Medical 3D printing – where are we?

Milos Todorovic, Lux Research look at where we are with medical applications of 3D printing and says that while mankind awaits replacement organs, nuts and bolts dominate the market

The biggest leap for medical 3D printing still lies ahead. Starting to address the eternal dream of engineering replacement organs, so that a patient who needs a transplant doesn’t have to search for a donor, has led bioprinting developers, such as Organovo and Emulate, to focus on organ-on-a-chip devices useful for biopharmaceutical development and diagnostic applications. Following in their footsteps, companies like EnvisionTEC and Syseng use their multi-modal systems that integrate multiple print heads to switch between printing living cells, biomaterials, and thermoplastics during the same process to produce multimaterial end products, such as cellular networks on top of a biocompatible scaffold. The next step for development in this space will primarily focus on creating organ tissues with specific sub-organ features like a kidney’s nephrons and creating supporting structures such as vasculature.

While some of the 3D printing systems are already capable of printing cells, proteins, DNA, and drugs, there are significant barriers to mainstream adoption in these segments of healthcare, and it will be at least another decade before we see any meaningful clinical applications of 3D printing in organ transplantation. In the meantime, more immediate medical markets will focus on implants, prosthetics, and orthopaedics, with knee and hip replacements presenting a very compelling business opportunity given the combined size of these markets is close to $15 billion. In the day and age of personalised everything, a key driver for medical 3D printing has become customization.

Medical professionals find significant value in customising the design of medical devices to fit each patient’s unique anatomical and physiological needs. Dentistry professionals were among the first to adopt 3D printing technologies, with dentists, oral surgeons, and orthodontists now commonly producing crowns, bridges, stone models, and orthodontic appliances using in-office 3D printing equipment. Companies like Sonova led adoption of the technology in the auditory space, by 3D printing custom fitted hearing aids to ensure proper device positioning in the ear and, therefore, optimal hearing improvement for patients. In just a few short years the market grew to the point where the majority of the hearing aid manufacturers now offer devices that are personalised to the shape of the customer’s ear.

Prosthetic applications for 3D printing have utilised the same customisation impetus that drove interest in the dental and auditory markets. Lower leg prostheses have become a popular early application thanks to the relatively simple design and large market for such devices – driven, in part, by the increasing veteran amputee population. Variations on these devices range from 3-spark’s lower leg prostheses with integrated, 3D printed strain sensors to Standard Cyborg’s waterproof products meant for use while swimming and bathing. More recently, 3D printed hand prosthetics have become a major medical application of interest, thanks in large part to the efforts of consortiums like e-NABLE and the Open Hand Project focused on low-cost prosthetics for less developed regions.

Orthopaedic implant applications have also benefited from patient-specific customisation. Knee and hip joint implants were among the first to receive regulatory clearance in the space, but spinal implants have garnered significant interest in the past year, highlighted by FDA 510(k) clearances for Joimax and Oxford Performance Materials (OPM). Titanium implants like Joimax’s EndoLIF spinal fusion implant have dominated the implant space thanks to the material’s relative strength and biocompatibility, but OPM’s PEKK-based spinal implant represents the first 3D printed polymer-based load bearing implant. Further development and commercialisation of lower cost polymer-based devices will prove to be a major driver for adoption of 3D printed devices given healthcare providers and payers’ increased focus on lowering healthcare costs.

In closing, as witnessed by the sheer breadth of medical applications of 3D printing, the future for this rapidly growing industry looks bright. However, major obstacles still loom large, the biggest ones related to regulations, performance, and the limited selection of (biocompatible) printable materials. With the visions of custom-fitted medical devices printed at home and new hearts beating in the chests of heart attack survivors, it is important to understand that years of additional research and development are needed to reach commercial maturity for these more demanding applications. While mankind awaits the unlimited supply of replacement organs, the industry will look for mechanical nuts and bolts – from dental and cochlear implants to joint replacements and surgical tools – to fuel the growth in the next five to ten years.