Reuben Lichter with his son William. [Image: Darren England/AAP]

Eight months ago, Caity Bell gave birth to her first child, a baby boy named William. Two days later, the baby’s father was admitted to the hospital with severe leg pain. Bell had to bring the baby home from the hospital by herself as her fiancé, Reuben Lichter, found out that he had a bone infection called tibial osteomyelitis. The infection destroyed the majority of his tibia, and doctors told Lichter that he had two options: they could amputate his leg above the knee, or he could undergo an experimental treatment that might or might not work. Lichter opted to go for the experimental treatment.

“If there was a chance for me to save my leg and do the things I want to do with my son, then I was going to take it,” he said. “I wasn’t going to lose my leg without having a fight.”

The experimental procedure involved transplanting a 3D printed scaffold into Lichter’s leg, where it would slowly grow into a new bone. The scaffold was designed at Queensland University of Technology and 3D printed in Singapore, after which it was brought back to Princess Alexandra Hospital in Brisbane, Australia, where Lichter was being treated. The scaffold would then have to be wrapped in tissue and blood vessels to facilitate the growth of new bone.

“We needed to work out where we could get tissue that had the potential to grow bone,” said Dr. Michael Wagels, the reconstructive surgeon who led the series of operations on Lichter’s leg.

A replica of Lichter’s 3D printed tibia [Image: Darren England/AAP]

The tissue and blood vessels ended up being taken from both of his legs. Lichter had to undergo five surgeries in about six months, as prototype scaffolds were tested and adjusted before the final one was implanted. The most recent surgery made sure that there is enough blood flow for the new bone tissue to grow around the outside of the scaffold. As it grows, the scaffold will slowly dissolve to be replaced by an entirely new bone. Later this year, experimental biomechanical research using live sheep will be done to assess the strength and rate of bone growth in Lichter’s shin.

“We are not willing to take any chances with Reuben’s leg until that biomechanical testing has been done,” Dr. Wagels said.

Lichter and William with Dr. Michael Wagels and Cameron Dick [Image: Darren England/AAP]

Lichter still has a long process of recovery ahead of him. Doctors say that it will be at least 18 months until he can walk again, and his infant son will be walking before he does. But he’s remaining positive, and is looking forward to walking Bell down the aisle and one day taking his son skiing.

The surgery marked the first time that a 3D printed tibia has been transplanted into a patient, and officials say that this opens the door for more operations of this kind.

“This is the first time this surgery has been done anywhere in the world,” said Health Minister Cameron Dick. “For me, as the Minister for Health, it is very inspiring to ensure that this world-first surgery happened in Queensland.”

While 3D printing is advanced in Queensland, bioprinting in particular still needs more development, which is why the actual 3D printing of the scaffold was carried out in Singapore.

A 3D printed tibia next to a real one [Image: Sophie Meixner/ABC News]

“We see this operation as an opportunity to make this happen here, locally,” said Dr. Wagels.

The successful surgery is a huge step for bioprinting. The technology has been making great progress lately, but real-world applications like this are one of the biggest reasons bioprinting research is so important. 3D printed prosthetics are another area that has been advancing rapidly, but if surgeries like this one become more commonplace, we could greatly reduce the number of people who need prosthetics at all by preventing amputation altogether.

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[Sources: ABC, Brisbane Times]

 

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