In recent years, additive manufacturing has emerged as one of the most in-demand technologies in the world and is changing the lives of millions worldwide.
Heart of the matter: 3D printing of organs and tissues will revolutionise transplants and patient care, says Cyient
Additive manufacturing is defined as the process of joining materials to make objects from 3D model data, usually layer upon layer.This differs from traditional subtractive manufacturing methodologies, where a design is shaped by removing material from a solid or hollow mass. Its rise is often considered synonymous with industrial manufacturing and to have been boosted by enhancement in digital technologies.
Last year in particular, the capabilities of additive manufacturing began to be explored in the medical sector in greater detail than ever before, building on years of development in this area. Indeed, thanks to the renewed time and investment placed in the technology in recent times, it is now the source of some of the most cutting-edge and innovative developments within healthcare.
Figure 1: Annual Global Sales of Additive Manufacturing Equipment ($ Billions) (Source: BCG Perspectives)
As shown in Figure 1, the growth of the additive manufacturing industry shows no sign of abating, and the industry is projected to be worth more than $5 billion by the end of the year, having experienced 25% compound growth every year since 2009. But this isn’t solely based on the manufacturing sector – far from it.
The medical and dental markets represent a significant portion of this growth, and are estimated to account for 14% of additive manufacturing equipment sales globally. Dentistry has played a significant part in this, as use of the technology has allowed industry professionals to 3D print orthodontic and dental equipment, and consequently increase the number of services they are able to offer.
Additive manufacturing making its mark in 2015
Last year, medical additive manufacturing was more than a match for its 3D printing counterparts, and witnessed substantial growth in a number of areas. The most notable of these was in mass customisation, such as patient-specific surgical implants; where for the first time, surgeons were able to use additive manufacturing to 3D print implants that were tailored to the individual recipient and fitted them perfectly.
This will prove hugely beneficial to patients in the future, as they will receive an implant that responds to their bodily movements perfectly, unlike standardised implants, which can be an awkward fit. In time, this should result in a better clinical outcome for the patient, by removing any scope for potential discomfort, enabling a more expedient surgical procedure, as personalised implants require fewer adjustments during surgery and reducing the overall recovery period.
Aside from implants, medical institutions were also able to produce customised orthopaedic devices and pre-surgery preparation aids for surgeons, which will help improve the treatment that patients receive while using healthcare facilities.
Commercially, last year also saw some of the main players in additive manufacturing make waves in the medical sector. For instance, one of the two major 3D printing companies for plastics, Stratasys established its own medical solutions group, a move which shows a clear desire to be an integrated solutions provider that can handle all aspects of the 3D printing lifecycle in medicine.
Likewise, the year also saw a marked increase in commercial partnerships. Most notably Materialise, a Belgium-based, medical additive manufacturing software company, partnered with multiple organisations, including Arcam, to improve its lead times and reduce product development lifecycle costs through strong software support for all processes.
Healthcare – ripe for additive manufacturing growth
Such are the benefits of additive manufacturing that in recent years significant investment has been allocated to this area. As a result it is now one of the best-funded fields of medical research. To a certain extent, this can be attributed to the influence of the private healthcare sector; where the rapid rate of innovation and consistently high levels of demand that exists within the market have caused companies such as Siemens and Medtronics to significantly increase their R&D budgets in a bid to stay ahead of the other players in the market.
This competition should be seen as a positive, as not only do the general public benefit from pioneering new medical treatments but organisations continue to drive each other to explore the realms of what is medically possible.
The medical industry also has a significant cost advantage over other sectors when it comes to innovation in additive manufacturing. Take rail and aerospace for example – both are heavily governed by bureaucracy, regulations, and regional jurisdictions; aircraft design in particular is governed by a range of airworthiness directives.
This contrasts with medicine, which on the whole is more willing to push the boundaries in pursuit of improved clinical care. Of course, there are cases where approval is needed for new products - the US Food and Drug Administration requires approval for any surgical implants, for instance – but advances in medical technologies are increasingly pushing the boundaries of what is possible using additive manufacturing techniques. There have even been a few recent cases where emergency permission has been granted for implants such as 3D-printed tracheal splints, which is a new frontier in the treatment of respiratory illnesses.
Human and veterinary medicine encompasses a range of treatments and remedies and there are undoubtedly many areas of the discipline in which additive manufacturing can make an impact in the future. Currently however, there are three specific areas that we see are fostering new growth:
Single solution: Additive manufacturing allows for an entire prosthesis to be produced in one go, which can be fitted according to the patient’s dimensions
- Orthopaedic devices: Joints that frequently
- require replacement or intense management due to overexertion such as the knee, the hip and the spine have been the subject of intensive research when it comes to additive manufacturing. It is hoped that in the future the replacement of joints with customised 3D printed artificial versions (which correspond to recipients’ exact measurements by surgeons) will become commonplace.
- Prosthetics: Prosthetic limbs have been in production for some years now but previous examples have taken a long time to produce, given the fact that they are manufactured on a piece-by-piece basis. Additive manufacturing however, allows for an entire prosthesis to be produced in one go, which can easily be fitted according to the patient’s dimensions.
- Bio-printing: Bio-printing represents one of the most exciting developments to date when it comes to organ transplants and donations. Additive manufacturing technologies have advanced to the extent that the 3D printing of organs and tissues, which will revolutionise transplants and patient care, is not far away.
What next for additive manufacturing in the healthcare sector?
Surgery remains one of the most complex and highly-skilled disciplines within medicine, and additive manufacturing isn’t going to change that. While robotics has helped to enhance a number of surgical procedures, human expertise will undoubtedly remain integral to complex operations for the foreseeable future. But that’s not to say that additive manufacturing can’t be used to improve surgical practices – far from it.
- 3D printing as a surgery assist
We envisage that customised implants will be used more and more frequently in surgery, giving them a replacement that fits them perfectly and reduces the likelihood of further surgery being required.
This could happen through the introduction of 3D printers to hospitals and medical facilities. Giving surgeons 3D printers and training them how to use them would empower them to more closely assess a patient’s requirements and produce a replacement in a relatively short time, which could then be fitted during surgery. This could be life-changing for patients – implants and transplants will be more readily available, in a shorter space of time, and be tailored to the recipient. It will also help to de-skill and reduce the cost of surgery, which when applied to developing economies, could have a significant impact. In countries where access to expert medical care may not be so readily available, providing 3D printers and the associated training to surgeons could give millions of people unprecedented access to life-changing surgery - this is truly exciting.
- The increased availability of biocompatible materials
To make these implants and transplants feasible however, the influence of biocompatible materials on the additive manufacturing market will need to increase, and fortunately there has already been significant progress in this area in recent years. While the 3D printing of plastics is now well established, plastic implants can’t be placed into the body due to the chemicals used within the material. As such, implants rely on metallic 3D printing, which historically, has been far less advanced than plastics. However, metallic 3D printers are starting to emerge into the market, largely thanks to the growth of major players in Germany and Sweden like EOS, SLM and Arcam. By increasing the depth and breadth of the biocompatible additive manufacturing market, the possibilities for implants will develop significantly.
- Patent expiry and the reduced cost of innovation
The third and final area of focus for the years ahead will be on patents. As is common practice with manufacturing equipment, 3D printing machinery is governed by patents that stipulate that any such devices are designed in a specific way. A large number of these patents however, are due to expire, which gives manufacturers scope to be more innovative with their machinery and subsequent development of new printing technologies, and further opens up the boundaries of medical innovation in additive manufacturing.
This forms part of an increasing trend towards widespread adoption of additive manufacturing techniques across all sectors – not just medicine. As a result of decreasing equipment costs and an increase in the production of plastics in China, the overall cost of additive manufacturing has fallen significantly in recent times, and is consequently helping to foster growth in the sector. These reduced costs are very significant, particularly in medical terms, because they increase the amount of budget that firms can allocate to further innovation. The ability to print in different colours and sizes at the same time, for instance, is just one of the potential innovations that could be realised in the not-too-distant future.
While additive manufacturing may still be in its infancy, it has a strong foundation for use in healthcare. What is most exciting is that the true limits of what can be achieved have yet to be explored.