Tuesday, June 18, 2024

Replies-3D Printing question Part 1

Following is my original post, followed by replies
Hello All,
I would like to ask a question.  One that I don’t think has been asked openly.  I just saw a clip on ABC World News Tonight about how a child was gifted a 3D printed  BE prosthesis.  This was made by a group of engineers from a major university.  As we all know, the 3D plans are readily available to anyone that wants to print a prosthesis, free of charge.  They said on prime time news it costs $25 to $50 to make. 

Not if, but when someone puts together the programs already available with current prosthetic software anyone can produce a quality prosthesis.  They just follow the instructions for modifying a scanned model.  The whole secret can now be found in software.  It can be reproduced by a novice with computer skills.  Test sockets can be cheaply made until they get it right.  With the constant innovations in materials used for printing they will soon be able to print a foot ready prosthesis.  It will be a while before they can print feet.  The implications are serious for our profession.

I am an orthotist, and talented if I may say.  I have always felt prosthetics was a simple science, although I have never practiced prosthetics (orthotist bias in full bloom).  They can’t reproduce what I do.  But what if they can?  What if one of the geniuses out there can duplicate my techniques and write the program, with my cooperation?   But not necessarily my cooperation, any talented orthotist with proven techniques.  The program could be written and we all could be in a bit of a pickle.
Is this coming?  Is it?  I almost think it will.  Should we prepare?  Will we become THE 3D printing professionals? 

I could elaborate, but don’t want to put you through it.  Thoughts?  I’ll post responses.*****************************Hey Kevin,
I will have to say that it’s just another tool to allow those of us that are good with our hands to be that much better. I have a small facility and have on my leg right now a 1/2 printed AFO. In time you will be amazed how this will make you even better. The key is that it will be another tool in your tool bag. The abilities are going to be priceless for you. But, it’s just a tool. I make a ton of leather AFO’s and the 3D can’t take that away, but it can sure make parts of it easier and above simpler to reproduce. I see it as having the ability for me to be more competitive for what we get paid. I have much to learn, but already is getting close to a asset that you will have to pry out of my dead fingers. 😉
 Warren Hagen320-222-3260www.braceguy.com
********************************Let them have it.  Then let patients get “cheap software designed ” whatever – then let them find someone to actually do all the adjustments, follow ups, problem solving etc.
Yes, in good shop you can make a BK in 2 hrs out the door.  But how much of follow up care does it take by a KNOWLEDGEABLE practitioner thereafter?
Let ‘m have it.
**********************************Hi Kevin,

The advertising/marketing message is false and hurtful (if we as CPOs get alarmed, imagine what insurers and our interdisciplinary colleagues think). I think 3-D printing is similar to Cad/cam (remember when that started getting popular in O&P back in the 90’s?)  Patients still need ‘pt-centered care’. We don’t do a good job of describing our work: all of the $ saved and great outcomes.

– Sue*******************************Its coming. The question is… How do we leverage our skills and capitalize on it?

Tony Wickman CTPO
C.E.O Freedom Fabrication inc.
815 north Main St.
Havana Fl. 32333
850.539.4194
800.304.3733
Www.freedomfabrication.com
Fax 850.539.4195********************************I’m an LPO CPO. Orthotics is in more jeopardy then prosthetics. It’s more to it then it looks with prosthetics. Look at orthotics where we used to make a living fitting the correct back, knee, foot, or ankle brace. Now there are acceptable OTS braces insurances companies are only willing to pay for. The cost of those are being driven down monthly and in most cases a quality product does not meet sustainability for a business. Now complicated gait deficiencies we have the upper hand but reimbursement is being driven to unsustainable levels.
I’m a business owner and I’d say orthotics is at way more risk then prosthetics. Prosthetics is much patient care then orthotics. Look at an orthotics and prosthetics patients notes for a 5 year period. The prosthetic patient is much more time consuming and patient care. I can routinely fit complicated custom braces and have two appointments and have optimal results and the patient may not be seen again for 2-3 years. That just does not happen with prosthetics.

15 years experience with 20k+ patients.
****************************Too bad you’re not as ‘talented’ a writer as you fancy yourselve an orthotist.  Dante Molino, CPO
(I believe he meant yourself)**************************** I remember the very same questions being raised in about 1990 with the introduction of Cad Cam.
I think in weight bearing and bio mechanical applications where aligning and human motion are involved, that it will simply be another tool for us.
I use 3D printing in small animal prosthetics and orthotics and I use my regular Cad carver for large animals and humans.
The key word to me is that “I” use them. I’m also mentoring a High School junior in our industry and allowing him to work and experiment on my equipment. He’s our future. It will come no matter what.
Metal workers made legs in England by hammering metal until it fit the human shape. They were needed then, and our profession will continue until we find a way to regrow limbs or resection parts that are crooked.
Just my opinion,
Ronnie N. Graves BOCPO, CO****************************Mr. Matthews,
  I have 30+ years experience using, and teaching CAD at the university level. I have degrees in Orthotics, Prosthetics and Education. Finally, my company has provided ABC & BOC continuing education and pre-cert classes since 2004. I hold a few ABC and BOC certifications and have sat on various boards and committees over the years. I tell you all of this not to apply for a job, but to humbly qualify my point.

My wife, also ABC certified, and I attended the Academy meeting last spring, as an invited speaker. While there, we attended a session with a panel of speakers relaying information on the future of 3D printing. You may very well have been in the room with the nearly 400 other practitioners there. At the end of their discussion, there was an opportunity for questions from the audience. No one came forward, except me. I asked who the individuals would be that would be the next generation of designers in our field. Technicians? Practitioners? Engineers? Someone else? The answer most given was “We don’t know”. One panel member said he hoped it would be a future generation of practitioner. I also asked where the existing practitioners would get their training. Again “We are not sure”.

Seeing a need long before the meeting, and being a professional O & P educator, we gathered the resources and created the Steampunk Bionics Academy. We are completing our third class tomorrow. Our students have been prosthetists (one being an Academy committee head), orthotists and pedorthists. We teach 3d scanning, 3D design and 3D printing at our humble learning center in Tulsa, OK. Our students learn to use open source scanning, design and printing tools to create foot orthoses, AFO/SMO/UCBL’s, upper and lower extremity carbon graphite and nylon sockets, and yes, even a student designed carbon graphite 3D printed prosthetic foot.

All of our designs are overseen by an orthotist and a prosthetist. All of our classes have been approved for CE’s by both ABC and BOC, some for as many as 40 CE’s. Please visit www.steampunkbionics.com for a look at what we do. Our facebook page www.facebook.com/steampunkbionics/ has near daily posts on student projects.

Its always better to be ahead of the wave, on the shore predicting where it will make landfall, than riding it. Less soggy that way…

Feel free to give me a call Thursday. It’s nearly my only day off from teaching this stuff for the next few weeks.

Best regards and keep the faith,

Rick

Rick E. Sevier BS Ed.
BOC Orthotist, Certified Pedorthist CPOA
Steampunk Bionics Academy a trademark of CFS Allied Health Education
10350 E. 21st Street South
Tulsa, OK 74129
(918) 266-3678
www.steampunkbionics.com

Kevin C. Matthews, CO/LOAdvanced Orthopedic Designs12315 Judson Rd. #206San Antonio, Texas  78233(210) 657-8100(210) 657-8105  fax

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