Patient specific prostheses are constructed through computer assisted design/computer assisted manufacturing (CAD/CAM).

 

Nowadays a combination of 3D print and computer-numeric-control milling is used. Combining the precision of a cone beam computed tomography-based patient-specific instrumentation system and patient-specific positioning guides (incision, cutting, drilling) developed with the latest web technology allows for an ideal fit. 

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A patient matched implant ensures a closer fit to patients’ anatomy as it is constructed to fit the individual anatomy perfectly which reduces the risk for micro-movement and results in more stability and longevity.  The use of templates during surgery is not necessary, reducing the risk of contamination due to fewer try-ins and reducing the length of surgery, as there’s barely any need for adjustments.

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Custom made prostheses are produced with the goal to remain stable even in patients with severe anatomical and bone stability issues for example due to multiple failed prior surgeries, failed materials or severe pathology. Stock prostheses can be difficult to adjust so that it might be necessary to bend the device, sacrifice host bone or shim with autologous bone, bone substitute or alloplastic cement. This is certainly not optimal as it can lead to material fatigue or overload, micro-motion and overall failure of the prosthesis.

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Maurice Mommaerts MD DMD PhD FEBOMFS