Surgeons at Queen Elizabeth Hospital in Birmingham, UK, have fitted a 3D printed sternum implant in a patient to help repair their breastbone.
Linda Edwards, a 52-year-old mental health support worker from Fleetwood, Lancashire, suffered from a collapsed breastbone following complications in a previous surgery. She was told, shortly after, that it could not be put back together. 3D printing, however, became a suitable alternative.
Contacting Ehab Bishay, consultant thoracic surgeon at University Hospitals Birmingham NHS Foundation Trust (UHB), Edwards was eventually able to undergo the 3D printed sternum procedure. It involved replacing part of her damaged rib cage with a 3D printed titanium prosthesis.
“I woke up from the operation feeling terrible and, at one point, I thought I had died,” Edwards told the Blackpool Gazette, “but,” she adds, “I am feeling better every day. I still feel numb because I am on a lot of drugs, but the main thing is my ribcage doesn’t keep shifting about.”
3D printing provides solution for rib cage complication
In 2016, Edwards contacted her GP complaining of indigestion and heartburn, where she was ultimately diagnosed with angina, a condition that causes reduced blood flow to the heart muscles. She underwent a heart bypass surgery, in which surgeons cut open her sternum to access affected organs. After the operation, surgeons pieced the breastbone together using wires, however these failed to hold and Edwards’ sternum consequently collapsed. Following an additional failed procedure in February 2017, Edwards was forced to look elsewhere due to the pain caused by her damaged rib cage.
She contacted Bishay on Facebook after watching a documentary on the surgeon’s work regarding 3D printed transplants. “It was out of sheer desperation that I contacted Mr Bishay because the situation with my rib cage was critical,” Edwards said, “it was getting steadily worse and I couldn’t see a way forward.” Bishay agreed to help Edwards, though advised her to seek and apply for the operation via her GP.
After receiving initial permission for the operation in 2018, the procedure was successfully carried out in July 2019 by a cardiac team at Queen Elizabeth Hospital led by Stephen Rooney.
Bishay, who was also part of the operating team, explains that his team used titanium for the implant as it is resistant to infection, lightweight, tough and functional. “It’s fantastic to see that Mrs Edwards is doing extraordinarily well given the complexity of the procedure she has undergone,” Bishay adds. “That is due in part to the collaborative working of three highly-skilled surgical teams and their focus on improving long-term outcomes for patients by developing its capacity and experience to undertake these highly-complex procedures.”
Other 3D printed sternum implants
In 2017, Bishay previously took part in a similar operation on patient Edward Evans at Heartlands Hospital in Birmingham. It involved a team of surgeons operating to replace his sternum with a 3D printed titanium and polymer implant, and was in fact the subject of the BBC documentary that encouraged Edwards to contact Bishay. The metal implant in that instance was 3D printed by Anatomics, a Melbourne-based and Australian-owned medical device company, and CSIRO, Australia’s national science agency.
This was after Anatomics and CSIRO initially collaborated in 2015 to 3D print a titanium sternum and rib implant for a 54-year-old Spanish cancer patient. CSIRO’s $6 million 3D printing lab, Lab 22, helped to design and manufacture the prosthesis with Anatomics. As well as Evans, the two Austrialian med-tech institutions have since gone on to 3D print a rib cage implant for a U.S. surgical team, who successfully performed an implant procedure on 20-year-old Penelope Heller.