by Stefania Fumo
ROME, Jan. 14 (Xinhua) -- A team of Italian orthopaedic surgeons and biomedical engineers have successfully created and implanted a 3D-printed prosthesis in a patient who could no longer flex his ankle or walk properly following a motorcycle accident, the Rizzoli Orthopedic Institute (IOR) and Bologna University announced Tuesday.
The ground-breaking surgery, a world first, took place in October 2019 and was followed by a period of physical rehabilitation of the patient, a 57-year-old man who has since recovered the ability to walk normally, the scientists explained during a press conference in the northern city of Bologna.
The patient's injury, sustained in 2007, had been considered to be inoperable until now.
The technique pioneered in Bologna is innovative because it personalizes the "entire procedure of the prosthetic substitution of the ankle: beginning with the anatomy of the patient...a tailor-made implant of the ankle was built with 3D printing," the IOR explained in a statement.
"The surgery is an absolute innovation at the global level, because it is the first time that a prosthetic ankle implant that preserves the isometry (contraction) of the ligaments is built through 3D printing and implanted via techniques that allow us to decrease surgical time and save bone tissue in a patient affected by post-traumatic destruction of the joint," explained Professor Cesare Faldini, who coordinated the team that carried out the operation and who directs the IOR Orthopaedic and Traumatology Clinic.
The operation was a world first because it was "doubly personalized", explained engineer Alberto Leardini, who directs the IOR Movement Analysis Laboratory.
"The implant, and the surgical technique with which it was implanted, were both tailor-made for that individual patient," Leardini explained in a video interview provided to Xinhua by the IOR.
BROKEN ANKLES MEANT A LIFETIME OF LIMPING... UNTIL NOW
Ankle fractures are mainly caused by road accidents or by falling from a great height. Patients typically never fully recover the use of the injured ankle, often ending up with a limp and forced to wear orthopaedic shoes.
Until now, the IOR explained, ankle implants were made up of standardized components designed for anatomically regular joints, so they were only usable in cases in which the trauma did not significantly alter the shape of the joint. The other option is surgically fusing together the two broken pieces of the joint.
"This leads to total loss of movement (of the ankle) and overburdening of the other joints in the foot," the IOR statement said.
A TWO-PHASE PROCEDURE
A few weeks before the surgery, the patient's ankle was scanned and a three-dimensional model of his leg and foot was built using software and procedures developed by a research team at the IOR's Movement Analysis Laboratory.
Orthopedic surgeons and biomedical engineers then simulated the surgery on a computer, working on the shape and size of each component of the prosthesis in order to match the patient's specific anatomical characteristics, until they found the best possible combination of the components of the two bones that make up the ankle.
After that, the team produced a plastic 3D model of the prosthesis for further testing. Finally, the actual prosthesis for implantation in the patient was printed in three dimensions in a Chromium-Cobalt-Molybdenum alloy using Electron Beam Melting (EBM) 3D printing technology.
After the operation, the patient followed a personalized rehabilitation program and ultimately recovered the use of his ankle, which had been blocked for almost 13 years.
"The results are very promising," Leardini said. "The first implant was a great success, and we plan to apply and develop it in many other patients in the coming months."
NEW HOPE FOR DISABLED TRAUMA PATIENTS
"For the first time, there is an option for trauma patients who could not find an effective surgical solution until now," IOR Director-General Mario Cavalli said in an interview provided to Xinhua. "Today this has been made possible."
The new technique "is for patients who cannot receive traditional prostheses," Faldini added. "We used a technology that puts engineers alongside orthopedists to build a custom-fitted solution for (the patients), so that they can walk correctly once more."
The technology has been developed over the course of 20 years of research at the IOR in collaboration with Oxford University, Faldini said.
