limitations & future of 3 d printing in orthopedics

Limitations & Future of 3D Printing

Dr VAIBHAV BAGARIA SIR HN RELIANCE FOUNDATION HOSPITAL

GIRGAUM MUMBAI INDIA

WWW.DRBAGARIA.IN

DISCLOSURES

Hold Shares in Timeless Innovation Ltd & 3D POST TM

Consultant to Extrudify & Ebionix

Research grant from SPD foundation

Royalties from Medjaden

Limitations and Future!

And by definition ‘the future’ is Unlimited & Ours to create!!

3D Printing Video

3D printing Avenues

Anatomical Models & Simulation tools

Patient Specific Jigs/ Instruments

3D printed Implants and Instruments

Bio Printing & Tissue Engineering

Models: where we started!

And today..

And yet..

Imaging dependant: Trash In -> Trash Out

Processing software are expensive time consuming

Surgeon dependant

Time Consuming

SEGMENTATION

Hopefully…

Better Images

Better Processing Algorithms

Artificial Intelligence to reduce Surgeon dependency

Quicker Turn around time

Cost: Well it is already rock bottom now!

Patient Specific Jigs/Instruments

Uses data from CT/ MRI/ X-rays

Planning is carried out in the preoperative stage

Surgeons and Engineers formulate a plan

Jigs are 3D printed and Shipped

Where we started…

Where we are now?

Current Limitations

No intraoperative measure to test the accuracy

Accuracy depends on the images/ Operators

Issues with the materials used for making these Jigs

Deals with all the deformities as static

The Future

Intraoperative integertaion with realtime navigation systems

Expansion to different areas beyond TKR/ Osteotomies and Resurfacing

Tactile feedback incorporation into the instrumentation systems

3D printed Implants

Era of ‘personalised medicine’

Newer materials are found suitable for implantation

Driven by better understanding of the human anatomy, physiology and biomechanics

Metal printing cost has dramatically fallen in last 2 years.

Exciting times!

Acetabular defects

Patient Specific Knees

Limitations

Still grappling with accuracy to match mass production

Material issues

Turn around time

Cost issues

Operator dependant

The Future

Newer Biocompatible materials: HA TCP printing/ Biopolymers

Faster turn around

Manufacture anywhere even in the OT

Get exactly what you and your patient require/ wish

Today - Limitations??

The Future is ‘Unlimited’

Bio printing - The Big Question?

Can we recreate what God created?

Yes we can - atleast try

Bioprinters

In vitro..

Regenerating Cartilage , Bones & Scaffolds

Use natural polymers: Collagen/HA/Silk Proteins/Alginate

Coupled with hydrogels - PGA/ PCL/Methacrylate

Cross linked chemically, thermally or using UV

Sprayed with hMSCs

We look forward to..

Going beyond the ‘hype’ phase to real action phase

Long term survivorship data

TKR becoming obsolete in my life time!

Thank You! www.drbagaria.in