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FREEDOM OF DESIGN TO MEET PATIENTS’ AND SURGEONS’ REQUIREMENTS
Thanks to the extreme versatility the additive manufacturing technology offers the
possibility of creating customized solutions to cope with the most complex
situations, which cannot be faced with standard systems.
In many years of clinical experience, Permedica has developed an important know-how
in 3D printing to offer the surgeon ad-hoc solutions for the treatment of
particular clinical scenarios.
Technology TRASER® (Trabecular Laser Melted Titanium) makes it possible to create systems of any shape and design to best adapt to the clinical case of interest.
MANUFACTURING PROCESS
Starting from the diagnostic images CT-Scan our R&D department analyzes the case in collaboration with the surgeon to determine the most suitable solution.
Once the study is approved by the surgeon, the components are realized by a 3D printer from titanium powder.
TRASER® (Selective Laser Melting) is an additive manufacturing technology that selectively fuses together specific portions of a thin layer of titanium powder using a laser beam to create solid objects.
At the end of the printing process the components are removed from the support, subjected to heat treatment and sandblasting, then to subsequent traditional mechanical processing to obtain the finished implant.
SOLUTIONS FOR HIP, KNEE AND SHOULDER
Custom made solutions play an increasing crucial role either for the creation of components with a specific design in order to address particular clinical scenarios (bone losses, complex anatomies, fractures or post-traumatic complications, hardware in situ) and to produce implants of small dimensions, for example for treatment of patients with dwarfism.
CLINICAL CASE [1]
CLINICAL HISTORY
Paziente maschio, 32 anni, affetto da nanismo. Altezza 1,08 metri e peso 30 Kg.
In anamnesi dolore quotidiano continuo all’anca destra con ridotta articolarità .
Importanti limitazioni cliniche. Dipendente da analgesici.
CLINICAL EXAMS
Cammino: zoppia lato destro. Segno di Duchenne/Trendelemburg negativo.
Articolarità : flesso-estensione 30-10-0°, rotazione esterna-interna 20-0-10°, abduzione-adduzione 10-0-20°.
Esame radiografico: coxartrosi anca destra secondaria a displasia (DDH, Crowe II, Paprosky IIb).
SURGERY
Il paziente è stato sottoposto ad intervento di artroprotesi totale d’anca utilizzando un allograft d’osso di teste femorale da banca dell’osso fissato con alcune viti per ricostruire il bordo acetabolare laterale.
Quindi un cotile custom made di diametro 30mm realizzato con tecnologia TRASER in titanio trabecolare è stato impiantato senza l’utilizzo di cemento e fissato con alcune viti da spongiosa aggiuntive.
Sul lato femorale è stato impiantato uno stelo custom made realizzato con la stessa tecnologia TRASER con una testina in metallo che si articolava con un inserto in UHMWPE.
RESULT
The final result is stable with a perfect covering of the cup implant and central seating of the TRASER custom made cup.
FOLLOW-UP
4 months after surgery perfect walk.
No crutches since the second month postoperatively; no limping.
Joint function : F/E 120-0-20, ER/IR in 90° of flexion 40-0-30.
Radiologically the implant is stable; bone graft is stable, the cup is integrated.
