Skip to main content

Military Health System

Test of Sitewide Banner

This is a test of the sitewide banner capability. In the case of an emergency, site visitors would be able to visit the news page for addition information.

From Prosthetic Legs to Cranial Implants: How the MHS is using 3D Tech

Image of 3D MAC Director Peter Liacouras. 3D MAC Director Peter Liacouras, in a 2017 photo (Photo by: Regina Randolph, Walter Reed National Military Medical Center).

This is the fourth and final in a series of articles on advances in military health care and technology since the Persian Gulf War, 30 years ago this year. See part 1 here, part 2 here, and part 3 here.

Technology for 3D printing is transforming the Military Health System (MHS).

Advances in prosthetics are helping wounded warriors take on activities like ice hockey, rock climbing, and CrossFit. For combat veterans with severe head injuries, sophisticated 3D printing machines can "print" customized cranial implants to restore damaged skulls to their original shape and density. And using 3D tech to make models for doctors to train on is reducing the time required for surgeries and improving outcomes.

These technologies were essentially unheard of 30 years ago in the wake of the first Gulf War. Yet after some initial advances in the 1990s, the MHS began to rapidly increase the use and application of 3D printing after the start of the wars in Iraq and Afghanistan.

"During these conflicts, we saw our services expand," said Peter Liacouras, director of services at the 3D Medical Applications Center, known as 3D MAC, which is part of the Walter Reed National Military Medical Center in Bethesda, Maryland.

Liacouras was the first engineer brought in to Walter Reed Bethesda for 3D applications. "Our primary goal, in the beginning and for the first five or six years, was the 3D printing and 3D reconstruction from medical imaging," he said.

With "stacks" of CT scans or MRI images, they could use 3D printers to construct life-size physical models for providers to hold in their hands. Patient-specific medical models give surgeons the feeling "like they have been there before," improving outcomes, Liacouras said.

Military personnel printing 3D face masks
Air Force Staff Sgt. Jonathan Bahr, 312th Training Squadron Special Instruments Training course instructor, and Tech. Sgt. Donald Kramer prepare and don 3D printed face shields at the Louis F Garland Department of Defense Fire Academy on Goodfellow Air Force Base, Texas in March 2020. The instructors got the idea after seeing other organizations modeling and printing these supplies to provide for medical facilities (Photo by: Airman 1st Class Robyn Hunsinger).

"One primary application was for the department of neurosurgery, and involved designing custom cranial implants," he explained. "To do this, we would model the skull in the current state, perform mirror imaging techniques, and then adapt the surface by morphing the missing section to the native anatomy. These 'missing sections' were then molded and made into an implantable material."

What started out as a center with two employees and two 3D printers has now evolved into a manufacturing facility with seven employees and more than 10 printers. Materials used for printing include plastic blends, plaster and metal alloys. The 3D-MAC at Walter Reed Bethesda is the largest 3D medical printing facility within the Department of Defense and now incorporates other processes such as 3D scanning, design, and post-production finishing. (See a video overview of the 3D-MAC here.)

3D Printing and Military Medicine

Now, after years of further technological development, 3D printing is being used in the civilian world for everything from toys to architecture to manufacturing. The MHS is using it to enhance beneficiaries' lives by providing pre-surgical models, custom implants, surgical guides, facial prosthetic molds, assistive technology and hand-like devices for amputees.

Specialized prosthetics allow amputees to take part in complex activities such as ice hockey, rock climbing, and cross-fit activities, he said.

Surgical simulators allow providers the ability to practice a procedure before treating an actual patient.

"By printing at the point of care, providers and engineers can work together to solve a particular problem, while reducing cost, time, and the necessity to outsource," he said.

The 3D capability also "aids in [the patients'] mental recovery, by knowing they are no longer limited by their injuries," he added.

A technician at the 3D MAC center works on dental reconstruction
A technician at the 3D MAC center works on dental reconstruction (Photo by: 3D MAC video, Walter Reed National Military Medical Center).

Liacouras said his team went from a lab only producing models of CT/MRI images to now producing dozens of practical items, such as 100 sets of "shorty feet" - devices that help bilateral above-the-knee amputees move like they are walking on their knees. Amputees initially use these devices when they are learning how to walk again, starting them out lower to the ground, and later to walk/lounge around the house, play on the floor with their children, or hang out at the pool. These tasks are sometimes difficult for service members requiring two full-length prosthetics limbs.

Future of 3D

"Our advances in diagnostics in the neuro-imaging space have grown incredibly, including our ability to recreate 3D images of any part of the body," said Dr. Paul Pasquina, a retired Army colonel who is now a professor and chair of the Department of Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences (USU) in Bethesda, Maryland.

"It is really amazing," he said.

The printing of 3D organs is still some distance away from reality, Pasquina explained, but the ability to build "basic scaffolds" of certain cells, body tissues, and nerve-grafting has been a major evolution in the technology. And the more sophisticated 3D imaging gets, the more it has helped service members who have lost a limb. Bioprinting efforts are now being performed, researched, and investigated by staff of USU.

In recent years, 3D MAC has added materials like titanium to the mix. They have also collaborated with dentistry and other departments throughout the hospital to print devices like maxillofacial prosthetic molds, Liacouras said.

Elsewhere, 3D printing is one of four lines of effort meant to push forward the curriculum and instructional delivery at the Medical Education and Training Campus at Joint Base San Antonio-Fort Sam Houston, Texas. The 3D printed simulation models allow students and other trainees to gain exposure to a variety of technological tools and procedures.

Despite these exciting medical advances involving 3D imaging and 3D printing, significant scientific and regulatory challenges remain. Liacouras and Pasquina agree more transformative applications for this technology will need time to evolve.

You also may be interested in...

Virtual Medical Center Awarded for Ground-Breaking Technologies

Article Around MHS
6/6/2023
Zekelia Rembert and Anna Moore, virtual health nurse care coordinators, coordinate virtual health projects and outline participating military hospitals and clinics at the Virtual Medical Center in Fort Sam Houston, Texas, on May 16, 2019. Virtual health nurse care coordinators train nurses at varying military hospitals and clinics while providing each nurse with 3.5 hours of continued education. Moore created the program. (Photo by Jason W. Edwards, U.S. Army)

The Virtual Medical Center at Brooke Army Medical Center will be recognized for four groundbreaking programs at the 2023 FORUM Information Technology Innovation Awards on June 7 at the National Press Club in Washington, D.C.

U.S. Space Force Details Holistic Health Approach, Continuous Fitness Assessment Study

Article Around MHS
6/5/2023
The U.S. Space Force becomes the first service component to use wearables to keep track of their Guardians fitness and other measures of readiness, with the introduction of the holistic health approach. (Graphic by U.S. Space Force)

The U.S. Space Force is implementing a holistic health approach for uniformed Guardians, including a voluntary two-year continuous fitness assessment study to assess and validate a new fitness concept using wearable devices for the service.

Building DHA Network Took ‘Massive Amount of World-Class Engineering’

Article
5/31/2023
Building DHA Network Took ‘Massive Amount of World-Class Engineering’

How do you take almost 400 military hospitals and clinics, over 398,000 users, half a million medical devices, and 9.5 million beneficiaries, from four different networks, and combine them into one sustainable system?

Effective Health IT Reduces Burnout, Improves Patient Care

Article
5/25/2023
Effective Health IT Reduces Burnout, Improves Patient Care

Information technology and its intersection with military health care was at the forefront of a key discussion at the annual Healthcare Information and Management Systems Society conference, held in Chicago, Illinois, from April 17 to 21.

DHA Senior Leader: ‘Virtual First’ is the Future of Military Health System

Article
5/25/2023
DHA Senior Leader: ‘Virtual First’ is the Future of Military Health System

The Military Health System needs to invest in culture change to truly put the patient first.

Navy Medicine at War: Stories of Service and Sacrifice at the Battle of Coral Sea

Article Around MHS
5/19/2023
Throughout the Battle of the Coral Sea, U.S. Navy medical personnel serving shipboard played important roles keeping sailors in the fight while providing life-saving medical care under the severest of conditions. (Courtesy Photo)

The Battle of the Coral Sea was fought primarily by carrier-based planes across this marginal sea off the northeast coast of Australia from May 4 to 8, 1942. Throughout the battle, U.S. Navy medical personnel serving shipboard played important roles keeping sailors in the fight while providing life-saving medical care under the severest of conditions. These are some of their stories.

Imaging Specialists Look Beyond the Skin

Article Around MHS
5/10/2023
U.S. Air Force Tech. Sgt. Leila Liza Smith, a diagnostic imaging specialist with the 6th Medical Group, practices abdominal ultrasound procedures at MacDill Air Force Base, Florida, on ct. 25, 2022. Smith evaluates the images produced by the ultrasound for abnormalities, such as lumps or nodules on the thyroid gland. (Photo by U.S. Air Force Senior Airman Lauren Cobin)

Diagnostic imaging specialists are medical professionals that use imaging equipment and soundwaves to form images of many parts of the body, known as ultrasounds. They are trained to acquire and analyze these sonographic images so that doctors can diagnose and treat many medical conditions.

Defense Occupational and Environmental Health Readiness System – Hearing Conservation (DOEHRS-HC)

Fact Sheet
5/8/2023

The Defense Occupational and Environmental Health Readiness System – Hearing Conservation (DOEHRS-HC) is an information system designed to support personal auditory readiness and help prevent hearing loss through early detection.

Department of Defense Investing in Wearable Technology That Could Rapidly Predict Disease

Article Around MHS
5/8/2023
U.S. Air Force Airman Katiha Falcon wears a watch at Hill Air Force Base, Utah, on Dec. 3, 2020. The wearable technology is part of a study with the Defense Innovation Unit that will allow detection of illnesses such as COVID-19 within 48 hours. (Photo by Cynthia Griggs, U.S. Air Force)

The Defense Innovation Unit, in partnership with the private sector, has developed a wearable device that was highly successful during the COVID-19 pandemic in identifying infections.

Lab Professionals Play Key Role in Public Health and Patient Care

Article
5/2/2023
Lab Professionals Play Key Role in Public Health and Patient Care

Lab professionals provide value to the MHS and DHA communities.

Crosland Discusses Dawn of Digital Health at HIMSS 2023

Article
4/28/2023
Crosland Discusses Dawn of Digital Health at HIMSS 2023

“My priorities as a combat support agency are about health of the force, and the redesign of our health care system is about health of our patient,” said U.S. Army Lt. Gen. Crosland. “And as an agency, it's about health of our people.”

Blanchfield Army Community Hospital ICU joins DHA’s Joint Tele-Critical Care Network

Article Around MHS
4/18/2023
Blanchfield Army Community Hospital Intensive Care Unit Chief Nurse U.S. Army Maj. Brenda Mitchell preforms a communication check with a nurse at the Defense Health Agency Virtual Medical Operations Center at Naval Medical Center San Diego, California, using the Joint Tele-Critical Care Network, on March 27. (Photo by Justin Moeller, Blanchefield Army Community Hospital

Blanchfield Army Community Hospital is the latest military hospital or clinic in the Military Health System to join the Defense Health Agency’s Joint Tele-Critical Care Network. The JTCCN virtually integrates 24/7 access to highly skilled critical care physicians, or intensivists, from DHA medical centers, or hubs like Naval Medical Center San Diego and Brooke Army Medical Center, with satellite intensive care units at nearly 20 military hospitals or clinics worldwide.

Like a Cable Boss: Connecting Medical Technology

Article Around MHS
4/12/2023
U.S. Air Force Senior Airman Andrea President, a medical information service systems technician, 379th EMDSS, demonstrates using a cable testing device at the 379th EMDG radiology lab at Al Udeid Air Base, Qatar. (Photo by U.S. Air Force 1st Lt. Bayard Lewis)

Inspecting and connecting tiny wires may seem like a small task, but it’s one that has a big effect on medical care that military patients receive in deployed locations like Qatar.

American Medical Center in Europe to Celebrate 70 Years

Article Around MHS
4/10/2023
U.S. soldiers, airmen and civilian staff at Landstuhl Regional Medical Center  provide care to U.S. service members and Afghan civilians who were injured in a series of attacks outside of Hamid Karzai International Airport in Kabul. (Photo by Marcy Sanchez, Landstuhl Regional Medical Center)

Landstuhl Regional Medical Center is slated to host a week-long celebration, open to all Department of Defense cardholders, marking 70 years of selfless service and military medicine in Germany, from April 11-14.

5 Reasons to Download MyCare Overseas App

Article
4/6/2023
5 Reasons to Download MyCare Overseas App

If you live overseas, the MyCare Overseas app makes it easy to manage your health care at home and on the go.

Page 1 of 15 , showing items 1 - 15
First < 1 2 3 4 5  ... > Last 
Refine your search
Last Updated: January 31, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery