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FDA clearance paves the way for Walter Reed to deploy 3D‑printed titanium cranial implants in patient care

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Titanium cranial plate fitted to an anatomical skull model.
Credit: 3D Systems

Remember when we examined in-house versus outsourced 3D printing in healthcare, where the debate is often the compliance infrastructure? Well, with the support of the right partner, Walter Reed has shown what a clinical site can carry. That includes both the quality system and the submission for FDA clearance.

The 3D Medical Applications Center (3D MAC) at Walter Reed National Military Medical Center has received FDA premarket clearance for its Titanium Cranial Plate (TCP) System, listed under submission number K253116. According to the Defense Health Agency, Walter Reed is the first US point-of-care facility with FDA clearance for a patient-specific implant. The implant is also the 3D MAC’s first FDA-cleared medical device.

The patient-specific plate reconstructs complex cranial and facial defects caused by trauma, disease or cancer. It will treat active duty personnel and war fighters with traumatic head injuries. It was designed by Dr Peter Liacouras, director of services at the 3D MAC, a unit within Walter Reed’s Department of Radiology producing anatomical models, surgical guides, implants and custom devices.
The center has been leveraging medical 3D printing since the late 1990s, and the 3D MAC was created at the former Walter Reed Army Medical Center in the early 2000s.

The 3D‑printed titanium cranial implants

Titanium has become widely used alongside polymethyl methacrylate (PMMA) in cranial reconstruction because PMMA, while it restores structural integrity, does not integrate with surrounding tissue. Titanium is biocompatible and can promote tissue integration.

The TCP System’s distinguishing feature is built-in fixation. “One feature of the TCP is that the fixation bars are already incorporated into the design, so you can simply place it and screw it down,” Liacouras said. “You can also plan the fixation locations using the CT scans and the 3D reconstructions. We can get these out quite quickly because we receive the CT scans and do all the design and manufacturing in-house.”

What the regulatory route looked like

The clearance follows work that started in 2020. Liacouras then began coordinating with Dr Beth Ripley of the VA Puget Sound Health Care System. Anticipating tighter FDA oversight of point-of-care printing, the two secured a joint incentive fund to implement quality management systems at both sites.

The Defense Health Agency’s Office of Regulated Activities later sponsored the 510(k). It gained clearance on the first attempt. Biomedical engineer Nikki McMinn noted that this is unusual for a first-time submitter.

3D Systems supported the multi-year effort, contributing process controls, device design optimization, additive manufacturing workflows and regulatory strategy. Natalie Byrnes, Manager of Product Development, Patient Specific Medical Technology at 3D Systems, said: “This clearance underscores the power of combining clinical innovation with deep expertise in additive manufacturing and regulatory compliance. We are honored to help enable expanded access to personalized care delivered at the point of treatment.”

The 3D MAC is now pursuing a PEEK implant, a non-metallic alternative with stress distribution closer to bone. It is also pursuing a custom titanium ridge augmentation matrix designed to support bone regeneration ahead of dental implant placement.

Liacouras also intends to enrol other military facilities as contract designers working under the 3D MAC’s quality management system. They would send design files to Walter Reed for manufacture.

Dive deeper in our dossier on reimbursement pathways for 3D printing in Europe.

Source: FDA — 3D MAC Titanium Cranial Plate System, K253116.

Source: Defense Health Agency — Walter Reed point-of-care clearance.

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