If you break a bone catastrophically and require surgery, there are usually just two ways to fix it. You can either cut a section of bone from another part of your body, or insert a strong titanium implant to patch the original break.
However, there are complications. Using your own bone will mean intense pain in the area where the bone was removed – the pain may go on for months and beyond. Metal-based implants can be affected by ambient temperatures, causing severe discomfort. Both options can result in infections and rejection by the body.
Singaporean medical technology firm Osteopore is offering a third, possibly more palatable, option for reconstructive surgery: Insert a biodegradable and customised bone scaffold that allows new bone tissues to grow into it organically.
Since this regenerated bone comes from the patient’s body, there is also little risk of immune rejection or infection.
Bones may look tough from the outside, but they’re actually porous inside – a web-like network of holes allows blood vessels and stem cells to grow within the bone and nourish it with essential nutrients.
Using 3D printing technology, Osteopore designed scaffolds that mimic the porous structure of the human bone. This structure enables existing red blood cells, bone marrow and other growth factors to integrate into the scaffold, which then encourages the growth of new bone tissues around the injured area.
Osteopore’s scaffolds can be customised to the exact shape and size of the bone gap, which allows it to be successfully used in major surgeries.
For instance, the scaffold was used in a world-first surgery in September 2017, when an Australian father became the first person in the world to receive a 3D-printed shinbone implant.
The scaffolds have also played a major part in restoring mobility to patients with damaged bones. In Vietnam, Osteopore’s scaffolds were used to patch a section of backbone for a girl from a village who suffered from a spine tumour. The successful surgery was televised nationally, and the girl has been able to sit, eat, and go to school since she was operated on.
The many successful surgeries using Osteopore’s scaffolds have are possible, thanks to powerful printers in the in-house 3D-printing lab. Osteopore analyses CT scans sent by surgeons and turn them into machine code, which are then sent to the 3D printers.
When the printers were first designed, they ran on manually-programmed processes and multiple software modules which took several minutes to analyse and interpret scans.
However, this processing time has been cut down to a fifth, thanks to a new and improved code customised by A*STAR’s Singapore Institute of Manufacturing Technology (SIMTech). SIMTech develops high-value technology and human capital for Singapore’s manufacturing industry.
The new programme that SIMTech licensed to Osteopore has helped reduce the number of software modules needed on the 3D printers to just one. The company can now complete the processing in a matter of seconds.
Osteopore plans to expand the application of its scaffolds, which are currently used for reconstructive surgery, into different areas of medical specialisation – from dental and oral reconstruction, to implants used for aesthetic surgeries.
It will collaborate further with SIMTech to develop second-generation 3D printers that are more user-friendly to surgeons and customisable to specific operating techniques. For instance, the company hopes to incorporate robotic arms into the design to reduce reliance on manpower to handle its printers and improve productivity.
Osteopore also intends to develop time-release machines, which would allow scaffolds to release nutrients into the body at specific time intervals. This would help to control tissue growth and develop a second generation of scaffolds that release nutrients as they disintegrate.
Osteopore sees their bone scaffolds as an initial foray into more advanced projects with 3D technology. In the near future, it aims to design structural supports for bio-printing (printing cells in 3D) – and even print entire human organs down the line.
The potential applications of 3D printing in the health and biological sectors are vast – from reconstructing bones and cartilages, to fit-to-print wound dressings that go over crevices, to bio-printing and beyond.
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