Getting a leg up with 3D printing

A faster, cheaper method of equipping amputees with prosthetics

BY CHIHIRO MIYA

A 2012 Statistics Canada study reported that 3.8 million Canadians are living with a disability as a result of lost limbs. The reasons vary from accidents, to illness. People with such disabilities risk developing an inferiority complex, leaving them feeling as if they are a burden. Although life may be challenging without the use of one or multiple body functions, there is something that can be considered the next best thing – prosthetic limbs.

An artificial or prosthetic extremity helps to improve one’s Quality of Life (QoL). People who have lost a part of their body decrease their QoL regardless of their intention. They are racked with not only a sense of loss but many other negative factors. A 2008 study done by The University of British Colombia says that depression, perceived prosthetic mobility, social support, age and social activity participation may impact QoL after having a lower limb amputation.

18-year-old Leakhena gets ready to try her first 3D printed below-the-knee prosthetic socket as part of a clinical study by Nia Technologies Inc. and the Cambodian School of Prosthetics and Orthotics. 3D PrintAbility Clinical Study, Phnom Penh, August 2016. Courtesy of Nia Technologies Inc.

Nia Technologies Inc. is a Canadian non-profit social enterprise which provides 3D artificial limbs to younger generations who live in developing countries by using a technology called 3D PrintAbility. 3D PrintAbility is the first of their ventures. According to their website, it equips orthopedic clinicians with digital tools to produce high-quality mobility devices faster than with conventional manual methods. The products fabrication tool chain combines 3D scanning, modeling, and printing technologies with custom software and affordable hardware.

David Singh, a product support specialist for Nia Technologies Inc., is the main contact for clinical trial between customers and companies. Singh says that their company uses the nylon filament to create 3D products. The nylon filament for 3D printed prostheses is cheaper, durable and flexible. It is also cheaper and quicker to make in comparison to other formable plastics.

“Our purpose is that we make the 3D model by using perspective design software on the computer, and send it to the 3D printers where it creates a model layer by layer,” Singh says.

Singh also says that the biggest benefit of 3D printing with Nia technologies is speed. They only take a few days to produce the final device for patients, however, the process between scanning and printing the prosthetic limb only take six to eight hours.

“Especially, our goal is a lower cost, and a faster reformation for developing countries,” Singh says.

Singh also says Nia Technologies Inc. has more than 100 patients around the world using their 3D printed devices. Some of the developing countries they aim to support are Cambodia, Tanzania and Uganda.

The reasoning behind Nia’s focus is that 30 million people in low-income countries need prosthetic devices, says Jerry Evans, Chief Executive Officer of Nia Technologies Inc. However, only about five per cent of those people get some sort of attention in that respect. There is a worldwide shortage of prosthetic and orthotic clinicians – approximately 40,000 – who possess the proper training and talent required to handle such projects.

“There are a number of different ways of looking at the problem. We can’t really address the educational or prevention problem,” Evans says.

Evans says that Nia Technologies focuses much of their attention on the younger generation. The reason behind this is that children tend to be the most vulnerable in this group of people that are living with disabilities and it is likely to have a huge impact on their quality of life.

“Children also grow out of their devices more quickly than adults,” says Evans. “So, if a child is born with a congenital condition, they need about 25 prosthetic devices in their lifetime because of their growth. We thought we could potentially achieve a greater impact starting with children as well.”

“If we can increase the throughput with existing infrastructure and clinicians, we will increase it by 15, 20, 25 percent. This represents a large number of people that will perhaps lead more productive lives, and the ripple effect of that is huge, and its also huge for the individual from a self-esteem perspective and their ability too, in the case of children,” says Evans. “So, if we can increase the number of individuals that receive some sort of mobility device, then we have achieved great value.”

The University of Toronto creates 3D PrintAbility with Nia Technologies Inc. Photo by Chihiro Miya

3D printing technology is an important piece for the development and progression of amputees. However, companies don’t seem eager to get involved just yet.

Mark Agro, Chief Executive Officer at Ottobock in North America, says 3D printing technology has seemed to have found a place in developing countries, as well as peaked the curiosity of young, aspiring clinicians.

“I have no experience with 3D printing in prosthetics, so I have no substantive comments. It seems to have found a place in developing countries and as a curiosity for the inexperienced, amateur tinkerer,” says Agro. “It is a tool that generates prosthesis inexpensively; however, what’s missing in almost all cases is the clinical assessment and knowledge of amputation and rehabilitation. A device is of no use if it doesn’t fit well or lacks function,” he says.

Not only with 3D printed prostheses, but traditional artificial limbs are also striving to be a lifelong reliability for patients.

Ottobock in North America was found in 1958 in Minneapolis, Minnesota. The company supports local needs while utilizing a global network of development and clinical expertise.

Agro says that every year they help roughly 80,000 people in North America, with equipment such as wheelchairs, braces and prosthetic limbs. In Canada, they help an estimated 10,000 people.

“I am able to walk much more confidently, and not to concern myself with falling down,” says Steve Wall, who has been an amputee since age 20 after losing his leg in a fluke waterskiing accident in 1987.

This accident turned Wall – a normally extroverted individual – into more of a recluse. Wall had to start rehabilitation with an artificial limb, and needed to have mechanical assistance for a long time.

“That was a frustrating time as a young man because I was just coming out of my teens, and I wasn’t quite a man at 20,” Wall says.

The turning point came to Wall in 2000, when he discovered Ottobock. Once he began using one of Otto bock’s prosthetic limbs his life changed drastically. Its features include being waterproof and having advanced microprocessor prosthetic limbs. After adapting with the prostheses, he can now walk with much more ease.

Since receiving his prosthetic limb, Wall has been participating in the Canadian National Para-Alpine ski team, pursuing a skiing career. The artificial limb gave him back his life, as well as his place in society.

“I hope that people requiring prosthetic do not have a limitation placed on the funding and money,” says Wall. “The province of Ontario and the country of Canada I believe still do great service for people that have lost limbs. They limited their potential because of their inability to get own their technology.”

With the recent innovations in prosthetic technology, people living with disabilities no longer need to feel isolated in their own lives. 3D printing, and other technological advancements, show promise of improving, and making prosthesis more functioning and reliable for future patients.

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