Detailed Analysis of Individual Stages

Edited CT data acquired during the treatment of a patient after a serious accident are to the
disposal thanks to a longer-term cooperation with St. Ann's Hospital in Brno.
We have commenced a close cooperation with the Faculty of Information Technologies at the
Brno University of Technology presently, which has been engaged in CT and MRI data
editing and 3D models creating long-term already. 3D data acquired in this way should
facilitate an essentially different view of using RP technologies in the construction of knee
joint replacements.

Fig. 8: 3D data of knee joint

It is the aim to make a new type of a knee joint replacement of its femoral part in the main in
the framework of creating an STL file of knee joint replacements. It should preserve partially
the shape of a total knee joint replacement of SVL type produced by Beznoska Company as
standard and get a new surface shape partially in the area of the contact of the femoral part of
the implant with an affected bone. It concerns cases above all when a bone is destructed
fundamentally due to a car accident or a tumour (an oncogenous disease). This part should be
adjusted according to the specific shape of the femur end depending on a CT image of a
particular patient.

Fig. 9 and 10: Reconstructed STL model of knee

joint replacement (SVL Beznoska)
The 3D file (STL) made and edited in this way is used for production ABS pattern by
applying the FDM (Fused Deposition Modelling) method. The use of this semi-finished
product is twofold. It is possible to use this pattern directly for the precision casting
technology on the one hand. Basically, it is a wax pattern replacement. A risk of the ABS
pattern or of the subsequent shell mould destruction is a disadvantage because it is necessary
to reprint the ABS pattern in such a case, which prolongs the production process and makes it
more expensive. Alternatively, it is possible to make a silicon mould using the ABS pattern,
with the help of which wax patterns are cast in the vacuum chamber. Precision casting
technology is applied hereafter. We get a knee joint replacement from the required
biologically compatible material after casting in both cases.

Fig. 11 and 12: Printed ABS model of knee joint replacement a silicon mould
A subsequent verification, measuring, and financial evaluation should help to find out,
whether this way of knee joint replacements production is feasible.

The technology of wax pattern production using

a silicon mould and ABS pattern will be verified also for other artificial replacements than a
total knee joint replacement with respect to very strict requirements concerning the use of
new technologies in medicine. Patterns produced in foundries as a standard will be tested,
too, to get data characterizing the quality of production as precise as possible. Very promising
results have been achieved already in this area in the Institute of Manufacturing Technology
(Dep. of Foundry Technology) from the viewpoint of dimensional accuracy of wax patterns
made in this way above all [8].
Fig. 13: Prototype of wax pattern for investment casting technology
Some castings or wax patterns made using Reverse Engineering method will be digitalised as
a back checking of total changes not only in dimensions but also in shapes, too.The abovementioned technology will be applied also in the production of other total replacements, as an
example of an acetabulum. This problem (the issue of shape and implant fixing to the bone
above all) is being solved in cooperation with St. Ann's Hospital at present.

Fig. 14 and 15: Prototype of a new matal knee joint replacement

7. Conclusions
The main aim of the work was to make a total knee joint replacement using new processes
other than those applied as a standard at present. The work endeavours to get such an implant
that will be more suitable for a patient from the medical standpoint especially thanks to
specific CT data of a particular patient being a base of the procedure. It is true to say that the
target is to produce an implant "tailor-made" for the patient. If material and mechanical
properties of implants made in this way were comparable with implants produced using
standard technologies, it would mean a new way of producing a total knee joint replacement
(any replacement) fast enough obviously for a particular patient under very advantageous
financial conditions. This work is also taking into account the very fast development in the
RP area and tries to make use of the resulting potential, which this technology offers and will
keep on offering in the future. [8]