Humans are invincible, or so we would prefer to believe. Few of us entertain the idea that at some point we will age, develop a malignant tumour, or suffer lifechanging injuries.

Health worries are for other people. The underlining dread that encompasses ill health is the idea that the vitality that seemed everlasting prior to ill health will not be returned in the same condition. Furthermore, we charge modern health professional and facilities with the task of putting us back together again.

One innovation, 3D printing, has captivated medical fields like no other, with its possibilities for its applications in surgery, devices, and teaching.

What makes 3D printing so unique from traditional manufacturing?

As HBR’s Drew Hendricks explains; “Part of the reason 3D-printed solutions are often cost-effective is the technology: the process involves building solid, threedimensional objects from a digital model, using additive processes in which successive layers of material are assembled on top of one another to build the desired object. This process means that items can be assembled directly from a digital model, increasing precision and removing room for error. Moreover, it is distinct from older manufacturing techniques, which usually rely on removal (by cutting, drilling, chopping, etc.) instead of addition. These waste and extraction costs add up; 3D printing gets around those issues.”

Why is 3D printing so promising for healthcare?

3D printing is so pro- mising for healthcare because of the high degree of individualisation that can be produced in developing a medical implant or designing new surgical procedures, without the need of trial and error that would otherwise place the patient at risk.

The quality of health care can also be improved with increasing individualised treatment, with focus on successful recovery at the core of treatment. For example, 3D printed casts for fractured bones, showed a remarkable 40% compared to conventional fracture casts. Improvements in recovery would also prove cost-effective for healthcare systems across the world, with less follow up treatments and consultations, freeing up resources.

Compared to non-additive manufacturing, attempting to combine different materials in one uniform object, whilst ensuring properties such as lightweight, strength, and durability – all on a micro scale. 3D printers are able to combine a multitude of materials in the same structure through developing polymers and advanced compounds. As these polymers become specialised, so do the applications.

What changes in medical implants and devices can patients expect?

In treating conditions with complex circumstances or injuries, 3D printing has allowed patients to receive highly bespoke treatment. December last year saw a patient diagnosed with chordoma, a cancerous spinal tumour, fitted with titanium vertebrae. Previously such as cancer would have led to an ever-diminishing death, with removed vertebrae replaced with crude substitutions from the patient’s rib bones. Using porous materials and accurate 3D scanning of the required vertebrae, Australian surgeons were able to implant after 15 hours of surgery. The patient enjoyed a remarkable recovery, slowly regaining movement to limbs as well as eating and breathing – all of which would have been limited without highly specialised implants.

From treating highly complex cases, 3D printing also holds promise for everyday healthcare, with attention drawn to improving recovery of fractures and joint replacements, with particular emphasis on the durability that 3D printed joints have over conventional assembled joints. Replacement knee joints can be adapted to the bone density and physical activity of the patient in question. In dentistry, braces that once cost $3,000 have been produced for $60, as a do-ityourself maverick Amos Dudley. With a basic understanding of density and access to a 3D printer, the 23 year old was able to correct his teeth in the space of 16 weeks.

In combining the capabilities of artificial intelligence, devices ranging from bionic limbs to hearing aids, are becoming increasingly smarter, smaller and liberated. Almost all hearing aid manufacturers in the US have switched to 3D manufacturing, arguing that conventional manufacturing remains utterly uncompetitive; both in integrating minuscule technologies and the cost base.

How will future surgery be practised?

Although many see the wonders of 3D printing for the use of medical implants and devices, surgeons have seen the merits of constructing entire practise models from real-life patients and conditions from 3D printing. One case was spinal surgery of a infant at Alder Hay Hospital in the UK, where surgeons were able to practise the complex procedure before attempting it on the patient. Alongside 3D printing and virtual reality, Dr. Redmond Burke of Miami’s children hospital, was able to train for the rare liver operation for twin infants in January. Without having to rely on the assistance of limited world-class surgeons to instruct. This new form of surgical training could hold promise for healthcare systems across the world, with remote and inexperienced clinics able to construct accurately simulated procedures for native populations, without the costly expense of outside professionals.

What challenges does medical 3D printing face?

Medical 3D printing faces numerous challenges in reaching ordinary healthcare users; the first is the price of such machines, £600,000 through charity had to be raised to purchase the machine used at Alder Hay Hospital. The second is the availability of highly specialist printers and materials, the patient who received the titanium vertebrae relied on the only titanium printer in Australia. As a result, the diffusion of 3D printers in healthcare will depend on the capabilities of machines as well as the enabling technologies presented in the polymers and materials used in manufacturing.

However, ageing demographics in the western world will shape the direction in which 3D printing will take, with an emphasise on joint replacements and recovery time. Treatment oriented around such demographics will progress further than treatment for rarer conditions in obscure parts of the world.

Finally, as healthcare systems will look for medical advancement, the producers of 3D printers are engaged in its own struggle for platform supremacy and intellectual protection. This poses some ethical dilemmas for producers; to what extent will they be responsible for denying software or printers, for patients unable to access the most promising treatment, because such treatment would be prohibitively expensive.

Photos: Redmond Burke & 3dprint.com