3D printing or Rapid prototyping is impacting Orthopaedics and Joint replacement in a significant manner. Patient Specific instruments and Implants are increasingly being issued apart from 3D printed Biomodels. The final frontier of tissue printing however remains a significant challenge.

1. Limitations & Future
of 3D Printing
Dr VAIBHAV BAGARIA
SIR HN RELIANCE FOUNDATION HOSPITAL
GIRGAUM MUMBAI
INDIA
WWW.DRBAGARIA.IN

2. DISCLOSURES
Hold Shares in Timeless Innovation Ltd & 3D POST TM
Consultant to Extrudify & Ebionix
Research grant from SPD foundation
Royalties from Medjaden

3. Limitations and Future!
And by definition ‘the future’ is Unlimited & Ours to create!!

4. 3D Printing Video

6. 3D printing Avenues
Anatomical Models & Simulation tools
Patient Specific Jigs/ Instruments
3D printed Implants and Instruments
Bio Printing & Tissue Engineering

7. Models: where we started!

8. And today..

9. And yet..
Imaging dependant: Trash In -> Trash Out
Processing software are expensive time consuming
Surgeon dependant
Time Consuming

10. SEGMENTATION

11. Hopefully…
Better Images
Better Processing Algorithms
Artificial Intelligence to reduce Surgeon dependency
Quicker Turn around time
Cost: Well it is already rock bottom now!

12. Patient Specific Jigs/
Instruments
Uses data from CT/ MRI/ X-rays
Planning is carried out in the preoperative stage
Surgeons and Engineers formulate a plan
Jigs are 3D printed and Shipped

13. Where we started…

14. Where we are now?

15. Current Limitations
No intraoperative measure to test the accuracy
Accuracy depends on the images/ Operators
Issues with the materials used for making these Jigs
Deals with all the deformities as static

16. The Future
Intraoperative integertaion with realtime navigation
systems
Expansion to different areas beyond TKR/ Osteotomies
and Resurfacing
Tactile feedback incorporation into the instrumentation
systems

17. 3D printed Implants
Era of ‘personalised medicine’
Newer materials are found suitable for implantation
Driven by better understanding of the human anatomy,
physiology and biomechanics
Metal printing cost has dramatically fallen in last 2
years.

18. Exciting times!

19. Acetabular defects

20. Patient Specific Knees

21. Limitations
Still grappling with accuracy to match mass production
Material issues
Turn around time
Cost issues
Operator dependant

22. The Future
Newer Biocompatible materials: HA TCP printing/
Biopolymers
Faster turn around
Manufacture anywhere even in the OT
Get exactly what you and your patient require/ wish

23. Today - Limitations??
The Future is ‘Unlimited’

24. Bio printing - The Big
Question?
Can we recreate what God created?
Yes we can - atleast try

25. Bioprinters

26. In vitro..
Regenerating Cartilage , Bones & Scaffolds
Use natural polymers: Collagen/HA/Silk Proteins/
Alginate
Coupled with hydrogels - PGA/ PCL/Methacrylate
Cross linked chemically, thermally or using UV
Sprayed with hMSCs

27. We look forward to..
Going beyond the ‘hype’ phase to real action phase
Long term survivorship data
TKR becoming obsolete in my life time!

28. Thank You!
www.drbagaria.in