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

2. 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)

3. 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
Link is to video about “prosthesis” for little girl for UE’s, maybe start video at 1:30

4. 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.

6. 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

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

8. 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.

9. 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

10. 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

11. 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

12. 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),
Printing 3, Printing F, Printing P et al. Medical - Purple Platypus. Purple Platypus Available at: Accessed July 10, 2016.
Replicator M, Z18 M, Mini M et al. 3D Printing Resources and Tools | MakerBot. MakerBot Available at: Accessed July 10, 2016.
Scott C, Millsaps B, Millsaps B, Millsaps B, Matisons M. 3d printed orthotics. 3DPrintcom Available at: Accessed July 9, 2016.
3D Printing Videos | Stratasys. Stratasyscom Available at: printing-videos?bcpid= &bckey=AQ~~,AAABZHZNdKk~,FM7H3b6my7ZRXiWW3RTJ- Ij4T2dr1Gmp&bctid= Accessed July 10, 2016.

13. Questions????