FREEDOM OF DESIGN TO MEET PATIENTS’ AND SURGEONS’ REQUIREMENTS<\/h4><\/div>Thanks to the extreme versatility the additive manufacturing technology offers the<\/strong>
\npossibility of creating customized solutions<\/strong> to cope with the most complex
\nsituations, which cannot be faced with standard systems.<\/p>\nIn many years of clinical experience, Permedica has developed together with osteobionix an important know-how<\/strong>
\nin 3D printing<\/strong> to offer the surgeon ad-hoc solutions for the treatment of
\nunique and unexpected clinical scenarios.<\/p>\nTechnology TRASER\u00ae<\/strong> (Trabecular Laser Melted Titanium)<\/a> makes it possible to create systems of any shape and design<\/strong> to best adapt to the clinical case of interest.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>MANUFACTURING PROCESS<\/h4><\/div>Starting from the diagnostic images CT-Scan our R&D department analyzes the case in collaboration with the surgeon<\/strong> to determine the most suitable solution.<\/p>\nOnce the study is approved by the surgeon, the components are realized by a 3D printer<\/strong> from titanium powder.<\/p>\nTRASER\u00ae (Selective Laser Melting) is an additive manufacturing technology<\/strong> that selectively fuses together specific portions of a thin layer of titanium powder using a laser beam to create solid objects.<\/p>\nAt the end of the printing process the components are removed from the support, subjected to heat treatment<\/strong> and sandblasting,<\/strong> then to subsequent traditional mechanical processing<\/strong> to obtain the finished implant.<\/p>\n<\/div>SOLUTIONS FOR UNEXPECTED SITUATIONS<\/h4><\/div>Custom made solutions play an increasing crucial role either for the creation of components with a specific design<\/strong> in order to address particular clinical scenarios (bone losses, complex anatomies, fractures or post-traumatic complications, hardware in situ<\/strong>) and to produce implants of small dimensions, for example for treatment of patients with dwarfism.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div>![](\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27722%27%20height%3D%271024%27%20viewBox%3D%270%200%20722%201024%27%3E%3Crect%20width%3D%27722%27%20height%3D%271024%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\")
<\/div><\/div><\/div><\/div><\/div><\/div><\/div>![](\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%271024%27%20height%3D%271432%27%20viewBox%3D%270%200%201024%201432%27%3E%3Crect%20width%3D%271024%27%20height%3D%271432%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\")
<\/div><\/div><\/div>CLINICAL CASE [1]<\/sup><\/h4><\/div>CLINICAL HISTORY<\/h4><\/div>Male patient, 32y old; dwarfism<\/strong>; 1.08m\/30 kg of bodyweight.
\nIn the anamnesis continuous daily pain in the right hip with restricted range of movement. Important clinical limitations. Pain killers dependent.<\/p>\n<\/div>CLINICAL EXAMS<\/p><\/h4><\/div>
Walk: limping right side<\/strong>; Duchenne\/Trendelenburg negative.
\nROM : F\/E 30-10-0\u00b0, ER\/IR 20-0-10\u00b0, ABD\/ADD 10-0-20\u00b0.
\nRadiologically: DDH: developmental dysplasia of the hip with secondary osteoarthritis<\/strong> (Crowe II, Paprosky IIb).<\/p>\n<\/div>SURGERY<\/h4><\/div>Total hip replacement is performed, using an allograft out of the femoral head, fixed with several screws to build up the lateral acetabular rim.
\nThen a TRASER Trabecular Titanium custom made cup of 30mm diameter<\/strong> is inserted without using bone cement and fixed with some trabecular bone screws.
\nOn the femoral side, a customized selective laser melted femoral stem is implanted, created with the same TRASER technology;<\/strong> reposition with a metal femoral head on a UHMWPE insert.<\/p>\n<\/div>RESULT<\/h4><\/div>The final result is stable with a perfect covering of the cup implant<\/strong> and central seating of the TRASER custom made cup.<\/p>\n<\/div>FOLLOW-UP<\/h4><\/div>4 months after surgery perfect walk.<\/strong>
\nNo crutches<\/strong> since the second month postoperatively; no limping.
\nJoint function : F\/E 120-0-20, ER\/IR in 90\u00b0 of flexion 40-0-30.
\nRadiologically the implant is stable; bone graft is stable, the cup is integrated.<\/p>\n[1] Memminger M, Banci L, Meoli A. Bilateral Total Hip Replacement in Dwarfism With a Custom Laser-Printed Trabecular Acetabular Shell. Orthopedics. 2019 Sep 1;42(5):e477-e479.<\/span><\/a><\/h6>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":14551,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[36],"tags":[],"class_list":["post-5538","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-knee"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t
Thanks to the extreme versatility the additive manufacturing technology offers the<\/strong> In many years of clinical experience, Permedica has developed together with osteobionix an important know-how<\/strong> Technology TRASER\u00ae<\/strong> (Trabecular Laser Melted Titanium)<\/a> makes it possible to create systems of any shape and design<\/strong> to best adapt to the clinical case of interest.<\/p>\n<\/div><\/div><\/div> Starting from the diagnostic images CT-Scan our R&D department analyzes the case in collaboration with the surgeon<\/strong> to determine the most suitable solution.<\/p>\n Once the study is approved by the surgeon, the components are realized by a 3D printer<\/strong> from titanium powder.<\/p>\n TRASER\u00ae (Selective Laser Melting) is an additive manufacturing technology<\/strong> that selectively fuses together specific portions of a thin layer of titanium powder using a laser beam to create solid objects.<\/p>\n At the end of the printing process the components are removed from the support, subjected to heat treatment<\/strong> and sandblasting,<\/strong> then to subsequent traditional mechanical processing<\/strong> to obtain the finished implant.<\/p>\n<\/div> Custom made solutions play an increasing crucial role either for the creation of components with a specific design<\/strong> in order to address particular clinical scenarios (bone losses, complex anatomies, fractures or post-traumatic complications, hardware in situ<\/strong>) and to produce implants of small dimensions, for example for treatment of patients with dwarfism.<\/p>\n<\/div><\/div><\/div> Male patient, 32y old; dwarfism<\/strong>; 1.08m\/30 kg of bodyweight. CLINICAL EXAMS<\/p><\/h4><\/div> Walk: limping right side<\/strong>; Duchenne\/Trendelenburg negative. Total hip replacement is performed, using an allograft out of the femoral head, fixed with several screws to build up the lateral acetabular rim. The final result is stable with a perfect covering of the cup implant<\/strong> and central seating of the TRASER custom made cup.<\/p>\n<\/div> 4 months after surgery perfect walk.<\/strong>
\npossibility of creating customized solutions<\/strong> to cope with the most complex
\nsituations, which cannot be faced with standard systems.<\/p>\n
\nin 3D printing<\/strong> to offer the surgeon ad-hoc solutions for the treatment of
\nunique and unexpected clinical scenarios.<\/p>\nMANUFACTURING PROCESS<\/h4><\/div>
SOLUTIONS FOR UNEXPECTED SITUATIONS<\/h4><\/div>
<\/div><\/div>
CLINICAL CASE [1]<\/sup><\/h4><\/div>
CLINICAL HISTORY<\/h4><\/div>
\nIn the anamnesis continuous daily pain in the right hip with restricted range of movement. Important clinical limitations. Pain killers dependent.<\/p>\n<\/div>
\nROM : F\/E 30-10-0\u00b0, ER\/IR 20-0-10\u00b0, ABD\/ADD 10-0-20\u00b0.
\nRadiologically: DDH: developmental dysplasia of the hip with secondary osteoarthritis<\/strong> (Crowe II, Paprosky IIb).<\/p>\n<\/div>SURGERY<\/h4><\/div>
\nThen a TRASER Trabecular Titanium custom made cup of 30mm diameter<\/strong> is inserted without using bone cement and fixed with some trabecular bone screws.
\nOn the femoral side, a customized selective laser melted femoral stem is implanted, created with the same TRASER technology;<\/strong> reposition with a metal femoral head on a UHMWPE insert.<\/p>\n<\/div>RESULT<\/h4><\/div>
FOLLOW-UP<\/h4><\/div>
\nNo crutches<\/strong> since the second month postoperatively; no limping.
\nJoint function : F\/E 120-0-20, ER\/IR in 90\u00b0 of flexion 40-0-30.
\nRadiologically the implant is stable; bone graft is stable, the cup is integrated.<\/p>\n[1] Memminger M, Banci L, Meoli A. Bilateral Total Hip Replacement in Dwarfism With a Custom Laser-Printed Trabecular Acetabular Shell. Orthopedics. 2019 Sep 1;42(5):e477-e479.<\/span><\/a><\/h6>\n<\/div>