ICOS™ Explained: How Patient-Matched Custom Implants Are Designed and Built
From CT scan to operating room — the end-to-end workflow behind AK Medical's ICOS custom orthopedic implant platform for tumor reconstruction and severe revision cases.
Standard orthopedic implants come in fixed sizes. For most primary hip and knee replacements, that is enough. But for bone tumor resections, severe revision surgery, and congenital deformities, no off-the-shelf implant fits the defect. This is the problem ICOS™ (Innovative Custom Orthopedic Solution) was built to solve.
The ICOS workflow, step by step
- Imaging — The hospital submits the patient's CT/MRI data.
- 3D reconstruction — Engineers rebuild the patient's anatomy as a digital model and map the planned resection with the surgical team.
- Implant design — A patient-matched implant is designed around the defect, combining solid load-bearing sections with 3DACT™ porous structures where bone ingrowth is desired.
- Surgeon review — The design, trial models, and cutting guides are reviewed and signed off by the operating surgeon.
- Additive manufacturing — The implant is printed in medical-grade titanium alloy, then machined, cleaned, inspected, and sterilized under Class III medical device controls.
- Delivery and surgery — Implant, guides, and instruments arrive as a case-specific kit.
Roughly 1,000 complex custom cases have been completed through this pathway.
Where custom implants change outcomes
- Pelvic and limb-salvage tumor surgery — restoring segments after wide resection without amputation
- Severe acetabular defects (Paprosky III) — custom triflange cups and augments where standard revision shells cannot achieve stability
- Congenital and post-traumatic deformity — implants that accommodate anatomy no standard system was designed for
Why 3D printing is the enabling technology
A custom implant is only practical if a one-off unit can be manufactured with the same quality controls as a mass-produced device. Additive manufacturing makes single-unit production economically and technically feasible — the same printer that builds standard porous cups can build a one-of-a-kind hemipelvis with equivalent material properties and traceability.
Frequently asked questions
How long does a custom implant take? Typical design-to-delivery time is measured in weeks and depends on case complexity and regulatory pathway; urgent oncology cases are prioritized.
Is a custom implant regulated? Yes. Custom devices follow dedicated regulatory pathways (e.g., NMPA custom device provisions in China) with full design documentation and traceability.
Which hospitals can access ICOS? Any partner hospital can initiate a case through AK Medical's clinical support team — get in touch here.