Several UK media outlets are reporting that UK NHS patients now have access to a titanium 3D printed shin bone cage (or graft, depending on how you look at it) that makes it possible to avoid amputation in case of severe bone damage.
While 3D printed cages are now common for vertebral implants and have been used in some rib cage implants as well, the use of cages for the shin bone is a more recent development. The new technique has now been used in more than 30 UK patients. First, the patient undergoes CT scans to produce a 3D image of what their bone looks like. The surgeon can then work out how much bone needs to be removed – and the metal cage that will fill the gap is designed on a computer.
Last May, St George’s trauma and orthopaedic team have carried out their first-ever 3D custom printed bone graft in a limb-saving operation. Russell Neighbour, 60, was the first patient to have the procedure at St George’s after he fell from a ladder in December 2018. His fall caused an open fracture to his right tibia and fibula – the two lower leg bones.
Russell said: “I was putting Christmas lights up on the outside of our house and slipped off the ladder. I fell backward, landing half on the grass and half on the footpath. My right tibia and fibula came out through the back of my leg and buried themselves in the grass.”
Russell underwent two operations to repair the fracture, but it failed to heal and Mr. Alex Trompeter, Consultant Orthopaedic Trauma and Limb Reconstruction Surgeon, recommended a 3D custom printed bone graft would give Russell the best chances of walking again. The alternatives were further surgery or an amputation.
Bone grafting is a procedure that uses transplanted bone, or an implant, to replace damaged bone. It is typically carried out for patients with complex fractures that fail to heal properly. Mr. Trompeter, who led the multidisciplinary team undertaking the operation on Tuesday 7 April, believes St George’s is one of the few centers in the UK to have performed a 3D custom printed bone graft.
Describing the procedure, Mr Trompeter said: “We removed the bottom six centimeters of Mr. Neighbour’s shin bone where the fracture hadn’t healed, and we replaced it with a custom made 3D metal cage.
“The cage is made of porous metal to allow new bone to grow through and is exactly the same shape as the piece of bone we cut away.
“The benefit of personalized implants is that they start performing their functions quickly and help to speed up recovery post-surgery.”
Russell is now recovering at home in Ash, Surrey. “Just a few days after surgery, it is fantastic to see that Russell is already bearing his full weight and walking comfortably again for the first time in over a year,” Mr Trompeter said.