One of the most common cancers in dogs is osteosarcoma (bone cancer). Typical treatment includes amputation, but for some patients, amputation is not an option due to neurologic or orthopedic issues, such as arthritis. The limb-spare technique developed by Flint Animal Cancer Center’s founding director Dr. Steve Withrow provided a solution for those patients (and human patients too). While a saving grace for many, it also comes with complications. Common challenges include infection, biomechanical failure, and local recurrence. Of these, implant failures – plate breaks, screws pulling out – occur in up to 60 percent of cases in pets.
FACC-trained surgical oncologist and associate professor, Dr. Bernard Séguin is hoping to use 3-D printing technology to overcome one or more of these challenges.
“This project came along as I was trying to think of a novel way to reduce the complication rates with traditional limb-spare surgery,” said Séguin.
Conventional implants are straight, which limits how well they fit and consequently increases the stress on the implant and bones when a patient places weight on the treated limb. Séguin hypothesized that implant failure would be reduced if the implant was designed to fit the shape of the bones of each dog. In his pilot study, Séguin worked with engineers at the Department of Mechanical Engineering at École de Technologie Supérieure in Montreal to 3-D print personalized implants using the patient’s CT scan images.
The pilot project included five patients. Séguin completed the first surgery in September 2017 and the final surgery in late December of that year. Before drawing any conclusions on his premise, Séguin will follow each patient’s progress for the next few years.
While no two patients responded in the same way to their 3-D implant, infection has been a challenge for most. Séguin has some ideas on how to address that using 3-D printing.
“I’m thinking about how we might be able to use the implant itself to address infection,” said Séguin. “Moving forward, I’d like to explore coating the implant with silver, which has antibacterial properties, or antibiotics.”
While results are still pending, Séguin believes he’s learned enough to continue to explore the potential of this personalized approach to limb-spare surgery.
“I’m excited about this technology, and as we work on refining the process, I’m hopeful we’ll address two of the major complications with traditional limb-spare surgery for both our patients and human patients as well.”