Casviglia reconstructed in 3D at Rizzoli, as was the case for the intervention

For the first time in the world, one ankle was reconstructed with a prosthesis, custom made 3D-printed. The plant occurred on the 9th of October last, at the Rizzoli orthopaedic Institute of Bologna and the 57 years old patient, who had lost joint function following a car accident, is back to walk. The operation was introduced today in Bologna to the press. The innovative system - explained by Rizzoli - is the result of a technique of customization of the entire procedure prosthetic replacement of the ankle, that part by the anatomy of each individual patient, and was developed thanks to the collaboration between orthopaedic surgeons and engineers from the Istituto ortopedico Rizzoli and university of Bologna. Cesare Faldini, director of the Orthopaedic Clinic at 1, he coordinated the team that carried out the implant on the patient, so far considered to be inoperable because of the severe alteration in the anatomy of his ankle. The intervention "The intervention to the Rizzoli - explains Cesare Faldini, director of the orthopaedic Clinic at 1, who coordinated the team in the operating room - represents an absolute innovation at the global level because it is the first time that a prosthetic implant for the ankle to the conservation of isometry ligamentous - highlights - is built in three-dimensional printing and implanted with a technical guide to cutting a custom, time-saving surgical and bone tissue, in a patient with destruction of the articular post-traumatic".

"The procedure took place in two times - rebuilds the Rizzoli - the patient has executed a few weeks before surgery, a CT examination of the ankle, in the standing position. From this examination, a careful 3D reconstruction has allowed us to derive a three-dimensional model of the leg and foot of the patient, using software and procedures developed at the motion analysis Laboratory of the Rizzoli group, research engineer Alberto Leardini".


the orthopaedic Surgeons and biomedical engineers have simulated the intervention of the computer, working on the shape and size of each component to the prosthetic to meet the anatomical characteristics specific to the patient, up to find the optimal combination of the components of the talus and the tibia, the two bones that make up the ankle.
The prosthesis once it is established the geometry of the prosthesis and the placement of the ideal, was the product of a corresponding bone model and prosthesis 3D printed in plastic material, for manual tests end. Achieved and verified and the result more satisfactory for both the surgeon and for the engineer, the prosthesis true for the final implant was finally printed in an alloy of Chrome-Cobalt-Molybdenum alloy with the technology Ebm (an electron beam to melt layer by layer in the metal powder according to the file provided by Rizzoli).

the Last phase of the path, of the patient. "The surgery - highlight the doctors of the Rizzoli - despite the complexity linked to the presence of a severe alteration in anatomy, was made less invasive by the use of customized guides, built always in 3D printing and designed to mold on the bone of the virtual patient, which have allowed us to remove only the exact part of the cartilage and bone accessories, sparing the bone tissue necessary to accommodate the prosthetic components".

"Both the tibia, the talus, thus prepared, are able to 'receive' an excellent service from the prosthetic implant to measure: already at the end of the intervention, the operating room, it was possible to assess the perfect placement and excellent recovery of range of motion of the ankle joint. Also, the protocol of post-operative was the custom: bringing back in a continuous motion a joint is blocked by the years, is complex and has required intense collaboration with the Unit of physical Medicine and rehabilitation of the Rizzoli directed by professor Maria Grazia Benedetti", and conclude from Rizzoli.

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