3D Printed Personalized Prosthesis For Limbs

The Applications of 3D printing are emerging almost every day, and this technology continues to grow and penetrate more widely and deeply across industrial sectors, as of today, we are only just beginning to see the true potential of 3D printing. The rapid rise of 3D printing has presented the healthcare industry with a massive opportunity. 3D printing could considerably enhance personalization within the healthcare industry. Patients in the past, feel that they are on a manufacturing conveyor belt, failing to receive optimum attention to their needs. With 3D printing, they could receive highly customized medical products, with far more accurate treatment. While 3D printing may not offer the fix all solution, yet it makes medical care more affordable, accessible and attainable.

Healthcare centres can test the 3D printed medical device in early prototype stages and get feedback instantly and improve the design iterations before the final production of the product. Subsequently, time to market of new medical devices is shortening significantly, meaning more patients can get benefit from these innovations. As healthcare requires fast-paced actions to enable rapid decision making in patient care, 3D printing can offer disruptive technologies in a cost-efficient manner.

An estimated 80% of the world’s disabled people live in developing countries. Persons with physical disabilities, who have a need for prosthetics/orthotics and related rehabilitation services in developing countries, represent 0.5% of the total population. Most them are poor and find difficulty in accessing appropriate health and rehabilitation services. This leads to their exclusion from society. With appropriate rehabilitation services, most people with disabilities can become critical contributors to the society and allocating resources to their rehabilitation is a long-term investment.

Low-cost 3D printers are being used in war-torn developing countries, such as the Sudan and Uganda, to make prosthetics for amputees, of which there are 50,000 in Sudan alone.

As the numerous applications of 3D printed materials in healthcare industry increase, the area of prosthetics is something that has been impacted by the rapid advancement of 3D printing. The prosthesis has been around for a long time but until recently very basic design and functionality.  In addition, the cost of the prosthetics is prohibitive and out of reach of many in resource-poor communities across the world. Now with the improvements in 3D printing, this has heralded a new wave of inexpensive yet state of the art prosthesis. This has increased the availability and patients can have customized options which are less expensive than the conventionally manufactured prosthesis. Thanks to the rapid turnaround time, it can be possible to produce personalized prosthetic prototypes. The researchers at U.S Department of Energy Oak Ridge National Laboratory used a 3D printer to produce a prosthetic hand with miniature hydraulics that moves the fingers-The hydraulics rely on the network of integrated ducts in the prosthesis- with no drilling holes necessary.

The medical industry presents with a broad range of opportunities for innovative products, cost saving, and applications in resource-poor communities using 3D printing. The technology is currently well developed and continues to advance, with rapidly falling costs and prices, however for 3D printing to get on mainstream adoption in the healthcare industry- there are still significant hurdles. In the medical industry, the applications are far reaching whether it is printing of organs or prosthetic arm. 

Source:

Heater B. Inexpensive 3D Limbs Could Bring New Hope to Sudan’s 50,000 Amputees. Yahoo! Tech. (2014). www.yahoo. com/tech/inexpensive-3d-limbs-could-bring-new-hope-tosudans-75055744752.html

Image: Oak Ridge National Laboratory Review

 

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Disability: The Role Of Conventional Prosthetic Devices In The World Today And The Impact Of 3D Printing.

Inclusion of people with Disability in the World today.According to the World Report on Disability, there are more than 1 billion people with disability worldwide, about 15% of the global population. Of this number, between 110 million and 190 million adults experience significant difficulties in functioning. It is estimated that some 93 children-or more than one in 20 of those under 15 years of age-live with a moderate or severe disability. The majority would benefit from prosthetics and orthotics services, if available within a country.

Upper limb prosthetic rehabilitation is more challenging, in regions where disability or disfigurement of the body is severely stigmatized, there is social and familial exclusion. Such shunning and exclusion can be very debilitating for young adults, especially children.

Prosthesis work with patients is just a part of the continuum of rehabilitation of the patient. Prosthesis work helps patient to overcome the emotional after-effects of limb-loss, to develop confidence and also the identify their capabilities and perform activities which help them to return to active life in their society.

Prosthetics is a specialty within the field of healthcare technology concerned with the design, manufacture and application of prostheses. Prosthesis (prosthetic device/product): externally applied device used to replace wholly, or in part, an absent or deficient limb segment (plural: prostheses). Common examples are artificial legs or hands.

Orthosis (orthotic device/product): an externally applied device used to modify the structural and
functional characteristics of the neuromuscular and skeletal systems (plural: orthoses). Common examples are braces, splints and supports,

Provision of prosthetics and orthotics devices are usually part of the secondary/tertiary care, habilitation and rehabilitation programs. A prosthesis/orthosis enables a person with a disability or functional impairment to remain active, productive and independent, participate in society and lead a healthy and dignified life. 

A good quality orthosis/prosthesis when appropriate to the user and the user’s environment has a significant impact on the level of independence of the user and reduces the need for formal support services.

The problem of accessing prosthesis devices is acuter in low- and middle-income countries. In this field, charities with non-trained professionals often provide prosthetics and orthotics services meaning that service quality is compromised which results in poor quality and fit. This kind of intervention can also cause secondary complications. Without access to prosthetics and orthotics services, people are often confined to their homes – excluded from participating in society and locked into poverty and isolation.

The current gap in access to such devices will be magnified in the future by the immense projected population growth, especially as the number of older people worldwide increases from 841 million in 2013 (11.7% of the world’s population) to more than 2 billion (21.1%) by 2050.

PICO issues: Effectiveness of prosthetics and orthotics services.

Population: People with physical impairments or limb loss or functional limitations or deformities in limb or spine

Intervention: Provision of prosthetics/orthotics services

Comparator: Non-provision of prosthetics/orthotics services or provision of alternative assistive products (such as crutches, walkers, sitting board with castors, wheelchairs, and tricycles)

Outcomes: Primary: Coverage or access to services; prevention of fall/injuries; prevention of deformities or secondary health conditions; avoidance of premature deaths; disability-adjusted life years (DALY)/ quality-adjusted life years (QALY); better health outcomes (functioning and quality of life); mobility and safety; user’s satisfaction; cosmetic/image; building human capacity; time and physical burden for care services or givers.

Outcomes: Secondary: Human rights; empowerment; economical gain for individual and family; independence; self-confidence and self-esteem; educational and job opportunities; social acceptance; participation and inclusion.

The key important tool for optimum utilization of any prosthesis devices is that it should address the following issues:

Comfortable to the user

  • Reduce the pain
  • Access to services
  • Enable Independence
  • Improved Participation
  • Increase the Quality of Life
  • Cost-effective short-term and long-term

The growth of additive manufacturing technologies has a significant impact on prosthetics applications. This is currently seen in trans-radial prosthetic hands, which enables the needs of child amputees. The 3D printed devices have improved the functionality with fully movable fingers, and some of the devices have integrated artificial intelligence tools, which can resemble the functions of an anatomical hand.

However, there are significant Challenges like:

  • Accessibility-Easily Available Durable, comfortable, and easy for patients to use and maintain
  • Affordability-Cost effective, modern and consistent with international standards with Easy for technicians to learn, use, and repair
  • Availability- Standardized but compatible with the climate in different world regions

The real benefit of 3D printing is when the customer-centric approach is taken to devise innovations, starting from the pain points of construction of patients and the assets of healthcare professionals.

Source:

WHO. World report on disability. Geneva, World Health Organization, 2011

United Nations, Department of Economic and Social Affairs, Population Division. 2013. World Population Ageing 2013