Granta’s custom skull implants break the mold for head trauma treatment

Granta is changing the game of how skull implants are created and manufactured for patients who suffer head trauma. Watch the video to learn about its innovative process.

Autodesk Video

March 27, 2019

  • Granta, a small start-up in Mexico City, is disrupting the way skull implants are created and manufactured for head-trauma patients.

  • Taking advantage of their industrial-design backgrounds, Carlos Monroy, CEO of Granta, and Martin Carcaño, head of Biomedical Design at Granta, create custom implants that fit easily during surgery and carry little risk of patient rejection.

  • The process involves using CT scans to create a 3D model of the skull and proposed implant, printing the model, consulting with doctors, and then manufacturing the final implant.

Watch the video to learn more about how they’re changing lives with their innovative process.

View transcript

Ismael Montes de Oca, Adriana’s brother: I remember very clearly that she was speaking to me on that week. The week before everything happened we realized that she had something because she was telling constantly, “I don’t feel good. I feel headache all the time. I feel nauseous.”

Martin Carcaño, Head of Biomedical Design, Granta: The surgeon just put the implant in and the implant just got infected two days later. They had to remove the implant again.

Dr. Pedro Pablo de Juambelz, Neurosurgeon, Hospital Español, Mexico City: The plate that had been previously placed looked very bad, and despite our efforts to make it look attractive, she was left with a very deformed skull.

Montes de Oca: So after the first implant didn’t work that well, we started looking through different options. And my oldest sister Gabriela, she was really into everything, so she started looking and giving the doctor different choices. And we started watching videos about how they were making it, and it looked so precise, looked so good. So we just decided to trust again.

Carlos Monroy, CEO, Granta: Granta is trying to change people’s lives, to improve people’s lives. That’s what we’re trying to do, and we’re starting by creating this skull implant, this patient-specific implant to fix and reconstruct the skull of the patient that had been suffering from a head trauma, neurovascular accident. From a tumor, from being born with deformation, we’re trying to help them.

Carcaño: Her implant was very, very, very tough because it’s not a small implant. It’s pretty much half of the skull, so that was challenging.

Monroy: It’s the easiest to design, probably most difficult to fabricate because it’s a very organic and complex shape. We received the CT scan from the patient. From there we proposed a design that may help to fix the problem, and then we 3D print a model of the skull and the implant that we were proposing. Got it together with the doctor and talk about if it’s the best solution. We manufacture it in a five-axis CNC machine. We manufacture the final implant in the biocompatible material that then is shipped to the hospital to be sterilized. We use material that is completely biocompatible, that is called PEEK—polyether ether ketone—and it’s a material that has many properties. One of them is that the body will not attack the material, and it will not produce an infection.

Carcaño: We’re struggling with the timing because she needs [it] with urgency. We put everything in for her implant.

Monroy: We went along every day and received a phone call from the mom or the husband saying, “Adriana is worse every day. Adriana is coming down. Adriana is getting depressed. Please hurry; please do it as fast as you can. We don’t want to push you, but please do it.”

Carcaño: And then it came the day of surgery, and Carlos and I [were] there in the surgery room and suddenly we find out that this was real.

Monroy: One of the nurses actually said that it was going to take a very long time to do it—that they have tried before, and it didn’t work, and it was going to take a long time. I bet her that it will fit perfectly. When they took out the implant from the sterilized bag, and they put it on the skull, and we all saw that it fit perfectly, everybody was so happy and say, “Great. It worked; it’s fantastic.”

Montes de Oca: Afterwards when I came back and I saw her, her tone of voice was great. She had a little shaking in her hand but it was way better than when I left, and it was a huge difference just to see her loose and remembering what day is it. Like a lot of things, you know? Even joking or having friends over.

Dr. Juambelz: Adriana’s case was the first time this type of implant was used. We are really satisfied with the results and with the technical part of the placement. It helped us a lot to have a very aesthetic implant because she had a very large defect.

Montes de Oca: Since everything happened the doctor told us it was going to be really long and slow recovery, but she has a lot of different therapies right now. Every day she does something different, and it’s great to see her, like, pushed to the limits.

Monroy: The main thing, that it is a software-related innovation, is going from the CT scan—from something that is a series of X-rays—to creating a 3D mold. That has been an improvement in the last, I’m going to say five or probably ten years that has allowed this to happen. Taking that information from a CT scan, I’m creating a solid 3D model—that is the big innovation. I went the next day to meet her, and she received me with a huge smile and said, “Thank you for what you have done for me. You have changed my life.” And in reality, it’s the other way around. The way she changed my life is something that I will always be grateful for. After Adriana, we have designed already something like ten other cases. Out of those, four are already in place.

Carcaño: All my life I’ve been doing design engineering for commercial, let’s say, products. From automotive, from product design, and yes, you could feel that you have an impact in the world, that you’re doing or designing stuff that people are using. But when you start to design something that is so critical for a human being—I mean a part that he or she relies on to live—it has a complete different level. So, I was so excited to be a part of that, and actually when we got our first implant in a person, at the end she’s telling you “thank you”—that’s amazing. That’s a life changer.

Monroy: The greatest reward of what I do is seeing the people after the surgery and seeing that they’re okay. Being able to call them two, three, four months down the line and seeing that they are happy, that they went for a meal together as a family. That is the best thing. The best feeling ever.

Adriana Montes de Oca: It feels awesome. I’m very grateful to God for being alive and to the doctors from Granta for the plate they kindly made for me.

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