Original article from Veterinary Practice News (July 28, 2018)
UF’s 3-D printer can create bone models with which veterinarians can “practice” a surgical procedure prior to actual surgery, as well as patient-specific surgical guides that improve accuracy and reduce surgery time
Chance, a greater Swiss mountain dog abandoned with a severe limb deformity, is walking better.
Bebop, a pot-bellied pig is back to rooting in his yard after a painful shoulder injury stopped him.
Chance and Bebop are the first two clinical cases treated over the past six months at the University of Florida College of Veterinary Medicine through a state-of-the-art 3-D printer that uses high-performance plastics and offers numerous advances in patient care, teaching, and research, according to UF veterinarians.
Among the printer’s capabilities are the ability to create bone models with which veterinarians can “practice” a surgical procedure prior to actual surgery, as well as patient-specific surgical guides that improve accuracy and reduce surgery time, according to the university.
“We have the Rolls-Royce of 3-D printers,” said Adam Biedrzycki, BVSc, Ph.D., an assistant professor of large animal surgery at UF, who purchased the printer with startup funds when he was hired by the UF College of Veterinary Medicine three years ago. “It can not only print parts that are approved in the aerospace industry to go into aircraft but also parts that are biocompatible for medical applications. That is, they can be used in live tissues.”
This is important, because he and UF small animal surgeons, including Stanley Kim, BVSc, an associate professor of small animal surgery who operated on Chance, wanted bone models that “actually feel and handle like the real thing” during presurgery practice, he said.
“If you use cheap plastic, when you drill it or cut it, it tends to melt, so it does not perform like the real thing,” Dr. Biedrzycki said. “So, for practicing surgeries or for teaching, it is not the best thing.”
Although 3-D tech is used at a handful of U.S. veterinary teaching hospitals, UF says its printing capabilities are unique for several reasons. The printer and the materials it uses are high quality, being located at the college allows for a quick turnaround time, and the software allows surgeries to be planned out on a computer ahead of time.
“We can first make the cuts and simulate the repair and unite the bones virtually with plates and screws in the 3-D computer environment, then print them out and complete the surgery using the printed models,” Biedrzycki said. “This means time spent on the front end leads to time saved in the operating room, greater patient safety due to reduced risk and enhancement of surgical accuracy.”
The process begins with the inputting of diagnostic CT scans into specialized software the veterinarians use to plan a specific surgical procedure. Then, a model of the patient’s bone is printed, to which a customized 3-D printed surgical guide is attached.
“We affix the guide with a couple of pins, and like Cinderella’s slipper, it fits absolutely perfectly and only fits that bone,” Dr. Kim said. “It’s matched to the contour of the bone, then we know just where to cut.”
The printer’s primary usefulness clinically is the ability to create these customized printed guides, he added.
Biedrzycki has only used the technology clinically on Bebop, the pot-bellied pig, who had a chronic shoulder luxation that required a complicated surgery to correct.
“We didn’t use the guide in Bebop’s case, but we eyeballed where we’d make the cut on the bones, then contoured bone plates to fit the model so we’d know where to put the plates in surgery. The procedure went much more rapidly because we did a lot of the hard work beforehand.”
Biedrzycki is investigating the technology’s potential for surgery on horse hooves. He also is excited about the potential use of 3-D printing in teaching and research.
“We are doing and trying things with the 3-D printer in the veterinary medical field that people haven’t done before, particularly if you look at the implantable high-performance plastics,” Biedrzycki said. “What is key for us is that the printer is in a surgeon-friendly lab rather than locked away in some engineering department on campus printing one-off examples. The guides and work we are doing are changing the way we approach cases. We hope that the knowledge and expertise we have will allow this to become routine, benefiting many more patients.”
The road to recovery
Kristin Campbell, Bebop’s owner, said the 2-year-old pig is doing well and that his recovery exceeded her expectations.
Chance’s life has taken a huge turn for the better thanks to the Greater Swiss Mountain Dog Rescue Foundation, which facilitated his transport to UF—and the procedure Kim conducted to help him.
“Chance was found tied to a pole with a note asking that someone please find a new home for him,” said Pat Saxon, president and chair of the Bradenton, Fla., foundation. “He was then taken to a shelter in Canada and we were contacted to see if we could help.”
A veterinarian in Canada diagnosed the dog with a bilateral patellar luxation due to limb deformities, with the right hind leg being the most severely affected. Aware of the 3-D technology, the veterinarian believed it could help Chance, although he felt the prognosis was guarded at best, Saxon said.
“Thankfully, Dr. Kim’s expertise proved him incorrect,” she said. “He was so gracious in answering any question I had prior to seeing Chance that we decided to take him to UF.”
During his recuperation period, Chance received water treadmill therapy in Sarasota and has continued to recuperate well. Although he may still need surgery on his other leg, Saxon plans to see how Chance does over the summer.
“We are so happy to see him be able to walk, run, and play more normally,” she said.