Brett Hager & Becca Thompson 3D Printed Prosthetics Brett Hager & Becca Thompson

NOT for prosthetics :-) 3D Printing Basics How Does it Work??? Much like a regular printer, but instead of using ink uses layers of plastic (or other material!) layered on top of each other to create a 3D structure of whatever was designed Food??? Metals Plastics Aluminum Cobalt Stainless steel Gold & Silver Titanium Yes! ...Chocolate! ...Pasta and meat! NOT for prosthetics :-) Nylon and polyamide: strong, flexible, durable: RELIABLE ABS: Strong PLA: Biodegradable, not durable Works through a process called additive manufacturing (adding layer on top of layer to construct desired item)

Uses in Prosthetics NIH 3D Print Exchange The NIH 3D Print Exchange is a collaborative effort led by the National Institute of Allergy and Infectious Diseases in collaboration with the Eunice Kennedy Shriver National Institute for Child Health and Human Development and the National Library of Medicine. Simple prosthetics primarily for upper extremity Fashion and prosthetic 3D-printed covers growing in popularity http://bcove.me/z8mykift Link is to video about “prosthesis” for little girl for UE’s, maybe start video at 1:30

Uses in Orthotics Capable of producing AFO Insoles Spacers Arch support spacer Various braces SOLS - company that utilizes 3D printing and technology in unique ways to create custom foot orthotics Align Relieve Propel The price is diminished all around as well as the prints are easier to make and also cut down on the amount of labor required for production of the AFO. Excess material, such as that found during the traditional heat molding process, is eliminated as well with 3D printing.

Who is Impacted?? The Common Patient 3D Printing *Estim. 15/100,000 babies with congenital UE anomalies (+ Trauma!!) *Kids outgrow prosthetics *Very Expensive! may lower costs and get kids in prosthetics sooner! 2011: ‘Robohand’ printed by Richard Van As and Ivan Owen Utilizes wrist motion & tenodesis effect to open/close mechanical fingers Open source project; anyone with 3D printer can print Robohand parts estimated that about 15 out of 100,000 newborns are affected with congenital upper limb anomalies, and 6000–10,000 people undergo upper limb amputations each year. Often, kids don’t get fit with prosthetics because they are expensive and the kids outgrow them quickly even though a prosthetist can change joint capsule size 3D Printed prosthetics may be able to help! UE is more common than LE

Meet Ellie *13 years old *Transradial amputee *Trauma induced amputation *Active lifestyle Would 3D printed prosthetic work for her?

Gretsch Et. Al Worked with a 13 year old female transradial limb amputee The overall design is a shoulder-controlled, externally powered, 3D-printed prosthetic arm with a voluntary-open, anthropomorphic terminal device The estimated weight of the prosthesis is 240 g with a cost of US$300. An inertial measurement unit (IMU) is an electronic device that measures and reports a body's specific force, angular rate, and sometimes the magnetic field surrounding the body, using a combination of accelerometers and gyroscopes, sometimes also magnetometers.

Gretsch et al Discussion The patient cited that biggest advantages of the new prosthetic were the individual thumb movement the ability to grasp objects with all five fingers the low weight compared to other externally powered prostheses The patient’s family also noted the design’s financial feasibility The device is inexpensive and the size of the hand and socket can be scaled, users can easily print new devices as they grow older. Limitations short battery life noise from the motors low grip strength of the terminal device low durability of mechanical components

Role for Physical Therapist Stay up to date on what is happening in the development of 3D printed prosthetics and orthotics If you work with patient with a 3D printed P/O, help them to move functionally with it If necessary, refer to another PT or prosthetist who specializes in fitting these devices

What about Ellie?? (and others like her?) Nice interim tool Useful for reach-grasp Not useful for heavy weight bearing activities Not great for sports Would recommend as a short term device until she has finished growing and can be fitted with a more durable prosthetic 3D printing for prosthetics is still a relatively new technology

References Gretsch, K. F., Lather, H. D., Peddada, K. V., Deeken, C. R., Wall, L. B., & Goldfarb, C. A. (2016). Development of novel 3D-printed robotic prosthetic for transradial amputees. Prosthetics and orthotics international, 40(3), 400-403. Printing 3, Printing F, Printing P et al. Medical - Purple Platypus. Purple Platypus. 2016. Available at: http://www.purpleplatypus.com/resources/industries/medical/. Accessed July 10, 2016. Replicator M, Z18 M, Mini M et al. 3D Printing Resources and Tools | MakerBot. MakerBot. 2016. Available at: http://www.makerbot.com/. Accessed July 10, 2016. Scott C, Millsaps B, Millsaps B, Millsaps B, Matisons M. 3d printed orthotics. 3DPrintcom. 2016. Available at: https://3dprint.com/tag/3d-printed-orthotics/. Accessed July 9, 2016. 3D Printing Videos | Stratasys. Stratasyscom. 2016. Available at: http://www.stratasys.com/resources/3d- printing-videos?bcpid=1594609720001&bckey=AQ~~,AAABZHZNdKk~,FM7H3b6my7ZRXiWW3RTJ- Ij4T2dr1Gmp&bctid=1838625224001. Accessed July 10, 2016.

Questions????