#3DPrintConfSJ

1. Engineering on Human Anatomy
Presented by David Flynn
Materialise USA
Committed to innovations for a
better and healthier world
Inside 3D Printing
San Jose, CA
09/18/13

2. About Materialise
• Company
• Established 1990
• Leuven, Belgium
• ±1000 employees
• Worldwide presence
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3. We are Materialise
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Additive
Manufacturing
Services
Industrial
Prototyping &
Mfg Services
Software for
Additive
Manufacturing
• Magics
• Streamics
• 3-Matic
Biomedical
Engineering
Mimics Innovation
Suite
Cranio-Maxillo
Facial
Clinical Service
RapidFit+
Custom
modular fixture
development
service
i.Materialise
Online 3D
Printing
Services
.MGX
Additive
Manufactured Artwork
Orthopaedics
Clinical Service
PRODUC-
TION
PRODUC-
TION
SOFTWARESOFTWARE
SERVICESSERVICES

4. Diversity means strength
Courtesy of TotalSim Ltd.
Courtesy of IDEE / Maastricht Instrument
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5. Mimics Innovation Suite:
Our Total Solution
• Mimics®
• Processing software to take 2D
image (CT, MRI, etc.) to
construct 3D models
• 3-matic®
• Design and meshing
software ideal for
anatomical data
• Services
• Anotomical Models, HeartPrint
• Engineering services
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6. Medical scanner (CT/MR/US)
Your own PC or laptop
Mimics

7. 3-matic ®
• Design and meshing software ideally suited for use
with anatomical data
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Design: custom cranial plate Meshing: vertebrae remeshing

8. Case Studies
•Visual and Diagnostic Aids:
• Medical Models
• Surgical Intervention
•Engineering Functionality:
• Surgical Guides
• Patient Specific Implants
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9. MEDICAL MODELS AS
VISUALIZATION AND
DIAGNOSTIC AIDS
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10. Medical Models
• Separate conjoined twins
• Arteries could not be tracked with X-rays
• Operation time reduced from 97 to 22 hours
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Kenneth E. Salyer, M.D. and Objet Geometries Ltd., 2002

11. Medical Models
• 3D ultrasound with tomographic output
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Jorge Santos et al. 2009, Royal College of Art, UK

12. MEDICAL MODELS USED FOR
SURGICAL INTERVENTION
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13. SURGICAL INTERVENTION CASE
STUDY: AORTIC DISSECTION
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14. Case Study: Aortic Dissection
•Demographics
• Incidence 1-10:100,000
• Rarely < 60
• Mostly male
•Medical emergency
• Tear in inner wall of aorta
• Blood flows between layers
• True vs false lumen
• 80% mortality rate if rupture
occurs

15. Modeling from CT images

16. Outcomes
• No intervention possible
• Model revealed multiple leakage paths in need of
repair
• Location of leakage paths closer to neck arteries
than originally thought
• Comorbidity risks too high
• Gave tangible view on leakage paths and relation
to connecting anatomy
• Modeling software and 3D printed model helped
identify new risks

17. SURGICAL INTERVENTION CASE
STUDY: CONGENITAL CARDIAC
MALFORMATION
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18. Case: Congenital Cardiac Malformation
• Irregular Anatomy
• No two cases are the same
• Provides guidance for the
surgeon
• Benefits
• Anatomically accurate
• Capture arrangement of
chambers and GV
• Model characteristics
• Flexible to mimic soft tissue
• Ability to bend and cut
Emory University Hospital

19. How was it created?
Emory University Hospital

20. SURGICAL GUIDES: TOTAL
KNEE REPLACEMENT
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21. Patient Specific Guides
for Total Knee Replacement
Scan
Patient
Construct
3D models
Plan the
surgery
Design &
build guides
Enter the
OR

22. Scan
Patient
Construct
3D models
Plan the
surgery
Design &
build guides
Enter the
OR
Patient Specific Guides
for Total Knee Replacement

23. Scan
Patient
Construct
3D models
Plan the
surgery
Design &
build guides
Enter the
OR
Patient Specific Guides
for Total Knee Replacement

24. Scan
Patient
Construct
3D models
Plan the
surgery
Design &
build guides
Enter the
OR
Laser Sintering
(LS)
Patient Specific Guides
for Total Knee Replacement

25. Scan
Patient
Construct
3D models
Plan the
surgery
Design &
build guides
Enter the
OR
Patient Specific Guides
for Total Knee Replacement

26. SURGICAL GUIDES: CMF
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27. CMF Software & Surgical Guides
Upload CT
data
Perform Planning
session online with
Materialise
Printing of planning
outcome: Models
and/or guides
Synthes to deliver
models, guides and /
or implants

28. Case presented by Daniel Buchbinder, MD DMD, Beth Israel New York
CMF Software & Surgical Guides

29. Guide Benefits
• Increase collaboration between doctors
• Reduced cost and complexity of procedure
• Decrease the number of surgical instruments to sterilize
• Potential to decrease OR time
• Expedite patient recovery
• Increase longevity of implants
• Allow surgeon to try different approaches before lifting a scalpel
• Avoid making critical decisions on the spot

30. Guide Production
• 5 dedicated LS machines in Belgium
• Started USA Production 2010
• Key partners in USA
• Surgeons predominently in USA
• 3 LS Machines 6 by end of 2011 in Plymouth, MI
• Room to grow to 24 machines!
• Medical Production Focus in USA (growth)

31. PATIENT SPECIFIC
IMPLANTS
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32. • Design in 30 minutes
• Design was watertight and ready to print
• Model printed in Ti6Al4V with EBM (Arcam)
Custom Implant Design- 3-matic®

33. Custom Implant Design
• Cranio-Plate
• Porosity Built In

34. Patient specific implant design
• Increasing demand
for revision total hip arthroplasty
• Growing number primary implants
• 15% require revision
• >50% involve acetabular component
• Extensive bone loss
• Complex defects
• Patient-specific surgical planning
• Custom implant design
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Mechanical loosening
Hip instability
Infection
Fracture

35. Patient-Specific Acetabular Cup Implant
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Segmentation/reconstruction
of anatomy Custom fit implant designed Automated screw placement
based on bone thickness
Mesh refinement of bone and
implant assembly
CourtesyofBartelsetal.KULeuven
CT-derived material properties Patient-specific MSM

36. Patient specific implant design using FEA
• Model results
• Manufacturing (selective laser melting)
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Implant integrity Bone loading

37. Custom Implants– Acetabular Cup
• Custom Acetabulum Implant

38. Where do we go from here?
• Future of healthcare is customization
• Key to better patent care lies in patient specific solutions
tailored to individual anatomy

39. Thank you!
dave.flynn@materialise.com