Additive manufacturing to veterinary practice: recovery of bony defects after the osteosarcoma resection in canines

Abstract

The paper outlines the achievements and challenges in the additive manufacturing (AM) application to veterinary practice. The state-of-the-art in AM application to the veterinary surgery is presented, with the focus of AM for patient-specific implants manufacturing. It also provides critical discussion on some of the potential issues design and technology should overcome for wider and more effective implementation of additively manufactured parts in veterinary practices. Most of the discussions in present paper are related to the metallic implants, manufactured in this case using so-called powder bed additive manufacturing (PB-AM) in titanium alloy Ti-6AL-4V, and to the corresponding process of their design, manufacturing and implementation in veterinary surgery. Procedures of the implant design and individualization for veterinary surgery are illustrated basing on the four performed surgery cases with dog patients. Results of the replacement surgery in dogs indicate that individualized additively manufactured metallic implants significantly increase chances for successful recovery process, and AM techniques present a viable alternative to amputation in a large number of veterinary cases. The same time overcoming challenges of implant individualization in veterinary practice significantly contributes to the knowledge directly relevant to the modern medical practice. An experience from veterinary cases where organ-preserving surgery with 3D-printed patient-specific implants is performed provides a unique opportunity for future development of better human implants.

Keywords: Additive manufacturing; Clinical cases; Dogs; Implants; Osteosarcoma; Ti–6Al–4V; Veterinary applications of 3D printing.

Fig. 1

Case 2: a, c photographic images of application of cutting/drilling guides during the surgery; b, d digital images of the defected limb with the tumor and cutting/drilling guides set into proper positions

Fig. 2

Case 1: a the photo of the dog with the limb prepared for surgery; b, d X-ray images of the limb; c, e corresponding images of the digital models of the defected limb

Fig. 3

Case 1: a the photo of the dog with the limb prepared for surgery; b image of the final EBM-manufactured titanium implant with the preoperational bone model additively manufactured from a polymer; c surgical placement of the implant; d, e final CT images after surgery

Fig. 4

Case 2: a the photo of the dog with the limb prepared for surgery; b, d X-ray images of the limb; c, e images of the digital model of the damaged limb

Fig. 5

Case 2: a, b image of the digital model of titanium implant with the bone; c surgical replacement of the implant; d, e CT 2 days after surgery

Fig. 6

Case 3: a the photo of the dog with the limb prepared for surgery; b, d X-ray images of the limb; c, e images of the digital models of the defected limb

Fig. 7

Case 3: a digital model of the titanium implant with the bone; b surgical placement of the implant; c, d CT after several days after surgery

Fig. 8

Case 4: a the photo of the dog with the limb prepared for surgery; b, d, e X-ray images of the defected limb; c, f digital model of the defected limb and joint

Fig. 9

Case 4: a, b digital models of the bones and virtually installed implant; c, d images of the final 3D-printed models of the bones and installed titanium implant; e, f final CT after surgery