AMS Spring 2023

Bangkok Surgeons Successfully Replace First Metacarpal with 3D Printed Titanium Bone

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12512560_1087283477968970_6461622700749120937_nThose being introduced to 3D printing for the first time often see it as something akin to magic. With the click of a button we can suddenly make items we never dreamed of before. While bringing designs to fruition at the desktop is certainly both enchanting and exciting, imagine how one Bangkok woman felt upon hearing that 3D printing had the potential to both fix and give her complete use of her hand again.

Indeed, surgeons at Phramongkutklao Hospital and Chulalongkorn University have just announced the world’s first successful replacement of a metacarpal thumb bone with a 3D printed titanium prosthesis. They gave all the details at a recent screening and press conference at the Bangkok hospital, showing detailed video of the new and highly successful surgery which was performed last September. Four months have passed now and the patient has not shown any signs of rejecting the part.

The implant beside a coin.

The 3D printed titanium bone beside a coin.

The recipient was a 37-year-old woman whose bone deteriorated due to a bout with cancer. After a giant-cell tumor damaged her thumb, the metacarpal bone was removed. The doctors involved spent a great deal of time and effort monitoring the patient, indeed researching the procedure itself for two years, and waiting over a year to see if the tumor was going to recur. When it did not, they proceeded with the surgery to insert the 3D printed titanium part, stitching it to the patient’s nearest tendon, in the hopes that the thumb would be able to move freely.

Not only has the patient’s body completely accepted the part, full function has returned to her thumb. Without this innovation, a patient would not have had a recovery and functionality anywhere close to this.

“The patient would not have been able to move their thumb or the tumor 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.

Phramongkutklao Hospital orthopedists were responsible for the design of the tendon connectors, but according to Boonrat Lohwongwatana, from the faculty of engineering, their team was able to use mirror imaging to convert an X-ray of the patient’s good thumb on her other hand to make the digital file for the 3D printed resin model which allowed for a casting of the prosthesis, which was made locally. What’s so incredible about this process is that as Lohwongwatana points out, this type of ‘bone’ could be customized for any individual in need, and made quite quickly.

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“This technique can also be used to replace damaged bones from other parts of the body and it only takes a couple of weeks to make one of these bones,” said Lohwongwatana.

This surgery is also a perfect example of nearly all the benefits that can be experienced with 3D printing. Due to the latitude afforded with digital design and 3D printing, surgeons were able to come up with a new prosthetic and design it digitally, creating something completely innovative that is of higher, stronger, more lightweight quality, can be fabricated quickly, and is even more secure–and affordable.

The surgeons and medical professionals involved hope to publish their findings soon, and they foresee applying for a patent regarding this new procedure. Are you surprised to hear about this new surgery? Tell us your thoughts in the 3D Printed Titanium Thumb Bone forum over at 3DPB.com.

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