World first as Vietnamese patient has entire arm bone replaced

November, 05/2021 - 17:25

Doctors at the Vinmec Center for Orthopedic Trauma & Sports Medicine have made a successful surgery to recover the arm for a patient with bone cancer. This is the first time in the world that a combination of materials, titanium alloy and PEEK biomedical material, based on 3D printing technology has been used to replace a bone in the arm.

HÀ NỘI — Doctors at the Vinmec Center for Orthopedic Trauma & Sports Medicine have made a successful surgery to recover the arm for a patient with bone cancer. This is the first time in the world that a combination of materials, titanium alloy and PEEK biomedical material, based on 3D printing technology has been used to replace a bone in the arm.

A journey to retain the arm of the 18-year-old young man

The patient, who has been named only as V.T.D, is an 18-year-old male living in Hà Nội. He initially suffered pain in his right arm while studying in Grade 12, when he needed to focus on studying for graduation exams. The persistent pain made him sleepless at night. He went to various medical facilities for examinations but the disease was not detected. 

When his arm swelled up, he went to have an examination for osteosarcoma. A rare type of bone cancer was diagnosed. He was advised that amputation was the best treatment, but the team of specialists from Vinmec Center for Orthopedic Trauma & Sports Medicine had another idea. 

Prof. PhD. Doctor Trần Trung Dũng, Director of the Center, said, “The tumour had invaded the entire canal and surrounding soft tissue, and it was no longer possible to cut and preserve part of the bone, therefore we had to make an adventurous decision. That is to make a surgery to remove the entire arm bone and tumour, and at the same time replace the entire arm bone with a composite artificial material to overcome the disadvantages of metal materials,” he said. 

 

An X-ray image of the right arm of the patient after the tone arm bone replacement surgery — Photo VinMec

The surgical team made a plan to use the most modern technology in bone reconstruction, including reconstruction of the shoulder and elbow joints using titanium alloy materials. The centre’s doctors made the decision to not only use metals, but also 3D printing technology of biopolymer materials (PEEK). This material is manufactured by the Research Department of 3D printing technology of VinUni University. It connects the shoulder and elbow joints and simultaneously restores the attachment points of the tendons around the arm. This is regarded as an innovative decision based on extensive research and experiments from many successful cases by the surgical team.

 

X-ray image comparing the two humeral bones after surgery — Photo VinMec

3D printing technology is regarded as the only technology that offers the ability to personalise implant details. Thanks to this technology, all three parts of the artificial arm bone are 'specifically designed; in line with the actual arm size of the patient. There are fixed points to support the recovery of the tendon system attached to the bone. Before manufacturing, all of these designs are tested virtually, stimulating mobility and bearing capacity. This means that after transplant, the artificial bone will be a 'perfect match' to the patient's body. This improves the functionality of the new bone and shortens the recovery time for the patient. 

After surgery, Patient D. was able to return to normal activities and can easily his shoulder joint by raising the arm high. — Photo VinMec

The most unique material combination technology in the world

This arm surgery is the first in the world that uses a combination of titanium alloy and PEEK biomedical material, made by doctors of Vinmec Center for Orthopedic Trauma & Sports Medicine. 

Using these materials for the artificial bone allows for precise and flexible mobility of the titanium alloy at the joint. The weight of the artificial arm can be decreased by half and there is a reduction in the cost by more than one third, in comparison to metal-only solutions.

After surgery, Patient D (far left) has been able to write with his right hand, allowing him to continue studying to be an IT engineer in the future. — Photo VinMec

Five months after surgery Patient D. has been able to move the shoulder flexibly, returning to daily activities with his new arm. D now is confident writing and performing light tasks with his own hands daily. 

This innovation is the second case of artificial bone replacement using a combination of materials, but the first using 3D printing. Usually, a combination of titanium and cement is used. Doctors have sent the research procedure and application of this innovative technique to a reputable scientific journal specialising in oncology in Europe, for international publication. This success demonstrates that the treatment qualification for bone cancer, as well as the application of 3D technology in the health sector of Việt Nam, is improving rapidly and is being recognised in the international arena.

Vinmec Center for Orthopedic Trauma & Sports Medicine – Vinmec International Hospital is a convergent place of many experienced, skilled and dedicated specialists in many fields, such as shoulder and elbow surgery; hip and knee replacement surgery; laparoscopic surgery and sports medicine; surgery of bone cancer and soft parts. — VNS

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