On a recent media tour of innovative Dutch medical facilities we were privileged to visit XILLOC, a company based in Geleen, a city in the south of the country, just outside of Maastricht. It’s a small firm that focuses on patient-specific 3D-printed titanium implants, but also does related work for the auto, aerospace, and other industries that have unusual manufacturing requirements. It was founded in 2011 within the Maastricht University Medical Centre by Maikel Beerens as a spinoff of Maastricht Instruments B.V., a company that develops new medical technologies in the pre-approval stage.
Maikel has been running the firm ever since, building a product portfolio, expanding the available materials used during printing, and offering customers (surgeons and others) the opportunity to take advantage of XILLOC’s expertise. Nevertheless, work in the other industries is meant to support expansion of the firm’s efforts at making 3D printing more widely used for medical applications.
XILLOC has been doing a lot of work in cranial reconstructions and within the face, replacing critical bones with custom manufactured implants made of titanium, PEEK (polyether ether ketone), ultra-high-molecular-weight polyethylene (UHMWPE), and poly(methyl methacrylate) (PMMA). Since each material has its own benefits and drawbacks, the surgeon can decide which to go with depending on the specific needs of each case.
The manufacturing process involves performing a CT scan on the patient, which is uploaded to XILLOC’s computer for a review. The company sends back a a quotation based on the case, and once approved the surgeon works with the implant designers on the important little details. After validation, the 3D file is sent to the printer.
Maikel showed us one of the printers, but also the more impressive next generation machines which were still sitting within wooden shipping boxes. They’ll now be using the additive manufacturing machines, including EOS M 400 for metal and EOS P 396 for printing using polymers.
But to show us the clinical impact of 3D printing in clinical practice, Maikel gave us an example of a patient, Marc, whose life was saved because of a titanium implant. Marc was involved in a biking accident and suffered a serious concussion. His brain swelled to such a degree that an entire section of the cranium was removed to relieve the intracranial pressure. In the meantime the sections of bone that were removed were preserved inside an incision in Marc’s belly and are then months later, in a series of surgeries, re-implanted back where they came from. One of those surgeries failed, with serious issues that followed, and he was advised to receive a patient specific implant based on a CT scan of his head.
The part was designed, printed, and implanted into Marc’s head, and since it’s titanium it doesn’t get infected, has just the right shape, osseointegrates with nearby tissue, and is way stronger than the original! Considering the high failure rate of re-implanted bone, the 3D printed implants have a lot going for them. Currently they’re expensive and new, and it will take time for adoption to progress. But certainly 3D printing of implants is one of the huge new medical technology industries that’s still in an infant stage.
We’d like to thank Maikel for an enlightening lecture and tour XILLOC’s research and development facilities. Seeing how specific patient implants were being designed, we could not show you more photos of the facility. Rest assured there’s a small group of dedicated folks that may not be inside a hospital, but are improving and saving lives of real patients.