Patient-specific Ti-6Al-4V lattice implants for critical-sized load-bearing bone defects reconstruction

Abstract

The advancement in additive manufacturing in recent years opened a new era for bone reconstruction methods, allowing for the design of customized implants that perfectly match clinical needs. This challenge is even more prominent in critical-sized bone defects, where the bone cannot heal independently. Here we present a novel workflow for such cases. First, a multidisciplinary team conducted the surgical plan, including the design of an intraoperative patient-specific instrument. Then, a Ti-6Al-4V implant was created to exactly fit the resected tumor's bone gap. An ambitious bone regenerative approach was taken in designing the implants with a porous-lattice body acting as a scaffold for new bone formation, reinforced with standard orthopedic instruments for adequate mechanical support. To prevent future failure of the implant, a finite element analysis was used to evaluate stress distribution simulation according to the multi-axis forces and moments applied on the bone during walking. Our results demonstrate the potential for Ti-6Al-4V implants to become the best practice for reconstructing significant bone defects. This proof-of-concept may enhance clinical care and catalyze new frontiers in patient-specific medicine. To the best of our knowledge, this is the first study to describe in detail the design and fabrication of this method.