First Use of a 3D-Printed Bone Implant

In 2015, a 61-year-old British man named Edward Evans became the first person to receive a fully 3D-printed titanium-polymer sternum implant. His surgeon, Ehab Bishay, performed the procedure at Birmingham's Heartlands Hospital after traditional implants couldn't address Evans's complete sternum loss. The implant was developed by Melbourne-based Anatomics using Australia's CSIRO's metal printing technology. Evans recovered without complications or infection. There's a lot more to this remarkable story than meets the eye.

Key Takeaways

• In 2015, Edward Evans, a 61-year-old British man, became the first person to receive a fully 3D-printed titanium-polymer sternum implant.
• The groundbreaking procedure was performed by cardiothoracic surgeon Ehab Bishay and his team at Birmingham's Heartlands Hospital.
• Melbourne-based Anatomics and Australia's CSIRO collaborated to develop the custom implant using advanced metal 3D printing technology.
• CT scan data was used to digitally design the implant, ensuring it precisely matched Evans's unique anatomy.
• Evans made a full recovery with no complications or infection, demonstrating the procedure's remarkable success.

The Patient Who Made History With a 3D-Printed Bone

In 2015, a 61-year-old British man named Edward Evans made medical history as the first patient to receive a fully 3D-printed titanium-polymer sternum implant. Evans had suffered a rare infection that required complete sternum removal, leaving his chest and lungs exposed and preventing him from performing basic activities.

Surgeons at Birmingham's Heartlands Hospital selected him for the groundbreaking procedure, performed by cardiothoracic surgeon Ehab Bishay and his team. The implant, developed through international collaboration between Melbourne-based Anatomics and Australia's CSIRO, was custom-built to match Evans's exact anatomy.

The patient's recovery exceeded expectations — he experienced no complications or infection and regained his ability to walk, sit up, and live a normal life. The titanium implant was coated with porous polyethylene as an alternative to using a synthetic mesh, contributing to the implant's successful integration. Procedures like this are expected to become more common as 3D printing techniques continue to advance and demonstrate their potential in the medical field.

Why Traditional Implants Couldn't Rebuild a Sternum

When Evans's sternum was removed, surgeons couldn't simply bolt in a standard replacement — traditional implants weren't designed for full sternal reconstruction. Steel wires cut into tissue, fracture under stress, and offer no locking mechanism, making them useless against full sternal loss.

Infection risk in traditional systems runs alarmingly high, with sternal wound infections reaching 54.5% in some wire-based reconstructions, forcing hardware removal in nearly two-thirds of affected patients. Wire compression restricts periosteal blood supply, creating conditions where bacteria thrive and bone healing stalls.

Sternal dehiscence complications affect up to 5% of sternotomy patients, demanding reoperation months later with no guarantee of success. For Evans, whose entire sternum was gone, these systems offered nothing structurally viable — a completely different solution was needed.

What Made the First 3D-Printed Bone Implant Technologically Possible

Several converging technologies had to exist simultaneously before a 3D-printed bone implant could become surgically viable. Advanced biomaterials like titanium and PEKK gave engineers biocompatible options that matched bone's mechanical demands.

Metal 3D printing at CSIRO Lab 22 then made it possible to fabricate intricate structures previously impossible through conventional manufacturing. CT scan data allowed digital designs to match each patient's exact anatomy, eliminating the guesswork that had compromised earlier surgical procedures.

Porous lattice architectures encouraged real bone and blood vessel ingrowth rather than simple load-bearing replacement. NanoParticle Jetting™ ceramic printing added another layer of precision, replicating natural bone microstructure at nanoscale resolution. Together, these breakthroughs transformed implant surgery from a compromise into a genuinely patient-specific solution you couldn't have achieved even a decade earlier.

MyBone, developed by Cerhum, demonstrated the full potential of these combined technologies by achieving seven times faster bone ingrowth than currently available bone graft granules. Zirconia-toughened alumina ceramic architecture has also emerged as a defining material breakthrough, producing a bone-like ceramic structure that eliminates the metal-related complications historically associated with spinal and orthopedic implants.

How CT Scans Created an Exact Blueprint of the Patient's Bone

Before surgeons could print a single layer of titanium, they needed an exact map of what they were replacing. CT scans provided that map through a precise segmentation process that isolated bone structures using Hounsfield unit thresholding.

Each CT slice became a digital file capturing exact bone geometry, with slice thickness matching the original scan to guarantee accurate replication. Software converted those DICOM images directly into 3D printer instructions, maintaining high accuracy in organ geometry throughout.

Spectral CT confirmed accurate attenuation profiles across X-ray energies, validating that the phantom matched the patient's actual tissue densities. The result was patient specific anatomic models that surgeons could review, approve, and use to design implants matching real bone defects — making aesthetic and functional perfection achievable where it previously wasn't. The foundation for this entire workflow traces back to Chuck Hull's stereolithography patent issued in 1987, which established the core technology that made printing patient-matched structures physically possible.

Once the CT scan data is sent to a company like Ossiform, it is used to create a 3D model of the implant, which a surgeon reviews and approves before production begins — a process that enables patient-specific bone implants composed of beta-tricalcium phosphate to be printed, sterilized, and delivered directly to the patient's hospital.

How Titanium Became the Material of Choice for 3D-Printed Implants

Titanium's dominance in 3D-printed implants didn't happen by accident — it earned that position through a combination of biological compatibility, mechanical performance, and long-term durability that no competing material could fully match.

Its biocompatibility advantages start with a naturally forming titanium oxide layer that integrates directly with biological tissues, enabling osseointegration without adhesives. You're looking at over 95% success rates in dental implants alone. That same oxide layer delivers critical corrosion resistance features, acting as a permanent barrier against body fluids that would deteriorate lesser metals like cobalt alloys.

Mechanically, titanium's Young's modulus of 110 GPa closely mirrors bone, reducing stress shielding and preventing bone density loss. It's also non-ferromagnetic, keeping patients safe during MRI exams — an advantage stainless steel simply can't offer.

Titanium's role in medicine dates back to the 1940s, when it was first introduced to the medical industry and initially applied to dental implants, laying the groundwork for the advanced 3D-printed applications used in modern healthcare today.

Spinal implants manufactured from titanium may require diameters held within 0.001 mm of specifications, demonstrating just how critical dimensional precision is to ensuring implant safety and surgical success.

How 3D Printing Turned Titanium Powder Into a Working Bone

The journey from loose titanium powder to a functioning bone implant begins at CSIRO's Lab 22 facility, where an enterprise-grade 3D printer fuses Ti-6Al-4V alloy dust into a solid structure one precise layer at a time. Powder selection for biocompatibility drives this choice, since Ti-6Al-4V's stable oxide layer actively promotes osseointegration while resisting infection.

The printer builds customized implant geometries directly from CT-scan-derived digital models, replicating every curve of a patient's sternum and ribs without traditional casting. Each fused layer creates a porous internal architecture that mimics natural bone, encouraging tissue ingrowth. Screw-securing pieces are printed into the implant simultaneously, eliminating separate components.

The result isn't just a rigid prosthesis — it's a structure your body can genuinely bond with over time. Anatomics and CSIRO collaborated to develop this titanium implant as a solution for a patient whose sternum and ribs were affected by sarcoma, a rare form of cancer that traditional prosthetics could not adequately address. This breakthrough builds on the foundational work of Dr. Per-Ingvar Brånemark, who first discovered osseointegration in the 1950s when titanium casings implanted in rabbit leg bones fused irreversibly with the surrounding bone tissue.

The People Who Actually Built the First 3D-Printed Sternum

Behind that titanium structure's precision lies a team of people who actually made it happen. Anatomics, a Melbourne-based medical device company, led the design using high-resolution CT scans and their AnatomicsRx software platform. CSIRO's Lab 22 facility then printed the implant using titanium dust on an enterprise-grade 3D printer.

This groundbreaking medical innovation required more than two organizations. In 2015, Spanish surgeons Dr. José Aranda, Dr. Marcelo Jimene, and Dr. Gonzalo Varela from Salamanca University Hospital performed the actual implantation on a 54-year-old cancer patient.

That international collaboration set the foundation for future procedures. Anatomics Executive Chairman Paul D'Urso and CSIRO Director Dr. Keith McLean jointly developed and patented this world-first titanium sternum and rib implant, proving that cross-border teamwork drives medical progress. The surgery was also prominently featured on the BBC series "Trust Me I'm a Doctor," bringing widespread public attention to this remarkable achievement in reconstructive prosthetics. The US procedure was led by Jeffrey L. Port M.D., an attending cardiothoracic surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, marking the first time this technology was used in the United States.

What the First 3D-Printed Sternum Proved About the Future of Implants

What did one titanium implant prove about the future of medicine? More than you might expect. The first 3D-printed titanium sternum demonstrated that customized implants aren't just possible — they're superior. Improved surgical planning through high-resolution CT scans meant surgeons could design patient-specific structures that replicated bone, cartilage, and tissue with remarkable precision.

The results spoke clearly. Patients experienced reduced recovery time, with the Spanish patient discharged just 15 days post-surgery. Others reported fewer breathing issues, less pain, and no medical side effects. You're looking at outcomes that traditional implants simply couldn't match.

Beyond individual cases, this milestone proved that 3D printing suits complex skeletal reconstruction best, that composite materials like titanium-polymer are viable, and that multinational collaboration between surgery and industry can genuinely transform patient care. The implant itself was developed by CSIRO and Anatomics, whose cross-industry partnership demonstrated that medical device innovation thrives when engineering and surgical expertise work in unison. The procedure was made possible through the FDA's Expanded Access Program, which allowed the use of this groundbreaking technology before it had received full marketing approval.