For over 30 years, Materialise has been pioneering 3D printing, software and consultancy for clients around the world in aerospace, automotive, and medtech to name a few. With the beginning of the full-scale Russian invasion of Ukraine, the company has been determined not only to keep the business running but also use their expertise to help the people who were injured during the war, and to supply packages of standard implants and medical equipment to local hospitals, in particular, the Lviv Military Hospital and the Lviv Regional Children’s Clinical Hospital Okhmatdyt. We spoke with Andriy Kuzmenko, Medical Software Department Manager, to learn about the initiative started by volunteers of Materialise that provides patient-specific implants to both civilians and the military affected by the war.
I’ve been in tech for the past sixteen years, ten of which I’ve been working at Materialise. I started as a Software Engineer, then worked as a Scrum Master and Team Lead. About five years ago, I transitioned to our medical department. Since then, I’ve been responsible for medical software development in Ukraine. The department runs various medical projects and consists of over 100 professionals.
When I transitioned to the medical department, it wasn’t necessarily a reasoned decision. It was the position of the department manager that attracted me, a different leadership role. Back then, I didn’t know much about the healthcare industry as I don’t have any formal background in medicine. Speaking about healthcare in general, I like it because of the emotional part. Materialise has a great mission aimed at making the world a better and healthier place.
We found a niche where we could be directly useful: helping to treat the wounded, both the military and civilians
The first two weeks following February 24th have been rather chaotic for the company. We mostly focused on finding safe spots to relocate our employees to. We have an office in Kyiv, and at that moment, over 400 people worked there, most of them being based in Kyiv and the northern part of the Kyiv region, including Bucha and Irpin.
We tried to stabilize the situation with people’s relocation while trying to support business processes simultaneously. In the first weeks since the invasion, a huge volunteer movement started, with many charity initiatives. The whole country joined the movement to help the armed forces. We weren’t an exception.
On the one hand, we were supporting volunteer projects financially, on the other hand – my colleague Oleksandr Zakorchenyi had an idea to contact surgeons and look for those who would be interested in using our competencies in treating patients. We saw how many injured soldiers were there. Often serious wartime injuries end up in fractured bones or bone destruction. We found a niche where we could be directly useful: helping to treat the wounded, both the military and civilians.
When bone destruction occurs, the treatment focuses on putting the bone together in the same way as before the injury. The standard approach for this is to conjunct bone fragments together using metal plates. Unfortunately, this way does not always help to achieve a good result.
The bone can be shortened because of destroyed parts, or its anatomical shape may be distorted.
An obvious benefit of this treatment is the fact that the plates are always available in the hospitals, allowing the surgery to be performed within days since the wound occurred, after the patient was admitted and diagnosed.
With the help of the 3D visualization of the wound that a personalized solution provides, a surgeon can better observe the patient’s bone condition and, therefore, decide which bones can still be used, how to conjunct them together, how to replace the destroyed part. The surgeon can prepare for the surgery better and plan every detail in advance. Based on the patient’s anatomy and their specific wound history, an implant that will perfectly match every specific case is created.
If the surgeon decides to use a personalized implant, we work on virtual planning. Together with the surgeon, we make the repositioning of bone fragments and agree on the type of surgery, which material to use, the shape of an implant, and what screws will be used to fix the implant. After this, we prepare the initial version of the implant design and schedule a second meeting with a surgeon. During the next meeting, we discuss the design and correct it based on the surgeon’s feedback. When the surgeon approves the design of the implant, we send the 3D model to a printing lab. 3D printing follows, the timing here depends on the workload of the printing lab. We have previously worked with titanium and PEEK materials. The price for a personalized implant depends on the size and material, but it can range from €200 to €1,500.
In addition to implant printing, we offer surgeons a chance to do a post-surgical analysis, by providing us with additional CT scans so we can compare and analyze the plan and results of the surgery.
One of the key challenges in this project is the fact that there aren’t too many surgeons who work with patient-specific solutions. It feels like we do a lot of educational work. We tell and show local surgeons what can be done and what solutions are already available on the market.
Elsewhere in Europe, insurance covers reconstructive surgeries, hence, personalized solutions are much more popular. Surgeons aren’t limited to what tools they can use. However, due to the war, surgeries for the wounded are now free both for standard and personalized solutions.
Another challenge – surgeons don’t have enough time to learn new techniques. They have experience with standard tools, and due to the increased flow of patients, they prefer to use those. But if a surgeon has worked with us before, they often come back with new cases. Having felt the difference, when they can’t use a standard solution, they approach us to design an implant.
Sometimes, bureaucracy comes in the way – the surgeon might be interested in using a personalized implant, but their management might be against it.
We never meet the patients. We only see their CT scans that help us to imagine what condition they are in. The only time we could actually see the patients was during the Face to Face mission in September when a group of American surgeons visited Ukraine and performed 35 surgeries for both civilians and the military.
We helped with planning 21 surgeries, both reconstructive and plastic surgeries. For 13 patients, we designed implants that were printed and delivered from Materialise’s HQ in Belgium. The mission was broadcasted live for a week. Importantly, it had an educational role as more than 100 surgeons in Ukraine could follow surgeries online. For our colleagues, it was interesting to observe how implants that we created were installed in a patient’s body.
The project started with three people. Through friends, we looked for contacts in hospitals and surgeons that would need help. A part of the job is just finding a surgeon that would be interested in using a personalized solution. I feel like since the beginning of the project, we have managed to get in touch with almost all medical institutions in the country. My colleague Oleksandr Zakorchenyi coordinates the search of surgeons, manages the surgery planning process, implant design and manufacturing. Since the beginning of the initiative, over thirty of our teammates have contributed to various stages of the project.
Early on, we agreed within the company that this is our volunteer project and it doesn’t have to impact our actual work. We continue working on our ongoing projects and focus on the initiative in our free time and during the weekends. It was easier in the summer because there was electricity and internet. Now with blackouts, it’s more complicated. It can be challenging to finish all your work tasks and make sure the business is working smoothly, and to find the time for the volunteer project on top of the regular workload.
The initiative we started nine months ago is extremely important for us because we feel that we can contribute greatly to helping the wounded, and helping the wounded is, in a way, our part in winning this war. With respect to this, we’ll continue searching for surgeons interested in patient-specific solutions. In addition, we plan to start an educational program to teach surgeons how to convert patients’ scans into 3D models and then plan surgeries.
In 2023, there will be similar missions to the Face to Face mission mentioned above organized in different cities. The preparations for the first one, planned for spring, are underway. In addition, we establish contacts with similar projects as we want to strengthen help to wounded people. We want more people to get back to normal lives.
I feel like after the war, Ukrainians will be able in a unique way to adapt quickly to external issues. Now it is more difficult to do with electricity shortages, but we find solutions, we find generators, we try to get the internet in the office to work, or we find ways for people to work from home.
I think military tech will develop quite actively here. Right now, our military uses the most advanced developments of Western companies, testing them on the ground in combat conditions. I think there will be a great demand for military specialists, and the combat experience they gained in Ukraine will be valued. The healthcare domain will also develop, and I’m already seeing several initiatives being launched. There are some companies focused on prosthetics, for instance, Esper Bionics. We will have many wounded people who will need prosthetics. In general, a personalized approach to patient treatment is a global trend. All key players in the healthtech market are investing in custom solutions, hence, they are investing in more sustainable solutions at the same time.
