It has been hypothesised that AM is ideal for patient specific orthopaedic implants such as those used in bone cancer
treatment, that can rapidly build structures such as lattices for bone and tissues to in-grow, that would be impossible
using current conventional subtractive manufacturing techniques.
The aim of this study was to describe the adoption of AM (direct metal laser sintering and electron beam melting) into
the design manufacturing and post-manufacturing processes and the early clinical use.
Prior to the clinical use of AM implants, extensive metallurgical and mechanical testing of both laser and electron beam
fabrications were undertaken. Concurrently, post-manufacturing processes evaluated included hipping, cleaning and
The first clinical application of a titanium alloy mega-implant was undertaken in November 2010. A 3D model of the
pelvic wing implant was designed from CT scans. Novel key features included extensive lattice structures at the bone
interfaces and integral flanges to fix the implant to the bone. The pelvic device was implanted with the aid of navigation
and to date the patient remains active. A further 18 patient specific mega-implants have now been implanted.
The early use of this advanced manufacturing route for patient specific implants has been very encouraging enabling the
engineer to produce more advanced and anatomical conforming implants. However, there are a new set of design,
manufacturing and regulatory challenges that require addressing to permit this technique to be used more widely. This
technology is changing the design and manufacturing paradigm for the fabrication of specialised orthopaedic implants.