I have seen a lot in the news lately about 3D prosthetic devices.  Do these work as well as custom made prosthetics?  I have heard they are a lot cheaper.

Answer:
Danielle Hill, CPO
Danielle Hill

3-D printing has been getting a lot of press attention and is a rapidly developing field.  3-D printers allow plastic to be melted and shaped into layers in order to create new shapes.  The shapes are generated through 3-D models created in the computer.  There has been a significant amount of research done on ways to use this technology in the field of orthotics and prosthetics.  You have likely seen many of the ‘success stories’ of devices being printed for a few hundred dollars, in comparison to the thousands it may cost to have a prosthesis made by a clinician.

These stories are very impressive, and show a great potential for the use of 3-D printers moving forward.  However, there are some obstacles with these types of devices that will need to be addressed before they are used for everyday treatment.

The first challenge that we face is the materials used to make the prosthesis.  Right now, the typical prosthetic socket is made with layers of carbon, fiberglass, epoxy, and other materials that create a lightweight, strong socket.  These sockets can withstand significant forces and impacts, which is very important for an arm being used to lift objects or a leg that must withstand forces from walking.  Unfortunately, 3-D printers cannot use these materials.  The plastics that these printers use are not as durable, and tend to be rather heavy, creating durability and comfort issues for the patient.

Another issue we face with 3-D printing is our ability to customize the socket.  Typically, when creating a traditional prosthesis, the practitioner will take a cast of a patient’s residual limb and hand-modify this mold to create the ideal fit of the socket.  Unfortunately, with 3-D printers, this process is very difficult as the mold is much harder to capture and modify.  This can lead to fit and comfort issues, which may also create skin irritation and breakdown.  Researchers are working to improve the technology for socket modification, including 3-D scanners and modification software, but at this time the hands-on approach is preferred by many practitioners.  Additionally, the size and cost of 3-d printing is a challenge for many facilities.  A basic 3-D printer can only print objects that are a few inches tall or wide.  Many of the prosthetic sockets we design are far too large to be made on one of these printers.  Printers that are large enough to fabricate the necessary sockets can cost thousands of dollars, making them cost-prohibitive for many facilities.  Up-front costs for the plastic must also be taken into consideration, which is typically much more expensive than the raw material used to create traditional prosthetic sockets.

Finally, the evaluation and fitting by the clinician must be taken into account.  The stories of prostheses for a few hundred dollars often utilize students in a research facility, operating under a grant or scholarship to do their study.  However, in an O & P office, you are going to be evaluated and treated by a trained clinician.  This clinician will provide you with medical advice, perform any necessary modifications or changes to your prosthesis, and follow-up with you for years to come.  This time and knowledge is also factored in to the cost of the initial prosthesis, as prosthetists cannot charge for time or follow-up appointments.  When you pay for a prosthesis, you are also paying for the peace of mind that you are in the hands of a prosthetist and staff who will have your best interest at heart throughout your treatment plan, and use their expertise to ensure that you continue to progress with your prosthesis.

While 3-D printers show great potential for changing the Orthotic and Prosthetic field, more research will need to be done before they are capable of providing the same quality of device that you receive from your current O & P provider.

Danielle Hill, CPO