3D Printing in Veterinary Medicine

First introduced about thirty years ago, 3D printing has sparked enthusiasm in both human medicine and veterinary medicine. This new, complementary, and innovative medical tool makes it possible to create custom-made products for animals of all sizes. More and more veterinarians are taking an interest in it and expanding its applications to nearly every field of animal health. 3D printing is a technology that emerged at the end of the last century and immediately sparked curiosity. Also known as additive manufacturing, this technology enables the creation of a three-dimensional object by depositing material layer by layer using a computer-controlled printing process. Its potential applications are as varied as the shapes and materials involved. Naturally, this infinite array of possibilities—described as a “new industrial revolution”—quickly sparked particular enthusiasm in many sectors, including the medical field. In human medicine, this custom manufacturing allows tools to be tailored to each patient, thereby pushing certain medical boundaries. Although less widely used in veterinary medicine, 3D printing has nevertheless been gaining momentum in recent years. Bioprinting is a branch of 3D printing that has seen the strongest growth and revolutionary innovations in recent years (models of molecules, cells, and human organs). The bioprinting market, estimated at $100 billion in 2015, is projected to grow by 36% between 2017 and 2022, outpacing many other fields related to 3D printing. As a result, more and more practitioners are taking an interest in it and expanding its applications to nearly all areas of veterinary medicine and veterinary surgery. Its use is expanding primarily around four major medical applications: surgical planning, the fabrication of surgical guides for preoperative use, the design of prostheses and implants, and medical education and training.  

Printing Prosthetics and Implants

With the rapid emergence of 3D printing technology, veterinarians have become interested in its applications across nearly all fields of surgery, particularly in the field of orthopedic surgery. Whether to stabilize fractures or support bony abnormalities in a limb, the spine, or any other bone in the body, 3D printing has gradually become an established part of the therapeutic arsenal in veterinary medicine, largely due to its high anatomical adaptability. Both a Chihuahua and an elephant can thus benefit from custom-made prostheses. The traditional manufacturing process for this type of prosthesis is often time-consuming and expensive. As a result, they were rarely considered as a treatment option for animals. 3D printing has made this type of option more widely available for animals as well, at a lower cost. Over the years, extensive research has been conducted to create bone substitutes using biocompatible materials. Porous metals are among the most commonly used due to their resistance to corrosion and their structure, which promotes osteogenesis. 3D printing allows for the design of customized porous metal models for each animal, used in particular for structural reinforcement, such as an artificial bone. Permanent implants can thus be printed to directly replace failing body parts (a hip, a knee, etc.), but the technology is also used to create more temporary implants, such as plates and screws to support surgical procedures. As with humans, custom-made prosthetics are becoming increasingly common in veterinary medicine. Commercial companies have even entered this field. In December 2014, 3D Systems fitted a dog named Derby with 3D-printed prosthetics. The dog suffered from a congenital malformation characterized by atrophied front limbs. The prosthetics allowed Derby to walk and even run freely. But dogs are far from the only ones benefiting from these anatomical aids, as researchers at Penn State University have already fitted a parrot with a 3D-printed prosthetic leg to help it walk again. Similarly, an interdisciplinary team of veterinarians and researchers specializing in 3D printing in Brazil successfully fitted a blue macaw with a prosthetic titanium beak. In March 2017, a Turkey-based company, BTech, which specializes in 3D implants for humans, printed a titanium prosthetic jaw for an injured sea turtle that was unable to feed itself. Examples have been multiplying over the years. Like human doctors before them, veterinarians specializing in orthopedics say they can no longer do without this technology, which has significantly expanded the range of treatment options and improved the quality of life for the animals involved. The ability to tailor models to each individual now makes it possible to treat increasingly complex cases.    

3D Printing as a Tool for Surgery

But 3D printing is not limited to producing prosthetics for animals. This process also helps practitioners plan and rehearse certain surgical procedures during the preoperative phase. Until now, they relied on various imaging tests (X-rays, CT scans, MRI) to prepare for their procedures. However, 2D or 3D images are often viewed on a two-dimensional surface, which does not allow for a spatial representation of anatomical structures or their manipulation in space. Today, surgeons can create a more accurate three-dimensional model using subtractive or additive techniques. Subtractive manufacturing has the advantage of being inexpensive, but the resulting model lacks precision and cannot be subjected to sterilization if necessary. In contrast, additive 3D manufacturing provides practitioners with a realistic three-dimensional representation of complex structures, enabling surgical planning and simulation prior to operations. These customized tools have undeniable intraoperative utility in facilitating complex surgical procedures. Overall, the use of 3D models prior to surgery reduces preoperative blood loss and the amount of blood transfused, shortens operating time and the duration of anesthesia, and lowers the risk of morbidity and surgical errors. Surgeons are more efficient and work faster during the procedure. In addition, the precision of their movements increases. In short, surgery becomes simpler, faster, and more precise . These models are particularly important in orthopedic and neurosurgery, but their use also extends to soft-tissue procedures. Furthermore, 3D printing enables the creation of customized surgical tools, thereby significantly reducing the time required for complex operations.  

3D Printing in Education

Furthermore, 3D anatomical prints are regularly used in education. Anatomy plays a key role in medical education. It enables students to understand anatomical structures and the spatial relationships between organ systems. It aids in understanding physiology, pathology, and possible therapeutic solutions. Currently, veterinary students primarily rely on cadavers, bones and organs preserved through plastination, 3D simulation software, and plastic models to learn their future profession. Direct handling and the ability to visualize structures in space are believed to promote a better understanding and assimilation of information. In this context, 3D printing offers a new way of teaching—one that is just as effective as traditional methods and reduces the use of animals. 3D models are particularly useful for replicating fragile structures that do not preserve well, such as the brain. In 2017, Schoenfeld-Tacher and her team created three 3D acrylic models of a canine brain based on images obtained through magnetic resonance imaging. These anatomical 3D prints are particularly useful for students, who can practice on them. Just as surgical models offer greater precision to experienced practitioners, simulating procedures provides students with additional hands-on training. Veterinarians use many diagnostic tools, such as ultrasound, otoscopy, and endoscopy, which require training. While simulation and training models for performing these exams do exist, they are expensive and in short supply. That is why several educators and researchers have turned to 3D printing to design simulators.  

A Promising Future for 3D Printing

In veterinary medicine, 3D printing thus offers a multitude of practical applications. From prosthetics and implants to customized tools and anatomical models—which assist both practicing veterinarians and their future colleagues in veterinary training— this innovative technique facilitates the performance of certain medical or surgical procedures and makes it possible to treat animals with complex malformations or anomalies in record time and at a relatively low cost. The use of various 3D printing techniques is becoming increasingly widespread at a rapid pace, but the technology’s potential is far from being fully realized. Now integrated into initial training, 3D printing is expected to become an established part of the daily practice of future generations of veterinarians. Although it is still in its infancy in animal health, its role in the therapeutic arsenal can only grow in the future.