The world’s first patient to receive a 3D-printed tibia transplant, Reuben Lichter, with his son, William. Photo: AAPSurgeons at Brisbane’s Princess Alexandra Hospital have performed world-first surgery and transplanted a 3D printed shinbone into the leg of a man who faced losing his leg.
Two weeks ago, the 3D printed tibia was transplanted into the Reuben Lichter’s right leg.
It was wrapped in leg tissue and blood vessels from both his legs.
It was the first stage in a nine-month journey, at least, to grow new bone in his right shin and allow Mr Lichter, of Mudgeeraba, to support his weight and walk again.
Health Minister Cameron Dick said the successful transplant, led by reconstructive surgeon Michael Wagels, opened the door for the successful transplanting of major bones in trauma accidents throughout Queensland and the world.
Mr Lichter’s right leg had developed a bone infection before Christmas which was slowly destroying his tibia.
The 27-year-old has since endured five major operations in six months to have the 36-centimetre “scaffold” transplanted his shin to effectively save his leg.
Surgeon Dr Michael Wagels and Queensland Health Minister Cameron Dick discuss the operation with Reuben Lichter and his son, William. Photo: AAP
Mr Lichter said he instantly grabbed at the chance to be the first to receive the revolutionary surgery.
“They (the surgical team) came to me and said there are two options,” he said at the PA Hospital on Friday morning.
“You can be amputated above the knee, or you can try this experimental stuff that may, or may not work and I said: ‘Bam, Do it’.”
Mr Lichter said he had to take the chance with the 3D surgery.
“It was not frightening at all,” he said.
“If there was a chance for me to save my leg and do the things I want to do with my son, then I was going to take it.
A replica of the 3D-printed tibia that was used in the operation. Photo: AAP
“I wasn’t going to lose my leg without having a fight.”
Those things now include taking his eight-month old son, William, skiing when both are older.
“But in the meantime, it looks like he might walk before me,” he said on Friday.
Fiance Caity Bell, 23, told how William was born two days before his father was taken to hospital in severe pain.
Ms Bell had to bring William home from hospital by herself.
“It was very scary,” she said.
“I was by myself, I was a first-time mum and I’d just had my baby and it was just me at home.”
Mr Dick praised the work of the surgical team.
“This is the first time this surgery has been done anywhere in the world,” he said.
“For me, as the Minister for Health, it is very inspiring to ensure that this world-first surgery happened in Queensland.”
The most recent surgery, about two weeks ago, makes sure there is sufficient blood flow to allow the new bone to grow around the outside of the 3D bone scaffold.
Dr Wagels said the 3D tibia “scaffold” was modelled at Queensland University of Technology, where it was “spun” from a polymer.
It was then “printed” in Singapore and brought back to the PA Hospital for the series of operations.
As the new bone grew around the scaffold, Dr Wagels said, the scaffold would slowly dissolve.
Pus inside Mr Lichter’s infected leg was drained first, then prototypes of the 3D shin scaffold were tested and tweaked in earlier operations before the final version was transplanted, Dr Wagels said.
“We needed to work out where we could get tissue that had the potential to grow bone,” he said.
Experimental biomechanical research using live sheep will be used late in 2017 to assess the pace and strength of bone growth around Mr Lichter’s new shinbone.
“We are not willing to take any chances with Reuben’s leg until that biomechanical testing has been done,” Dr Wagels said.
Mr Lichters’s two tibia bones together provided about half of the necessary tissue.
His left knee provided the rest of the tissue, now beginning to grow around the 3D-printed scaffold.
“So we took that from his opposite knee, which also has a blood supply and that needed to be connected back into the existing blood supply,” Dr Wagels said.
Dr Wagels said there was a good opportunity for ongoing medical research.
The design of medical 3D models is well advanced in Queensland, but the printing stage for internal medical applications – completed in Singapore – needs further refinements.
“We see this operation as an opportunity to make this happen here, locally,” Dr Wagels said.
Mr Lichter has been unable to work since September last year.
The couple planned to start a candle-making business as Mr Lichter recovers well enough to begin walking again.
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