3D Printed Titanium Cages: Q & A with Dr. Keith Heier, M.D. - Orthopedic Surgeon | Foot & Ankle

How Long Has 3D Printing Been Used by Orthopedic Surgeons?

3D printing technology has been available for over 30 years, but has only been used by orthopedic surgeons for the past 8-10 years.

How Long Have You Used Them in Your Practice?

I have used 3D printed titanium implants in my practice for 4 years.

What is The Difference Between a Custom Made and Off The Shelf Titanium Cage?

Off-the-shelf titanium cages refer to pre-manufactured 3D printed cages where the patient does not need any type of imaging to create them. Custom-made titanium cages require the patient to have a CAT scan prio r to the procedure so the manufacturer of the 3D cages can have an engineer and their graphic designer create the implant based off the images received.

How Many Surgeries Have You Used 3D Printed Titanium Cases?

I have done approximately 25 custom implants and somewhere between 40 and 50 off-the-shelf implants.

Are 3D Printed Cages Covered by Insurance?

Yes

How are Custom 3D Titanium Cages Made?

Typically, patients with a complex ankle case are the ones who need custom-made cages. In order to produce the custom implant, the patient would have a CAT scan of their foot or ankle. Those images would then be sent to the manufacturer where a virtual meeting is set up between an engineer, a designer and the orthopedic surgeon to create a custom-made cage that is specific to the patient’s problem. Then they would send me the actual details of the design for approval before they print the 3D cage. The cage is made to a high quality and is within 1/10th of a mm of the exact design dimensions. This is much higher accuracy than can be done with typical non-3 D printed designs.

What are the advantages of using the 3d printed cages vs traditional methods?

Patients experience a more predictable outcome in that the fusion may heal faster and we are able to get a better correction with the 3D printed cages. Before 3D printing technology, some cases were basically impossible. Because of technological advancements over the years, cases that were once impossible to treat are now treatable.

How long does it take to produce the 3d printed titanium cages?

It takes about 12-24 hours to make a typical titanium cage and this depends on the size and complications involved in the implant.

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