The material used must be based on the required mechanical properties of each structure, whether skin, bone, or liver.
“While numerous biologic tissues have been printed and tested pre-clinically, challenges remain to further develop and harness 3-D printing technologies for more complex tissues and organs. As scientists move away from modifying existing printers and begin to design new technologies, the range of materials can be extended and methods to deposit materials and cells with increasing precision and specificity can be developed,” Atala and Yoo wrote.
3-D printing already has demonstrated the kind of versatility Frederick Downs Jr., a prosthetics consultant for the Paralyzed Veterans of America and former national director of the VA’s artificial limb program for 30 years, has found in other technologies.
Future focus areas to achieve that include developing new biocompatible materials able to withstand external stress and maintain their shape after implantation; improving printer resolution to duplicate the detailed inner architecture of complex organs; creating new ways to vascularize and innervate 3-D-printed tissue and organs, especially complex volumetric organs; increasing printer speed while overcoming current issues of extrusion-based cell damage; and developing in vivo bioprinting for real-time tissue regeneration at the point of injury or during surgery.
The VA conducted a two-day “Make-a-Thon” July 29-30, 2015, hosted by the VA’s Center for Innovation, at the VA Medical Center in Richmond, Virginia. The first-of-its-kind event brought together 3-D researchers and manufacturers to discuss – and immediately begin working on – VA needs and challenges the evolving technology may help to resolve. Attendees were a mix of professionals and students, from high school to college, interested in new approaches to the science and technology of prosthetics.
On the first day, individuals and teams pitched their ideas to VA staff, veterans, each other, and additive manufacturing company reps. The latter provided more than a dozen 3-D printers to the forum to immediately convert any promising new ideas into actual products or prototypes. On day two, the proposed solutions were placed in competition and judged by a six-member panel that included representatives from the VA, Toyota, 3D Systems, and Google.
The winning team, whose members ranged from high school students to a nuclear engineer, received $20,000 from Google for their design of a three-piece coupler that allows for the removal and replacement of a lower-body prosthesis in minutes without having to switch the socket or full prosthetic leg. They began brainstorming ideas after the VA briefings, then designed and printed their winning device within two days.
They were helped by prosthetic user advice from Lisamarie Wiley, a 10th Mountain Division veteran human intelligence collector who lost much of her lower left leg to a land mine in Afghanistan. Wiley was one of several veterans who participated in the VA’s first Make-a-Thon, bringing with her half the 12 prosthetic legs she owns, each custom-made for a different activity. She would rather have fewer legs, preferably bought off the shelf and able to be adjusted to fit. Among other drawbacks, she told attendees, packing even half of those requires a bag too large for carry-on and so has to be checked.
“You never know what new technology will come out in the future that, while not originally intended for the disabled, may make things a lot better for them.”
“This leg cost about $70,000,” she said, holding up one, then pointed to two others. “These together cost about $50,000. I mean, do you really want to give your Porsche to some baggage handlers to throw around?”
The winning team’s Robotics Club coach, Ty Sayman, from Green Hope High School in Cary, North Carolina, said the new coupling design is simple, but could have a “game-changing” effect on the manufacture of lower-limb prosthetics.
3-D printing already has demonstrated the kind of versatility Frederick Downs Jr., a prosthetics consultant for the Paralyzed Veterans of America and former national director of the VA’s artificial limb program for 30 years, has found in other technologies.
“You never know what new technology will come out in the future that, while not originally intended for the disabled, may make things a lot better for them,” he said.
This article first appeared in The Year in Veterans Affairs & Military Medicine.