- Registrado
- 24 de Mar, 2021
I noticed the prosthetic bone/joint section is somewhat short. Also while some of the sintered powder metal development is certainly interesting, I feel it is just one small aspect of a larger whole. Also I would caution against getting too excited about materials developments here. There is a somewhat checkered past to consider- metal on metal joints have caused massive class-action suits, metal-on-ceramic implants have had unexpected and devestating cases of the ceramics exploding a lot like damaged tempered glass can be. Even if the underlying research is rock solid, this leads to a lot more onerous regulation in this specific part of the field. I know of a ceramics manufacturer that has been implanting their materials in static applications for at least a decade now. Even without testing raising any concerns or red flags over multiple rounds of testing, they are just recently getting to the point where they can use this in joint replacements. That's not a bad thing either imho. I mention it only as a warning that what you read about today might take longer than expected to be reality.
3D Printing and Additive manufacturing has had a major increase in notability and popularity recently. While this does help drive down manufacturing costs, it is child's play compared to the type of machining in practice to make implants. For example a small-ish manufacturer had multiple rows of 5-axis machines back when a pair and tooling would have hit seven figures. The types of machinists they contract will pick up work for things like chip fabricators, instrument makers, or NASA when not making implants. I can tell you from handling a lot of their work product and tooling, it is unparalleled quality. It's also so expensive most hospitals won't even drop the money on their own specific tool kit, instead using ones provided by the manufacturer and shuttled from hospital to hospital.
One very cool thing that was at least partially inspired by all the recent 3D printing popularity is actually in imaging. For quite some time implants were sized a lot like shoes. You can go bigger or larger at a predetermined granularity, but the implants are not made for a specific patient. Now there are companies like Conformis who are able to take a CT image of the joint, integrate that into their manufacturer's G-code, and crank out a bespoke implant for a specific patient without effecting treatment timelines. From talking with people whose job is basically to coach doctors and be SMEs on specific implants, fitment is one of the major causes of complications or needing a revision down the road.
3D Printing and Additive manufacturing has had a major increase in notability and popularity recently. While this does help drive down manufacturing costs, it is child's play compared to the type of machining in practice to make implants. For example a small-ish manufacturer had multiple rows of 5-axis machines back when a pair and tooling would have hit seven figures. The types of machinists they contract will pick up work for things like chip fabricators, instrument makers, or NASA when not making implants. I can tell you from handling a lot of their work product and tooling, it is unparalleled quality. It's also so expensive most hospitals won't even drop the money on their own specific tool kit, instead using ones provided by the manufacturer and shuttled from hospital to hospital.
One very cool thing that was at least partially inspired by all the recent 3D printing popularity is actually in imaging. For quite some time implants were sized a lot like shoes. You can go bigger or larger at a predetermined granularity, but the implants are not made for a specific patient. Now there are companies like Conformis who are able to take a CT image of the joint, integrate that into their manufacturer's G-code, and crank out a bespoke implant for a specific patient without effecting treatment timelines. From talking with people whose job is basically to coach doctors and be SMEs on specific implants, fitment is one of the major causes of complications or needing a revision down the road.
