3D printed hip implant, pegged as largest in India, conducted on Tanzanian patient

Doctors at a Gurugram hospital have successfully implanted a custom-made 3D printed hip implant, said to be the largest in India, on a 60-year-old Tanzanian patient who had a damaged pelvic bone.

The customized implant was required because the Tanzanian woman Hanifa had undergone three previous hip surgeries due to which her pelvic bone was badly damaged had left very little bony support for the new readily available hip implants.

A team of orthopedics led by Dr Subhash Jangid, Director and Unit Head, Bone and Joint Institute at Fortis Memorial Research Institute, Gurugram performed this difficult and challenging surgery, which took around seven hours.

The hip prosthesis was lying loose in the pelvis and the patient was not even able to sleep because of the pain caused by constant irritation of the surrounding muscles around the implant. She was wheelchair-bound and was barely able to go to the washroom with the support of a walker. Her leg was short by 6 cm because of the damage to the pelvic bone.

Besides this, she was also drained of her finances. After securing the required financial assistance from the government, Hanifa sought the medical opinion of Dr Jangid and his team at Fortis Memorial Research Institute.

After detailed examination and investigations, it was determined that there was a need for a custom-made 3D printed hip implant, for her third-time revision of the hip prosthesis. It was the only hope for her to move again without any support and lead a normal life.

Dr Jangid said, "This is the first time such a large 3D printed customized implant has been used for hip surgery in India. Such cases are very rare and complicated. We had to do a meticulous dissection of the important vessels and nerves supplying the limb as they were very close to the old prosthesis and embedded in the scar tissue of the previous surgery."

"Any damage to these important structures would have disastrous consequences as either the limb may get paralyzed or severe bleeding from major intrapelvic vessels can be life-threatening. We were able to save all important vessels, nerves and intra pelvic organs of the patient," he said.

Dr Jangid said that the team conducted several tests and had multiple virtual discussions (because of Corona pandemic) with a team of engineers. After two weeks of intense deliberations, the team was fully satisfied and confident about the prototype prosthesis. The final prosthesis came after 15 days with all certifications and quality checks.

While describing the challenges of such surgery, Dr Jangid said, "The surgery took almost seven hours as we had to negotiate safely through the old scar tissue and preserve all-important nerves, vessels, urinary bladder and other important pelvic organs. Our experienced team of anesthetists maintained the vitals of the patient during the long surgery. She required only four units of blood despite such extensive surgery. Her post-operative recovery period was very smooth."

"She started walking with support from the next day with equal limb lengths (her 6 cm shortened leg was made equal with this surgery). Sutures were removed after three weeks. She started walking with the support of a cane after six weeks of surgery," he concluded.

Soon after that, the patient was flown to her home country via a special flight because of the corona pandemic.

Talking about this significant achievement, Dr. Ritu Garg, Zonal Director, Fortis Memorial Research Institute, Gurugram said, "We are very proud to be the first hospital in India to conduct such a large, customized 3D print implant during the current pandemic, and our team of esteemed and experienced doctors worked to their full capacity to make this possible.

"The patient has been very satisfied with the consultative and thorough treatment approach and customized solution provided to her," Dr Garg said.

( With inputs from ANI )

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