Orthopedic surgeons can now get their hands on the bones of patients before they reach the operating table – with the help of 3-D printing, according to the new study

Using scans of current patient anatomy, the surgeon's doga flat scan. These models can be shared with patients to give them a deeper understanding of their upcoming surgeries. In the operating room, they serve as a visual aid for the surgeons and their teams.and

"The total number of orthopedic surgeons using 3-D printing at UCSF is higher than anywhere else in the country," said Alan Dang, MD, assistant professor of orthopedic surgery.

It's not just orthopedic surgeons taking advantage of this technology – pediatric cardiologists, radiologists, maxillofacial surgeons, dentists, and prosthetists are among the many incorporating 3-D prints in their work.

Beyond the operating room, the technology is enriching education and being studied for how it can improve patient careShane Burch (right), MD, a spinal surgeon in the Department of Orthopedic Surgery, and Musa Zaid, MD, a research resident in Orthopedic Surgery, discuss to use a 3-D printed spine created from a clinical CT scan of a patient with a spinal deformity. Credit: Barbara Ries

3-D Printing as a Health Care Tool

Printing onsite, at the hospital, renders the 3-D printing a helpful tool, rather than an expensive commodity. A single print can be turned around in less than 24 hours and made with sustainable materials, all for less than the cost of a pair of sterile gloves.

Three-dimensional prints help doctors save precious time in the operating room. For example, with a patient's anatomical in their hands, surgeons can test the fit of surgical implants in advance. Besides saving time on the table, this practice can save money by helping doctors visualize whether a patient needs a pricey or just a standard size.

Surgeons and their trainees can also use 3-D printing to practice procedures. "The trainees can perform the case on a replica of the patient's anatomy before the first incision is made, "said Aenor Sawyer, MD, assistant professor of orthopedic surgery.

As both seasoned surgeons and future doctors make use of the technology, Sawyer and her colleagues are researching if and how their application is improving patient care. They want to know which procedures are rendered safer, cheaper and faster by the use of 3-D printing.

The growth of 3-D printing's use across UCSF and affiliated healthcare organizations were spurred in part by an initiative known as EDGE Labs in the UCSF Department of Orthopedic Surgery. Founded by Alexis Dang, MD, Alan Dang, MD, and Aenor Sawyer, MD, EDGE Labs has established onsite 3-D printing at the UCSF Medical Centers at Parnassus and Mission Bay, Zuckerberg San Francisco General Hospital and the San Francisco VA Medical Center.

Educating Future Health Care Professionals

The next generation of health care professionals is also stepping into the 3-D printing technology mix through access to devices in the UCSF Library and the classroom.

Anyone with a UCSF ID has access to the Makers Lab – a creative space housed on the main floor of the UCSF Library at Parnassus that has 103-D printers open for business. UCSF students, faculty, staff, researchers, and practitioners can use the printers, print-planning software and necessary materials at no cost and can print just about anything they can imagine.

Through a partnership with the Department of Anatomy, the Makers Lab will launch a new 3-D printing elective this fall, called "3-D Printing for Health Science Students." Through the course, the students will learn to transformcommonCT scan into a 3-D model, from start to finish. They can take that knowledge forward to tackle their own, more complex projects.

The new 10-week elective – produced by Anatomy Learning Center Director Derek Harmon, Ph.D., Makers Lab Manager Dylan Romero, and medical student Cecilia Im- boosts the momentum of 3-D printing across campus.

Paving the Way for 3-D Technology

To cultivate the use of 3-D technologies in  health care , the UCSF School of Medicine awarded a grant to establish the Center for Advanced 3-D + Technologies. The center – formed by EDGE Labs, the Division of Pediatric Cardiology, and the Department of Radiology – fosters the development of onsite 3-D printing, as well as visualization technologies such as virtual and augmented reality.

A 3-D model of a skeletal foot sits on the instruction table during an Anatomy 3-D Printing class. The model is one of many UCSF uses to teach Physical Therapy students how to generate 3-D printed models from CT scans. Credit: Susan Merrell

Besides developing 3-D technologies for patient care, the center supports their use for designing and prototyping new medical devices. Onsite 3-D printing allows prototyping to be doneeasily, in-house, rather than outsourced.

Three-dimensional prints can serve as molds for bone grafts, custom splints or patient-specific implants. Alan Dang is currently designing and printing spinal implant prototypes from PEEK, a common implantable material. Sigurd Berven, MD; Safa Herfat, Ph.D .; and Aenor Sawyer are also prototyping spinal implants onsite at Zuckerberg San Francisco General Hospital.

"In the next couple of years, I think we will see an explosion in UCSF-designed medical devices," said Alexis Dang, "thanks to the benefits of 3-D printing."