Physicians and stem cell scientists at Southampton, UK have completed a hip surgery in which a 3D printed implant and stem cell graft were used to replace a diseased hip.
The 3D printed hip was made from titanium but it was designed using the patient’s CT scan and CAD CAM (computer aided design and computer aided manufacturing) technology. By printing the hip bone by means of CAD CAM technology the manufactured hip was designed to the patient’s exact specifications and measurements.
This implant will provide a new socket into which the ball of the femur bone is inserted. Between the titanium implant and the pelvis bone, the surgeons inserted a graft containing bone-making stem cells.
The stem cell graft should act as a filler for the loss of bone. The patient’s own bone marrow stem cells were added to the graft in order to provide a source of bone-making stem cells to encourage bone regeneration behind and around the metal implant.
Douglas Dunlop, a consultant orthopedic surgeon, who conducted this operation at the Southampton General Hospital, thinks that this type of procedure could be a genuine game changer. “The benefits to the patient through this pioneering procedure are numerous. The titanium used to make the hip is more durable and has been printed to match the patient’s exact measurements – this should improve the fit and could rescue the risk of having to have another surgery. The bone graft material that has been used has excellent biocompatibility and strength and will fill the defect behind the bone well, fusing it all together.”
Over the past decade Dr. Dunlop and University of Southampton scientist Professor Richard Oreffo have developed a translational research program that aims to use a patient’s own skeletal stem cells to replace damaged or lost bone during orthopedic procedures. For example, see A Aarvold, et al., J Tissue Eng Regen Med. 2012 Oct 5. doi: 10.1002/term.1577; JO Smith, et al., J Tissue Eng Regen Med. 2014 Apr;8(4):304-13; ER Tayton, et al., J Bone Joint Surg Br. 2012 Jun;94(6):848-55; E Tayton, et al., Acta Biomater. 2012 May;8(5):1918-27; A Aarvold, et al., Regen Med. 2011 Jul;6(4):461-7. doi: 10.2217/rme.11.33; and JO Smith, et al., Tissue Eng Part B Rev. 2011 Oct;17(5):307-20.
In this particular operation, the graft is made up of a bone scaffold that allows blood to flow through it. Stem cells from the bone marrow attach to this material and grow new bone. This implant will support the 3D printed hip implant.
Professor Oreffo comments: “The 3D printing of the implant in titanium, from CT scans of the patient and stem cell graft is cutting edge and offers the possibility of improved outcomes for patients.
“Fractures and bone loss due to trauma or disease are a significant clinical and socioeconomic problem. Growing bone at the point of injury alongside a hip implant that has been designed to the exact fit of the patient is exciting and offers real opportunities for improved recovery and quality of life.”
For the patient, Meryl Richards, from Hampshire, the procedure means an end to her hip troubles. In 1977 she was involved in a traffic accident and since then has had to have six operations to repair her injured hip.
She says: “The way medicine has evolved is fantastic. I hope that this will be the last time that I have to have a hip operation. I feel excited to have this pioneering surgery and I can see what a benefit it will have to me.”