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Delcam software helps surgeon provide alternatives to amputation

All machining at ISIQU is programmed with Delcam’s PowerMILL
All machining at ISIQU is programmed with Delcam’s PowerMILL

A range of Delcam software is being used by ISIQU Orthopaedics to design and manufacture custom-made bone and joint implants in patients with tumours and major bone loss.  In most cases, the only alternative to the implants would be amputation of the affected limb.

In the past three years, more than 250 people, of whom around 90% were under 30 years old have had life-changing, or even life-saving, surgery from ISIQU, which is based near Cape Town in South Africa.  Typical patients include a 19-year-old woman whose arm and scapula were saved from bone cancer, and a 70-year-old man diagnosed with a malignant tumour in his lower arm.

"We have been using Delcam products since the start of ISIQU’s manufacturing operations,” explained Director, Dr. George Vicatos.  "With the complexity of our work, we didn’t have a big selection of CADCAM products from which to choose.  The way that Georgio Yannikarkis from our reseller, Aztech, presented the software made all the difference.  In my mind, there were no other products on the market that offered the versatility, power and precision needed for our work.”

The ISIQU process begins with information from the patient, which comes either in x-ray format, or as an MRI or 3D CT scan.  If it is in the first two formats, the image is scanned and digitised, and the basic dimensions obtained to help in the design decisions.  If it is in CT scan format, it is first converted to an STL file format, which then is imported into Delcam’s CopyCAD reverse engineering software.  In this software, the STL file is converted into surfaces to produce a digital model of the skeletal part that will be replaced with the implant.  The surfaces produced by CopyCAD, or the dimensions from x-ray or MRI scans, are imported into the PowerSHAPE CAD software in which the design of the implant is completed.

The final design is passed into the PowerMILL CAM system, which is used exclusively by ISIQU technicians to program the company’s five-axis DMG milling machine.  "I do not believe that any other software in the market could create the programs as quickly and as easily as PowerMILL, especially with the complexity of the surfaces that we machine,” commented Dr. Vicatos.  "The programming and machining times for our implants are crucial.  We always produce custom implants and sometimes we have only two days’ notice before the operation.”

"Our implants are machined exclusively of a medical grade titanium alloy,” added Dr. Vicatos.  "The material offers superb compatibility with the skeletal structure, not only because the body tissue accepts it, but also because of its elasticity and light weight.

However, it is an unforgiving material if any aspect of the machining is not perfect.  We have studied technology that has been developed for cutting titanium in other industries when setting speeds and feeds, and, as well as having the best software, we use the best cutting tools that the market can provide.”

"The time constraints that we work under mean that the complete process from receiving the patient’s data, to the design, to the programming, to the machining and to the finished implant has to have no surprises that would delay the operation,” commented Dr. Vicatos.  "Although the process seems to be complicated, with the Delcam software, it is in fact straightforward and fast.  Most importantly, I feel comfortable that the patient will get exactly the implant I have designed, and this is what counts.  It would be difficult to undertake any of the surgery we perform without the software; it many cases it would be impossible.”