Aa personalized knee prosthesis, printed entirely in 3D was implanted in Humanitas through the intra-operative assistance of technologies as well as a computer: an operation of regret was carried out on a patient by Prof. Maurilio Marcacci, his assistant Dr. Tommaso Bonanzinga and Dr. Francesco Iacono of the Centre for the Reconstruction of the Knee Joint.

“The latest developments in medicine see the customization of treatments as an increasingly realistic option. Orthopedic is no exception, with studies 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. This intervention is the result of a new research project that opens the door to interesting therapeutic options for the benefit of the patients which we hope will stimulate the work of all professionals involved in science and medicine to find increasingly innovative clinical applications”, commented Prof. Maurilio Marcacci.

The knee replacement (TKR-Total Knee Replacement) is one of the most commonly performed orthopedic procedures, with up to 4 million cases per year worldwide: although it is “a routine procedure, 15% of the patients declare themselves dissatisfied with the results and 6.2% are likely to undergo a revision of the prosthesis in the next 10 years,” explained Dr. Bonanzinga.

A personalized 3D prosthetic operation

Customization and personalization have now become key words in the world of medicine and health care; especially the studies, the research and the technologies applied to joint reconstructions tend to follow the patient’s needs as closely as possible:

“Until now knee prostheses 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, causing problems after the surgery such as the rubbing of the tendons between the devices and the soft tissues, pain, inflammation, bone bleeding and affecting 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, also winner of a Horizon 2020 award in research and innovation, have designed a new procedure and 3D printed a total knee prosthesis in cobalt chrome alloy: “through CT and magnetic resonance scans you can identify the characteristics and anatomical parameters of the patient; with this information and on this basis you can print a 3D prosthesis that is faithfully reconstructed on the size of the patient’s knee”, clarified the orthopedist.

“Not only the implantation is printed in 3D – explained Dr. Bonanzinga -, but during the operation were also used ancillary technologies useful to minimize the risks, to place the prosthesis precisely. It will be the first step towards a customization of the intervention, increasingly important and necessary”.

The benefits

Personalized and “patient specific” interventions such as the one that took place at Humanitas allow “to have a faster operation”, thanks to the use of new technologies, and computerized surgical instruments useful for the positioning of the prosthesis, “and therefore also less complications, less infections, as well as a faster post-operative recovery that eliminates accessory pains related to the prosthesis,” added Prof. Marcacci.

Finally, with the use of a sensorized brace capable of transmitting all the information to the surgeon or physiotherapist during the post-operative phase, the rehabilitation will also be personalized and monitored in “real time” through an app that will allow to identify and recognize possible anomalies through the monitoring of the sensors during the recovery for a potential timely intervention.