The market for additively manufactured orthopedic implants is accelerating rapidly, driven by demands of biological fixation and personalization. This article explores how additive manufacturing is transforming the hip and knee replacement market.
Over one million hip and knee replacement surgeries are performed in the United States each year, and a quiet manufacturing revolution is reshaping how every one of these implants is made. Additive manufacturing (AM), once considered a niche prototyping tool, has crossed a decisive threshold: today, the majority of orthopedic original equipment manufacturers (OEMs) offer 3D-printed porous implant components as a standard part of their portfolio. This is no longer a technology on the horizon. It is the new baseline, and the industry is only beginning to unleash its full potential.
The new IDTechEx report, "Materials for Bone Implants 2026-2036: Trends, Players, and Forecasts", examines the materials, manufacturing techniques, and market trends shaping the next generation of orthopedic implants. With a particular focus on hip and knee replacement, the report covers the full spectrum of AM applications: from off-the-shelf porous components to patient-specific implants and surgical tools.
Application of additive manufacturing in hip and knee replacement. Source: IDTechEx.
Porous implants
The most established application of AM in orthopedics is the production of porous surfaces for cementless fixation. In total hip replacement, this is most visible in the acetabular shell, the cup-shaped component anchored directly into the pelvis. The intricate porous architecture of these components, with pore sizes typically in the 500-micrometer range, demands a level of geometric precision that conventional casting simply cannot achieve. AM, specifically powder bed fusion techniques, makes it possible to 3D-print the entire shell in a single continuous step, after which machining and polishing give the component its final surface finish.
Titanium alloys are the dominant base materials due to their high strength-to-density ratio and their capacity to allow direct bone bonding. Porous titanium implants often mimic the trabecular structure of natural bone, encouraging bone ingrowth and fixation without the need for cement. Therefore, AM is purpose-built for this application, and it is now the gold standard production method for such porous implants.
Patient-specific implants
Beyond off-the-shelf components, AM is uniquely suited to implants designed around the anatomy of a specific patient. Personalization begins with CT scan data, which is used to model the exact geometry required before production begins. The manufacturing step itself takes only a few days, but the upstream design and planning process can extend the total lead time to anywhere between two and nine weeks from scan to delivery.
The most established custom AM product is the patient-specific acetabular shell, aimed at complex primary cases and, more commonly, revision surgery, where anatomy has been significantly altered by a prior implant. Several smaller specialist manufacturers have made this a focus, although it is worth noting that modern revision shells have become highly modular, with a wide range of augments that can accommodate most revision needs without going fully custom. Custom acetabular shells will, therefore, remain a niche segment.
Custom-made surgical tools
AM's role in the operating theatre extends beyond the implant itself. A growing number of companies now offer 3D-printed patient-specific cutting guides and surgical tools, manufactured from polymers based on patient CT scans. These guides enable surgeons to achieve intraoperative precision that would be difficult to replicate with standard instruments, improving alignment accuracy and potentially reducing operation time. While this remains a secondary market relative to implant production, it broadens the value proposition of AM across the entire arthroplasty surgery.
Outlook of AM as the mainstream production method
AM will gradually become the dominant production method for hip and knee replacement implants. As AM hardware and materials costs continue to decline, the price premium that has historically constrained adoption will reduce further. The logic of adopting AM also extends beyond porous implants to non-porous components, where AM's design flexibility and supply chain advantages become increasingly attractive.
Perhaps the most significant longer-term shift will be the expansion of AM beyond metal. Advanced non-metallic materials, particularly polyether ether ketone (PEEK) and alumina/zirconia ceramics, are attracting growing interest in hip and knee replacement for their superior material properties. AM is well suited to processing both material classes, opening the door to a new generation of implants that combine the geometric freedom of 3D printing with the material properties of polymers and ceramics.
For more details on hip and knee replacement implants, material trends, and market forecasts, see the IDTechEx market report "Materials for Bone Implants 2026-2036: Trends, Players, and Forecasts".
For more information on this report, including downloadable sample pages, please visit www.IDTechEx.com/BoneImplants, or for the full portfolio of Materials, 3D Printing and Healthcare-related research available from IDTechEx, see www.IDTechEx.com.
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