The latest developments in medicine have seen the personalization of care as an increasingly realistic and concrete option. Orthopaedic is no exception, with studies that range from the development of prostheses with increasingly innovative materials tailored to the patient, to the use of stem cells that help the regeneration of tissues and cartilage. In Humanitas, under the guidance of Prof. Maurilio Marcacci, his help Dr. Tommaso Bonanzinga and Dr. Francesco Iacono of the Centre for the Reconstruction of the Knee Joint, an operation was performed with personalized knee prosthesis printed entirely in 3D, implanted through the intraoperative assistance of technologies and a computer.
The regretful operation with 3D printed prosthesis
“This intervention is the conclusion of a research project that opens the doors to interesting therapeutic options for the benefit of patients and that we hope will stimulate the work of all professionals in the field of science and medicine in order to find more and more innovative clinical applications,” commented Prof. Maurilio Marcacci. Knee replacement (TKR-Total Knee Replacement) is one of the most commonly performed orthopedic procedures, reaching 4 million cases per year worldwide: although it is considered a routine procedure, as many as 15% of patients say they are not satisfied with the results and 6.2% risk undergoing a revision of the prosthesis in the next 10 years. So far, knee implants have been designed for any patient without considering the specific anatomy of each individual patient – explained Prof. Marcacci -, consequently many implants have been larger or smaller than the patient’s knee, generating problems after surgery such as rubbing of the tendons between devices and soft tissue, pain, inflammation, bone bleeding and influencing the quality of life of the patient for years.
In this perspective, the surgeons of the Centre for Joint Reconstruction of Humanitas, in collaboration with the innovative Italian start-up Rejoint, which was also the winner of a Horizon 2020 call for research and innovation, have designed a new procedure and printed in 3D a total knee prosthesis in cobalt chrome alloy: “Through CT and magnetic resonance imaging, the characteristics and anatomical parameters of the patient are detected; on this basis and on the basis of this information, a 3D prosthesis is printed which is faithfully reconstructed on the size of the patient’s knee”, clarified the orthopedist.
“The regret is printed in 3D, but not only – explained Dr. Bonanzinga – During the operation were also used ancillary technologies to minimize risks, to position the prosthesis precisely. It will be the first step towards a customization of the intervention, more and more important and necessary”.
Rehabilitation is also computerized
In addition to allowing a faster operation, thanks to the use of technologies, computerized surgical instruments useful for the positioning of the prosthesis, this type of technique also ensures less complications, less infections, and a faster post-operative recovery, while eliminating pain accessories related to the prosthesis. “Finally, with the use of a sensorized brace capable of transmitting information to the surgeon or physiotherapist during the post-operative phase, the rehabilitation will also be customized and monitored “real time” through an app that will also identify and recognize any anomalies through the sensor-based monitoring during recovery for a potential timely intervention,” concluded the specialist.