‘Off the shelf’ bone replacements offer life-changing help to landmine victims

The Guardian
Ben Quinn

Mohammaed Mahdi, who lost his foot in a mine explosion in Kabul. He is among the thousands of people injured or killed by landmines each year. Photograph: Emilio Morenatti/AP

They are the hidden killers that maim or kill more than 4,000 men, women and children every year, in countries around the world. Recently, the challenge posed by landmines has been compounded by the increasing use of improvised explosive devices (IEDs).

“Every country has its own challenges,” explained Damian O’Brien, a programme manager for the international demining agency the Halo Trust, on a visit back to Britain from his ongoing work in Afghanistan.

“One of the problems in Afghanistan, for example, is the sheer density and the widespread availability of munitions which have fed conflicts. People are still digging things up and scooping out the explosives from anti tank mines to create IEDS.”

Injuries inflicted by mines or IEDs can be devastating. However, technology being developed to produce synthetically grown “off the shelf” bone replacements could prove life-changing.

A team behind the new £2.8m regenerative medicine project at the University of Glasgow are using a 3D printer to create bone “scaffolds”. The scaffolds are coated with nanolayers of a growth substance known as BMP-2 and stem cells.

They are then placed into a specially designed machine known as a Nanokick, developed at the university, which shakes the bone scaffold 1,000 times per second to stimulate the growth of bone tissue. When completed, it should be possible within three to four days for technicians to create tailor-made bone pieces from tissue that will continue to grow when implanted in the body.

“In principle, the technology is very flexible and can be used for the needs of all sorts of different patients, including children,” said Professor Manuel Salmeron-Sanchez, the project lead.

“The aim will be to create a bone which can then be ready to be delivered in a couple days anywhere in the world and which can then be used on a human being to minimise the impact of the injury as soon as possible.”

It is envisaged that the process of manufacture could be exported. “In the future there is the possibility that we could have small 3D printers in place in different countries with basic surgical theatres where the technology could be incorporated,” he added.

The Nanokick, which shakes bone scaffolds to stimulate the growth of bone tissue. Photograph: Courtesy Nanokick Technologies

Lou McGrath, CEO of the charity Find a Better Way, which is funding the project, said it could herald an important breakthrough for landmine blast survivors. “Advances in reconstructive surgical techniques now encourage trauma surgeons to retain as much of a limb as possible, instead of quickly amputating above the knee,” he said.

“In many cases, the amount of bone that can be recovered is a limiting factor in how much of a leg or arm can be salvaged. With the developments from this project, we could reach a situation where it is only the limitations of surgical techniques, not the amount of viable tissue remaining, that determines the outcome.”

Children are particularly vulnerable to landmine blasts. In 2015, there were 1,072 recorded child casualties from mines or other explosive devices, according to Landmine and Cluster Munition Monitor. The figure included 347 deaths and 725 injuries. However, the actual number of child casualties is believed to be far higher due to the difficulty in collecting data in hazardous environments.

As well as current conflict zones, countries such as Cambodia and Angola are still dealing with casualties from landmines. Earlier this year, Ukraine launched an operation in its war-torn east to defuse landmines laid across thousands of hectares of land.