India’s first case, 39-year-old man completed hip revision surgery and implanted 3D printed titanium  Although India is not as leading as Europe and the United States in the field of 3D printing, it is still advancing the application of this technology. On May 16, 2018, Antarctic Bear learned from foreign media that Amit Bhanot, a 39-year-old Indian man, had recently implanted a 3D printed titanium implant. Amit Bano used to be "an ordinary kid who liked cycling, playing cricket and other sports" until 1991 when he began to feel severe pain in his groin and right leg. He then went to different hospitals and received different diagnoses and treatments. At the same time, his right hip lost his mobility. In 2000, Bhanot was diagnosed with ankylosing spondylitis, a severe arthritis that can cause joint fusion. Bhanot's right hip has fused and his left side is beginning to be affected. In 2007, Bhanot underwent a total hip replacement on his right hip. His left hip was also replaced in 2008, and he has since regained mobility. But in 2017, he felt pain again and was told that he might need to complete the repair in a few years. Bhanot, 39, came to the surgical department of the All India Institute of Medical Sciences (AIIMS), the largest public hospital in India. Professor Rajesh Malhotra, the head of orthopedics, pointed out that Bhanot has lost most of his pelvis and the prosthesis has failed. This type of bone loss cannot be corrected with traditional surgical techniques or ready-made implants. Then, Malhotra turned to Sanjay Kumar Pathak and his company Global Health Care, which created the first 3D printed titanium vertebrae in India last year.
 
Pathak said: "After getting the CT scan data, we handed it over to a senior scientist, Dr. Vijay Meena, who runs a government-owned design and printing factory." “Because the metal implants already exist in the patient, the CT data is full of artifacts, and segmentation of the data is a challenge. By separating the existing implants, we have created a lot of bone models and put them on our FDM machine After the first prototype was created, we brought it to Professor Malhotra, just to find out what changes need to be made in the design according to the surgical requirements. In this way, seven prototypes were made one after another, the last one The prototype was approved. I immediately performed 3D printing on titanium and after some problems, the implant was printed with EOS Titanium Ti64ELI."
 

After the 3D printed titanium implant was brought into the hands of Bhanot's doctors, they realized that it was too smooth to be fixed in the cement cup. Pathak went to Gaurav Luhtra and his company Auxein, where the technicians helped create several 2-5 mm corner pits on the implant surface. In addition, a hole was drilled in the implant to fix the implant to the pubic bone with a screw. Finally, the implants were sent back to Professor Vijay Meena and his team, after inspection and ultrasonic cleaning, they were transferred to the hospital for multiple rounds of sterilization. On April 25, 2018, a revision operation was performed. This is a difficult nine-hour operation because it involves a large number of major blood vessels and nerves. But the patient is now recovering well and should be able to walk without pain or mobility. The surgical team includes:
Professor Rajesh Malhotra, Director of Orthopedics
Professor Vivek Trikha, specialist plastic surgeon, for Pelviacetabular surgery and trauma
Dr. Deepak Gautam, specialist in hip replacement surgery
Professor Biplam Mishra, Professor of Vascular Surgery and Expert
Prof. Anjan Trikha and Dr. Manpreet Kaur, Anesthesia and ICU
 
Unfortunately, Bhanot has to go through so many years of pain to finally obtain a perfectly fitting implant and allow him to move completely painlessly, but cases like his will become less and less common because 3D printing will It was used to create a custom implant for the first surgery, and no further revisions are needed. Many patients like him still have pain and movement problems in the early stages of implantation, but 3D printing technology is providing these patients with relief they could not achieve before.