• 3d printing
  • South Africa uses 3D printing to cure deafness

    3D printing technology is a rapidly expanding method to manufacturing across numerous industries, including health.  Recently, a South African team of medical doctors took advantage of this disruptive technology to become the first to cure a patient’s deafness.  This advancement in surgery will offer hope to many suffering from hearing loss.

    The operation was performed by Professor Mashudu Tshifularo and his team from the University of Pretoria (UP) Faculty of Health at the Steve Biko Academic hospital on March 13, 2019. Using 3D technology, the team was able to recreate the bones of the middle ear to replace the damaged ones.  The surgery was successfully completed in under 2 hours and immediately restored the patient’s hearing. 

    The best part about the surgery is that it will be available to patients of all ages, from newborns to the elderly.  The use of 3D printing also offers a cost advantage over conventional ENT surgeries addressing hearing loss, thus making it accessible for all patients.

    This has become the next prestigious medical achievement for South Africa after having performed the first heart transplant in 1967 and demonstrates the innovations health care workers are undertaking to achieve universal healthcare coverage in Africa.

  • 3D printing makes a breakthrough in personalised healthcare

    3D printing may open up a whole new chapter of opportunities in the pharmaceutical industry.  There are a number of ways it could be used; drug dosage forms, supporting delivery, or helping to research cures.

    3D printing, also called stereolithography, creates objects by fusing different materials, layer by layer, to form a physical version of a digital 3D image. In the last 15 years, 3D printing has expanded into the healthcare industry, where it’s used to create custom prosthetics and dental implants. 

    Now, there may be an opportunity to use it for personalised healthcare as well.  This was achieved by Aprecia Pharmaceuticals who became the first pharmaceutical company to produce an FDA approved 3D printed pill for epilepsy in 2015.   The drug is made using their proprietary ZipDose Technology platform to produce a high-dose of leviteracetam in a rapidly disintegrating, easy-to-swallow form. 

    Personalised 3D-printed medications, deploying customised dosages, may serve particularly well for patients who respond to the same drugs in different ways.  It may also allow pills to be printed in a complex construct of layers, using a combination of drugs to treat multiple conditions at once.  This could help reduce adverse drug reactions and poor adherence to medications for patients on multiple medications. For Africa, this could be a solution for adherence to ARV and TB medication, especially amongst children and the elderly.

  • 3D printing lends a hand to prostheses

    3D printing first appeared in the late 1980s, initially for use in industrial prototyping and manufacturing processes. With recent advances, the technology is being applied across many industries, including health, where it is reducing the cost and production time of a range of body parts, from hips to hearts.

    Now, a team of engineering students from the University of Witwatersrand have made a prosthetic hand prototype that will cost around R2,000 (about US$140). They hope that it will make this type of prosthesis more accessible to South Africans who find conventional prosthetic limbs, which can cost more than 50 times the prototype’s price, unaffordable.

    Abdul-Khaaliq Mohamed, a lecturer and PhD candidate in the School of Electrical and Information Engineering at Wits said, “We’re trying to create a hand that’s relatively cheap but has sufficient functionality that allows users to do basic daily movements”.   

    Development is iterative. Last year the group perfected a tripod pinch, the grip used to hold a pen. Next, bicep and triceps were hooked up to the hand and as the person moves the muscles, the hand closes or opens. Sensors were then added to the fingertips to enable the hand to sense force. This year the group has focused on integrating the sensors with vibrational feedback to provide an indication of how strong the hand’s grasp is.

    This promising work expands the range of 3D printing applications. It also brings many patients a big step closer to having a functional prosthesis. What will be 3D printed next?

  • Mice have ovaries from a 3D printer

    Fixing ovaries may have taken a big step forward. A team from Northwestern University, Illinois, in the US, has successfully implanted a bio-prosthetics created with a 3D printer in mice. The project’s eventual goal’s to help women who have become infertile due to cancer treatments. The effects can include an inability to undergo puberty, early menopause and infertility.

    The team’s report in Nature Communications says equivalent projects have implanted biomaterial in mice using isolated follicles or whole ovarian tissue encapsulated in plasma clots or fibrin hydrogel beads. These have clinical challenges for women, especially the implant sizes. Ovaries are heterogeneous organs that compartmentalise different follicle pools that may be critical to implants’ long-term functions. The team’s aiming towards a biomaterial strategy that can mimic spatially varying materials, so achieve an optimal implant function and longevity. 3D printing’s seen as a way to create human bio-prosthetic ovaries that meet these requirements.

    Using a 3D printer to construct the bio-prosthetic device uses collagen-based gelatine ink. It builds the tissue in a lattice pattern that matches structure of ovaries. The implant are microporous hydrogel scaffolds. 

    Implanted in nine mice, three successfully produced offspring. These produced their own offspring to test their long-term health. The 3D printer’s journey from mice to humans will take several years.

  • 3D print your heart

    There’s now a way to see, and touch, an exact replica of key parts of the heart, such as a diseased coronary artery, the blood vessels critical to functioning of the heart. It’s a project by doctors and engineers at the University of Melbourne and could revolutionise cardiac care. A piece in ehealthnews.eu carried the story.

    A key part of modern cardiology is getting the best possible view of what’s going on inside your heart, including a view of the heart's structure. Until recently the technology making this possible was echocardiography, which allows cardiologists to view ultrasound images of the functioning heart muscle, and angiography, which uses injected dye and x-rays to help doctors see what’s happening in the coronary vessels. Now there’s a third method that uses a supercomputer and a 3D printer.

    It all starts with a camera thinner than a human hair. It’s threaded into the blood vessels of the heart during an angiogram. The images it produces are fed into a supercomputer that creates a 3D model of the artery. Within hours, a model of a person’s artery is 3D printed, providing cardiologists with unique information about the structure of the artery, how it will affect blood flow, and what treatment options are most appropriate, including whether to insert a stent to keep a blocked artery open.

    Associate Professor Peter Barlis, one of the researchers, is an interventional cardiologist. "No two arteries are shaped the same.” He said. “We're all different, with arteries that have different branches and sizes, tapering from larger to smaller. And much like debris accumulates along a riverbank, plaque can cling to certain areas of a person's artery. So this technology really gives us a clearer picture of those areas.”

    It appears that this is only the beginning. Once the supercomputer has the structural information, there’s apparently a lot more that becomes possible. Scientists from Imperial College in London and Harvard University in Boston are collaborating with the University of Melbourne to explore ways to diagnose disorders of the heart vessels and plan personalized interventions. 

    Affordability for these types of innovations for many African countries may be challenging. However, with non-communicable disease on the rise, better research and a better understanding of conditions such as atherosclerosis is likely to be valuable. And if 3D printer prices fall along a similar curve to the 2D version, affordability may be improving soon.


    Images are from http://madeinneverland.tistory.com/201 from a different project involving 3D coronary vessel printing

  • World first: doctors transplant 3D-printed titanium thumb

    In a world-first, a team of doctors from Thailand have successfully transplanted a workable 3D-printed titanium thumb in a patient. The operation was performed on a 37 year old woman. Her thumb had deteriorated due to a tumour, says an article in The Nation.

    Traditionally, her lost bone would have been replaced by a bone from her hip or leg. As these bones don’t match thumb joints, they render thumbs unusable. This new innovation, replaces thumb bones with biomedical titanium, which is stitched on to the nearest tendon, allowing free movement.

    "The patient would not have been able to move their thumb or the tumour may have returned if the old method was used, but with the 3D-printed titanium bone, the patient can use their hand as normal," said Dr Thipachart Punyaratabandhu, the chief in Phramongkutklao Hospital’s Orthopaedic Section. 

    Doctors from the hospital worked with engineers from Chulalongkorn University and spent about two years researching and working on the project. The engineering team followed the X-ray of a thumb bone from the patient’s other hand to copy and create a 3D replacement. Later, the titanium was cast following the 3D model, which can be adjusted or adapted to match other patients. 

    Using a titanium bone is lighter, stronger, cheaper and securer that conventional implants. It’s claimed that the technique can easily be used to replace damaged bones from other parts of the body.

  • Low-cost 3D hand wins Dyson Award 2015

    The James Dyson Award challenges young engineers and scientists around the world to develop something that solves a problem. This year, Joel Gibbard did it, and won the UK award of $3,500, with his Open Bionics project that produced a prototype, low-cost 3D-printed robotic hand and arm. It can be made faster and more cheaply than alternatives. He plans to sell prosthetics next year for about £2,000, about $3,160, about the same price as conventional prosthetic with hooks.

    His hand is a skeleton covered with an artificial skin and has controllable fingers. These usually cost at least ten times more than Gibbard’s prosthetic. His Open Bionic hand uses myoelectric signals from muscle movements detected by sensors stuck to wearers' skin, then uses them to control grip.

    A single flex opens and closes the fingers. Two flexes forms a grip. Sensors can tell when fingers make contact with an object and limit the pressure they exert.

    Gibbard started Open Bionics as a crowdfunding project in 2013. It’s supported by Bristol Robotics Laboratory. They’ve shown how engineering and innovation can help healthcare across the world.


    Image from Open Bionics

  • 3D printers provide hip implants

    In 1962, Sir John Charnley successful completed a hip replacement. Five years later, he declared it as a viable operation, and it became a global service. The procedure relies on a range of prostheses from a range of suppliers.

    In 2014, surgeons succeeded with an implant derived from a 3D printer. that provide a more precise fit. At the Royal Society of Medicine’s Spring, Innovation Summit 2015, Douglas Dunlop, an orthopaedic surgeon at University Hospital Southampton, England, and Professor Richard Oreffo, chair of Musculoskeletal Science at Southampton University and co-founder of the Centre for Human Development, Stem Cells and Regeneration, described their work with 3D printers.

    The printers aren’t enough. They’re part of an integrated net of CD scanning, computer modelling and 3D printing. These provide Douglas Dunlop with the information he needs to create a bespoke model of patients’ conditions that he can use to test his planned operation before he goes into theatre. If all is good, he can construct the required prosthesis. If not, he can restart the process.

    From there, the replacement or revision proceeds with the transfer of each patients’ stem cells that encourages new cartilage growth. The result is a hip that works, with patients returning to normal activities sooner than with a now conventional Charnley implant.

    The benefits are huge. The first patient told Sky News about how pleased she is.

    Two disadvantages that Douglas Dunlop sees are first, the cost, which might be more than twice the cost of a Charnley implant. Secondly, if the 3D printed implant is shown as not quite right when the operation’s started, it’s too late to go back to the start. This hasn’t happened yet, but it’s important not to ignore the possibility.

    While 3D printing’s still at its early stages for surgery, it’s on its way. Teaching hospitals in Africa have an opportunity to start developing the techniques.

  • Africa's first 3D printing for surgical reconstruction

    Africa’s first, a groundbreaking dental surgical procedure, was performed at the Kimberley Hospital Complex 24 July 2014 when two patients received titanium mandible implants created with 3D printing technology. This procedure has been developed to help more than 500 patients diagnosed with head and neck cancer each year in the Northern Cape Province, South Africa’s largest, though most sparsely populated province.

    The titanium mandible prostheses were created using 350 3D machines through additive manufacturing 3D printing technology at the Central University of Technology in Bloemfontein. The cutting edge technology helps to restore parts of faces lost through cancer or other destructive processes like the terminally ill.

    Yesterday I met with the head of dental surgery at Kimberley Hospital, Dr Waleed Ikram, to learn more. He explained the difficulties of reconstructive surgery using conventional methods, which entailed more time in theatre, uncertain aesthetic outcome and were notoriously painful for patients. He says that the new procedure is “cost effective and much less painful for patients”. Prostheses are prepared in advance, theatre time is shortened and the aesthetic outcome is far better. He’s proud to part of the team driving the innovation, particularly that it’s taking place in one of South Africa’s smaller provincial hospitals.

    Dr Ikram performed the procedure with Dr Cules van den Heever, from the University of Pretoria and Central University of Technology in the Free State. Dr van den Heever said 3D innovations were “part of efforts to bring change to the lives of people affected by cancer; the idea with the implants is to fix the facial contour and restore normal function and appearance”. He added that the Kimberley procedure was only the second of its kind to be performed globally.

    The new procedure is not without disadvantages. The titanium implants are significantly heavier than bone and for the time being false teeth and dentures can’t be accommodated. It’s early days for the technique and for this research. Surgeons Ikram and van den Heever are eagerly reviewing results and investigating options to continue to improve the outcomes.

    The 3D printers are imported from Germany and cost approximately €500.000 (ZAR7.1 million).  The technology is under pilot in Kimberley with intentions to roll it out to other South African healthcare facilities countrywide.

    Image of the titanium prosthesis provided by Dr Ikram, Kimberley Hospital Complex. The team can be contacted using Email dentalkby@yahoo.com.