3D Printed Composite Sternum and Rib Cage Implanted for the First Time in the US

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Chondrosarcoma is a rare type of cancer that affects the bones and joints and is resistant to traditional cancer treatments such as chemotherapy and radiation. It requires surgical removal, and that’s what Penelope Heller faced in 2014 when she was diagnosed with the disease. In her successful surgery, the cancer was removed, but so were her sternum and part of her rib cage, which were replaced with an implant made from off-the-shelf Gore-Tex (low-density porous polytetrafluoroethylene, or PTFE) and Bone Cement (methyl methacrylate, or MMC).

Unfortunately, Heller’s problems didn’t end there. She continued to have trouble with pain and breathing issues because of the implant, so this year, the now 20-year-old Heller decided to try something different. After doing some online research, she came across the story of a Spanish patient who had been successfully treated for cancer and then had a customized, 3D printed sternum and partial rib cage implanted. The implant had been created by Australian company Anatomics.

Heller wanted to see if the same kind of implant could benefit her, so she and her family contacted the staff at Anatomics as well as at NewYork-Presbyterian/Weill Cornell Medical Center and worked with them to obtain an implant through the FDA’s Expanded Access program. Once they got the go-ahead, CT scans were taken of Heller and sent to Anatomics engineers via the company’s secure AnatomicsRX software platform.

The engineers used the scan data to create a 3D model, which was then reviewed and approved by Dr. Jeffrey L. Port, attending cardiothoracic surgeon at NewYork-Presbyterian/Weill Cornell Medical Center. A biomodel of Heller’s sternum and rib cage was created and a build code was sent to Lab 22, the 3D printing laboratory belonging to Australia’s Commonwealth Scientific and Industrial Research Organisation (CSIRO).

Heller’s old implant

On August 2, 2017, Dr. Port led a surgery in which the old implant was removed and the new 3D printed sternum and partial rib cage were implanted. The implant is a composite of titanium and porous polyethylene, and it’s the second 3D printed composite sternum and rib cage to be implanted in the world, after the Spanish patient. It is the first in the United States.

“After my initial resection and reconstruction surgery, I continued to experience breathing issues and pain,” said Heller. “With a long, active life ahead of me, I wanted to participate in activities that I love fully and without pain. Electing to have this procedure was a big decision, and I’m coming forward to empower other people in the same position.”

Heller’s implant is also only the second in the world to use Anatomics’ proprietary PoreStar technology, which is currently awaiting FDA marketing approval. PoreStar is a porous polyethylene material designed to resemble the architecture of bone. It’s about as close as a patient can get to having actual bone transplanted into them, and the difference between Heller’s new implant and her old one is tremendous. She should now be able to live a life without pain.

“Anatomics is humbled by the strength of the thousands of patients we have helped over 25 years since inventing BioModeling technology,” said Anatomics’ Executive Chairman Paul D’Urso, MBBS (Hons) Ph.D. FRACS. “The patient’s story is one of many, but what makes it truly remarkable is how the patient and her family, Dr. Port and the staff at NewYork-Presbyterian/Weill Cornell, Anatomics, and the FDA came together to make this story a reality. It was a group effort that began with the patient’s pursuit of information.”

The new implant

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[Images courtesy of Anatomics]

 

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