Orthopedics giant Stryker Corp. has long been committed to advancing 3-D printing in its manufacturing. It has completed a facility dedicated to 3-D manufacturing in Carrigtohill, County Cork, Ireland, and is now in the midst of filling it with the latest equipment.

As part of this effort, the Kalamazoo, Mich.-based company now has partnered with GE Additive, which focuses on additive manufacturing that encompasses 3-D printing. The deal includes the provision of new additive machines, materials and services for use throughout Stryker's global supply chain operations.

Stryker has a history of major buy-in for potentially transformative innovation. In 2013, it acquired Mako Surgical Corp. for $1.65 billion in order to integrate it for use in surgical procedures with Stryker implants. It's still in the midst of rolling that out for its products, with the latest in total knee replacement.

Adding to 3-D

"We built an entire building, and we're filling it with 3-D printing machines in Cork, Ireland. We have tremendous demand and interest from basically all of our implant businesses for 3-D printed products," explained Stryker chairman and CEO Kevin Lobo on an April earnings call.

The company markets the 3-D printed Tritanium Posterior Lumbar (PL) Cage, which was cleared by the FDA in March 2016 with a limited launch during the second quarter last year.

Stryker also sells its 3-D printed Triathlon Tritanium Knee System, as well as other 3-D printed knee and hip products. The 3-D printed knee implants, in particular, helped to drive growth in the company's Orthopaedics business last quarter with growth of 7.8 percent to $1.14 billion.

The 3-D additive process allows for substantial customization; the Tritanium PL Cage initially launched with four footprint options, eight height options and two lordosis options. Later, Stryker further expanded those options to include additional sizes and footprints.

"We're in the early stages with Tritanium, very early stages. And we believe that it's going to have broader application. We've had terrific success," said Lobo. "We have a claim that it promotes bone-in growth, which is a really powerful claim with Tritanium."

He added on the prospects for 3-D printed products, "We only had one product that did very, very well last year. We're launching more products this year."

Tritanium uncaged

The company has positioned Tritanium as a platform of 3-D printed implants. It expects to launch a 3-D printed hip cup later this year. The experience with Tritanium products means that Stryker has developed a lot of expertise around 3-D printing titanium. The company expects that titanium is a key metal that it will be using in the future, with interest across multiple Stryker divisions.

Tritanium, a novel, highly porous titanium alloy material, has been in clinical use for more than 10 years with more than 300,000 orthopedic devices implanted.

The latest one and the first spinal implant is the Tritanium PL posterior lumbar cage. It is designed to promote bone in-growth and biologic fixation in spinal patients with degenerative disc disease, grade I spondylolisthesis and degenerative scoliosis.

The device is a part of Stryker's Neurotechnology and Spine business, which is by far its smallest behind Medical Surgery and Orthopaedics. Last quarter, Neurotech and Spine sales grew by 7.7 percent to $515 million – with Tritanium highlighted as a major contributor to growth.

"The biggest part of our growth story in Spine has been our Tritanium, so our 3-D-printed interbody device, there was a limited launch last year, and that's really accelerating," said Lobo in April. He added that Stryker plans to have a "number of new products that are going to be 3-D printed that will be launched over the course of this year" that he said he expected would accelerate growth.

Lobo said that new 3-D printed products will focus on innovative efforts that will enable the elimination of the use of bone cement or create new geometries that didn't previously exist. He noted that there's a "healthy pipeline of demands" from businesses internally to use 3-D printing and that the company is scaling up as quickly as it can to meet those.

Working with GE

Stryker has already purchased Concept Laser and Arcam additive manufacturing machines. GE acquired a controlling interest in both Germany's Concept Laser GmbH and Sweden's Arcam AB last year. The Concept Laser deal was for $600 million, with the price tag for the Arcam deal bringing GE's total investment in the pair to $1.4 billion.

These deals have formed the basis for GE's efforts in additive manufacturing. The conglomerate has also invested about $1.5 billion in manufacturing and additive technologies at GE's Global Research Center (GRC) in Niskayuna, N.Y.

Concept Laser designs and manufacturers powder bed-based laser additive manufacturing machines, while Arcam AB is the inventor of electron beam melting machines for metal-based additive manufacturing

Stryker expects its further expansion into additive manufacturing will enable it to better address design complexity and to create previously unmanufacturable geometries. Last year, Stryker spent $490 million on capital expenditures, driven in large part by the construction of the dedicated additive manufacturing facility in Cork.

"GE and Stryker share a similar vision, and both of us understand the transformative power of additive design and manufacturing," said VP and General Manager of GE Additive Mohammad Ehteshami. "We regard Stryker as one of the most experienced practitioners of metal additive, with a range of commercialized medical products. We will continue to innovate with new additive products, materials and technologies, which will support their growth."

Mako gains traction

Stryker has proven eager to integrate new technologies such as 3-D printing and robotic surgery. The company is in the midst of training surgeons on how to use its Mako robots for total knee replacement, which had a full commercial launch at the American Academy of Orthopaedic Surgeons.

By the end of the first quarter, it had trained more than 200 surgeons on total knee arthroplasty with 40 training locations in the U.S. and another five outside the U.S. There are a total of 350 robots in the field in the U.S., which are being upgraded to do the total knee procedure.

Stryker expects that the Mako robots will enable it to entrench further and expand its market share. At the Goldman Sachs Annual Global Healthcare Conference on June 14, Stryker VP of Strategy and Investor Relations Katherine Owen said that total knee sales are about five times faster in centers with Mako robots in use.

"I think you're going to see Mako pick up around the world. Obviously, the U.S. is going to be the biggest market," said Lobo. "But as you saw even in the first quarter, we sold quite a lot of robots outside the United States. So the meeting was a huge success. We feel very bullish about the TK application with Mako."