AM Chronicle and Materialise Mimics Medical bring to you a series of interviews with medical professionals of India, who have adopted 3D printing and digital planning technologies. In this third edition of the series we had the opportunity to interview Dr. Aashish Chaudhry MD, Senior Consultant & Head Department of Orthopaedics & Joint Replacement at Aakash Healthcare Super Specialty Hospital, Delhi.
Aakash Healthcare is known for knee replacement and hip replacement in Delhi. Dr Chaudhry has a keen interest in Knee Replacement Surgery and employs minimally invasive surgical techniques in joint replacement, which helps in faster recovery. Dr. Aashish is one of the Best Orthopaedic Doctors in Delhi who treats patients suffering from osteoarthritis, rheumatoid arthritis, and other degenerative diseases of the knee.
Dr. Aashish Chaudhry experienced a transformative moment with 3D printing technology four years ago when faced with a complex surgery on a young cancer patient. This pivotal case led him to explore the potential of 3D printing in creating personalized implants and surgical guides. Throughout this interview, Dr. Aashish Chaudhry discusses his journey from that first case to becoming an advocate for 3D printing in orthopedics. He shares the challenges and rewards of adopting this technology and offers insights into its future impact on personalized care and bioprinting.
Dr. Aashish Chaudhry, can you share your initial experience with 3D printing technology. How did you get started with using 3D printing technology in your practice? and what were the motivating factors that led you to adopt this technology?
It happened about four years ago, by chance. A young patient, who had undergone chemotherapy and radiotherapy, required surgery due to cancer in his pelvic bone. The typical solution would have been to remove the entire hip joint and replace it with a prosthesis. However, this procedure is complex, with a high risk of deep infection, especially given that the patient was only 17 years old.
I wanted to find a solution that was both long-lasting and had a better chance of success and survival. This case made me realize that a standard implant might not be the best option. I started searching online for other solutions and came across a 3D printing company in Delhi. I contacted them, shared the patient’s details, and we discussed the best course of action.
After much deliberation, we decided on a plan. We went ahead with the surgery to remove the tumor and found that we could preserve the roof of the hip joint. We then used a 3D-printed implant to replace the removed bone, supplementing it with a bone graft to aid biological integration. About three weeks after the initial surgery, we had the custom implant ready, and we proceeded with the final surgery.
Now, nearly four years later, the patient is doing well. This experience was a turning point for me and sparked my interest in 3D printing technology. It was a motivating factor because, in a case where no other solution seemed viable, 3D printing provided a rescue.
During the planning process, I realized that this technology had numerous advantages and could be used in various clinical scenarios—not just rare cases like this, but also in routine situations where off-the-shelf implants don’t fit every patient’s anatomy. This revelation motivated me to think differently and consider 3D printing technology to solve problems that conventional implants and instruments often cannot address.
How has 3D planning and printing (Surgical guide, personalized implants) transformed the way you provide personalized care to your patients?
The convergence of surgical expertise and 3D printing technology has revolutionized the planning and execution of complex medical procedures. When medical professionals and engineers collaborate, they create innovative solutions tailored to individual patients’ needs. This collaboration involves extensive deliberation, integrating medical knowledge with engineering principles to ensure the best outcome.
The end products of this teamwork are highly beneficial to patients, whether it’s a surgical guide, personalized implant, or a surgical model. These models, created through advanced imaging techniques like CT and MRI, are especially useful for surgeons. For example, neurosurgeons and cardiac surgeons often use them to better understand a patient’s anatomy before surgery. If they’re repairing a congenital defect, having a detailed model allows them to visualize the internal structure in advance. This preparation can greatly reduce stress in the operating room, as the surgeons can practice on the model, plan their approach, and be fully prepared for the real surgery.
The planning phase is crucial—not just for surgeries but for any complex project. It’s like constructing a building: careful planning can lead to remarkable achievements, such as the famous example of a building in China constructed in just 47 days. Similarly, in medical procedures, thorough planning with 3D-printed models provides a roadmap for success. This technology allows medical teams to anticipate challenges and customize solutions for individual patients, leading to better outcomes and reduced risk of complications.
The use of 3D printing has dramatically changed how personalized care is delivered. Before this technology became widely available, patients were often treated with conventional methods and standard implants, which didn’t always fit well or could lead to complications, revisions, or failures. By contrast, 3D printing allows for customized solutions that improve patient care and reduce the need for repeat surgeries.
Overall, 3D printing technology has transformed the way surgeons plan and execute procedures, leading to more effective and personalized care. This advancement has not only improved surgical outcomes but has also provided a new level of precision and confidence in treating complex medical conditions.
Aakash Healthcare Super Speciality Hospital is one of the hospital which pioneering the establishment of 3D printing lab at point-of-care, can you share with us the journey of how it has started?
After that first successful case with 3D printing, I became inspired to explore more opportunities to use this technology. However, after handling three or four additional cases, I realized that the current approach had some limitations. The process of contacting a 3D printing company, designing the implant, discussing with engineers, and then waiting for the final product, including post-processing, was time-consuming. Moreover, the constant back-and-forth communication with engineers, sometimes every two or six hours, made planning challenging.
Given these challenges, I began thinking about how we could streamline the process to reduce the turnaround time. It was also necessary to communicate effectively with patients and their families, explaining the complex procedures we were planning. I thought it would be ideal to have a 3D printing and design lab within the hospital itself. This way, we could collaborate more efficiently and create custom solutions faster, which would not only benefit our patients but also other surgeons who might not have access to 3D printing in their own city.
Having a dedicated 3D printing facility within the hospital would be especially valuable in a high-traffic area like Delhi, which attracts patients from across the country and beyond. Delhi is a major metropolitan area, with patients from various regions seeking critical medical treatments. However, surgeons from other parts of India, like Bangalore and Hyderabad, often had to send their designs out for printing, resulting in longer wait times.
The introduction of an in-house 3D printing lab at our hospital provided a much-needed solution for the Delhi NCR region. It also yielded instant results. The plastic surgeons, orthopedic teams, dental specialists, and other medical professionals began to interact with our 3D lab experts, sharing their unique requirements for different cases. They needed customized surgical models, implant designs, and various other 3D-printed solutions. This interaction highlighted the broader range of applications for 3D printing in medicine.
The success of our in-house 3D printing lab demonstrated the potential for rapid prototyping and customization in healthcare. It not only improved efficiency but also encouraged other specialties to consider how they could leverage 3D printing technology to enhance patient care and streamline complex procedures.
Can you share with us your experience or thoughts on having the in-house 3D POC (Point of Care) facility to serve the multi-disciplinaries teams? Will a 3D POC facility able to accelerate the planning process by having shorter turn around for the printing of surgical models orsplints (in house)?
The 3D printing lab has proven invaluable in various applications, some of which we hadn’t initially anticipated. To maximize its potential, we created WhatsApp groups and organized Continuing Medical Education (CME) programs both within our hospital and externally. These initiatives aimed to educate medical professionals about the benefits and possible uses of 3D printing technology in solving various patient-related problems. We showcased how 3D printing could be used to create surgical guides, soft tissue and bone models, and personalized solutions, highlighting its versatility.
Educating the medical staff was a crucial step in establishing the lab’s utility. Once we did this, more surgeons and medical professionals started approaching us with requests for customized patient education models. We created around 50 such models, which they used to help patients understand their medical conditions better. These visual aids played a significant role in convincing patients about their treatment options, as seeing a 3D model of their own medical issue provided tangible clarity. This visual feedback greatly facilitated patient consultations and treatment planning.
Additionally, the planning process became much faster with the in-house 3D printing lab. The turnaround time reduced significantly, with design work typically completed within 24 to 48 hours. The printing process itself took no more than five to six days. Thus, within a week, we could develop a complete solution for any specialty, doctor, or complex medical case.
Overall, the establishment of our 3D printing lab streamlined workflows, improved patient education, and facilitated more effective treatment planning. It has been a transformative addition, allowing us to deliver better and faster care to our patients, while also supporting other medical professionals in their work.
What are the challenges of using 3D technologies for orthopaedic surgery?
While 3D printing technology offers significant benefits in personalized medical solutions, it also presents certain challenges. One of the key challenges is that the final plan heavily depends on the surgeon’s thought process. The surgeon is ultimately responsible for creating a practical and effective solution, not just a cosmetically pleasing one. There’s a risk that in the quest for innovation, a design might become overly complex, potentially affecting its long-term viability.
Mechanics and design principles are crucial in these cases. Surgeons need to be mindful of mechanical considerations and seek advice from engineering colleagues when necessary. Custom implants, designed for a unique situation, may either succeed or fail due to unforeseen factors. For example, in one case involving the removal of a tumor from a patient’s ankle, we had precise measurements for the implant. However, during surgery, the swelling and edema caused by the procedure changed the available space, leading to complications when inserting the implant.
This experience taught us to consider variables like surgical duration and expected edema. In some areas, like the thigh, there’s more flexibility and less risk of swelling affecting the implant. However, in tighter areas like the ankle, foot, or hand, even a slight miscalculation can lead to complications, such as an inability to close the wound. To address this, we started reducing implant sizes by about 20% in these high-risk areas, allowing for possible swelling during surgery.
Coordination among different teams is another significant challenge. When an implant involves multiple components—like a metal part and a plastic part—obtaining these from different vendors can lead to misalignment. Even a minor mismatch in size or shape can prevent proper fitting. This is why close collaboration with all stakeholders, including those responsible for cutting, designing, and shipping, is essential.
These challenges underscore the importance of a multidisciplinary approach. Proper communication among surgeons, engineers, and other medical professionals can help identify potential issues before they impact patient safety. While we’ve learned from our experiences, often through trial and error, the key is to be proactive and flexible in our problem-solving approach. We need to consider not only the technical aspects of the implant but also the human factors, such as tissue swelling and skin mobility. This ensures that while our engineering team might provide a technically sound solution, it also works effectively within the human body during real-world surgery.
What advice would you give to other orthopaedic surgeons who are considering adopting 3D planning and printing technology in their practices?
When it comes to adopting new technology, such as 3D printing in medical practice, it’s important to strike a balance. You shouldn’t be overly enthusiastic, nor should you outright reject it. The key is to assess the merits of the technology and focus on whether it will lead to better functional outcomes for your patients. If it does, then it’s worth exploring further.
Of course, cost can be a concern for many patients. However, it’s crucial to prioritize the well-being of the patient over any potential financial gain. If the focus shifts to profit, the quality of care can suffer, leading to inappropriate or ineffective solutions. I approach 3D printing with this mindset, ensuring that the primary goal is to improve patient outcomes.
Even though I’ve faced complications and learned a lot over the past 2.5 to 3 years, I’ve become more skilled in designing with 3D printing technology. As with any medical specialty, the more experience you gain, the better you understand the nuances of creating effective solutions. It’s crucial to avoid going overboard with complex designs while ensuring that the resulting solutions are robust and can withstand the forces exerted by the human body.
Orthopedics is an excellent example of a field that can benefit greatly from 3D printing. The technology has applications across a range of specialties, from orthopedic oncology to spinal surgery, and even in creating surgical guides for hip surgeries. It’s versatile and can be used in a variety of cases, offering customized solutions where traditional methods might fall short.
Collaboration is key. Medical professionals should work closely with engineers to ensure that the final product meets both technical and clinical requirements. If you’re in the Delhi NCR region, you can collaborate with our team, or if you’re elsewhere, you can connect with other 3D printing providers. The crucial element is the medical input; engineers will design based on the specifications you provide, but they might not fully grasp the intricacies of the human body. A successful outcome depends on the perfect amalgamation of medical and engineering expertise.
As a closing thought, where do you see the future of 3D planning and printing going? How do you think the technology will change the landscape of orthopaedic specialty in the next 5-10 years? How do you think personalized care empowered by 3D technology can be more accessible for patients?
The future of 3D printing in healthcare looks incredibly promising. In the next 5 to 10 years, I believe it will become a commonplace technology, with widespread adoption driving down costs and making it more accessible to a larger number of people. India, being a cost-sensitive market, has a massive population that could benefit from 3D printing. As the technology becomes more mainstream, it will naturally bring down prices and improve affordability for medical services.
However, current adoption rates are still low, primarily due to high costs and a lack of awareness among healthcare professionals. To address this, companies in the 3D printing industry should focus on educating medical staff and increasing awareness of the technology’s benefits. By doing so, they can encourage more healthcare providers to request 3D-printed solutions, thereby creating greater demand and driving down costs through increased production.
The growth of 3D printing is already evident, with discussions about it taking place in many healthcare forums. Alongside other emerging technologies like robotics, artificial intelligence, and machine learning, 3D printing is becoming part of the conversation around personalized care. The younger generation, who are increasingly making healthcare decisions, are also more open to these new technologies. As lifespans increase, the range of diseases and medical conditions is also expanding, leading to greater demand for personalized solutions that conventional products can’t always provide.
Looking ahead, I believe that bioprinting could be the next significant step in 3D printing technology. Bioprinting involves creating tissues and potentially entire organs through 3D printing processes, using cultured cells that can integrate with the human body. This has immense potential for patients suffering from chronic kidney or liver diseases, bone defects, heart issues, and other conditions that currently rely on organ donations. If bioprinting becomes a reality, it could revolutionize the field, providing life-saving organs and tissues without the need for traditional donors.
While bioprinting is still in its experimental stages, there have been encouraging results in laboratory settings. We’re witnessing innovative uses of animal organs, like pig kidneys, in human transplants, which indicates that organ and tissue printing may not be far behind. When 3D printing reaches this level of sophistication, it will be a game-changer, offering new hope for patients waiting for transplants.
The future of 3D printing in healthcare is filled with exciting possibilities. As the technology becomes more accessible and affordable, it will have a significant impact on patient care, offering personalized solutions that can address complex medical conditions. Bioprinting, in particular, holds the potential to transform the field, opening new avenues for treating chronic illnesses and organ failures. I’m looking forward to seeing how this technology evolves and what it means for the future of medicine.
Materialise Mimics Medical has been helping many doctors like Dr Aashish Chaudhry in improving patient outcomes and advancing patient-centric care with 3D technologies
Materialise Medical has pioneered many of the leading medical applications of 3D printing, enables researchers, engineers and clinicians to revolutionise innovative patient-specific treatment that helps improve and save lives. Materialise Medical’s open and flexible platform of software and services, Materialise Mimics Medical, forms the foundation of certified Medical 3D printing, in clinical as well as research environments, offering virtual planning software tools, 3D-printed anatomical models, and patient-specific surgical guides and implants.
For additional information, please visit: https://www.materialise.com/en/healthcare/hcps/point-of-care-3d-printing
