion O’Malley) who prepare them for 3D printing using the company’s Arcam EBM Q10plus machine. The implants are made from Titanium Ti6AI4V ELI, a material certified to the USP Class VI standard for biocompatibility and which is already used for FDA and CE marked implants.
Notably, CBM has obtained ISO 9001:2015 certification for the provision of a design, prototyping and small batch manufacturing service and ISO 13485:2016 and EN ISO 13485:2016 certification for the design and manufacturing of custom 3D printed surgical guides and implants. (The surgical guides and anatomical models created by the service are printed on polymer 3D printers).
Some of the pups that have been treated thanks to 3D printed implants include Lucca, a young Shih Tzu who was diagnosed as having angular limb deformity. After making the diagnosis, Dr. Parsons reached out to CBM to produce a cutting and repositioning surgical guide to reposition the dog’s limb as well as a titanium implant to hold the repositioned leg in place. The titanium implant was secured to the dog’s limb with ten 2.4 mm screws and was designed to contour the bone for a perfect fit.
A one-year-old Pug named Topsey was also diagnosed and treated at Langford Vets with the help of 3D printing. Dr. Shaw diagnosed Topsey with hind limb weakness caused by a severe spinal malformation. To treat the pup, the vet commissioned a stabilization implant and a surgical drilling guide, which would help the surgeon guide the pilot drill for accurate trajectories.
The implant, for its part, was designed to include ten screw holes each located in the same position as the drill cylinders of the surgical guide. This enabled Dr. Shaw to achieve precision when fitting the implant onto the dog’s spine.