Life Changing Solutions: 3D Printing Prosthetics

Westbrook: I can start diving into that with a bit of my own personal story. I was born without my right hand and went my entire life without any prosthesis or adapted equipment. It wasn’t until I was in high school when I got curious about what the options were for me and others like me. At that time, I realized the world was much bigger than I.

I walked away from that experience thinking a few things: the materials, the manufacturing, and just the traditional process around prosthetics are very outdated. They’re using wood and carbon-fiber, and some of the designs which these clinics provide are very dogmatic. They might say, “We have these five designs.” Or they’ll say, “We have this bionic arm, the latest and greatest device,” but it’s not price-accessible. That’s the second thing. Aside from a lack of innovation, the prosthetics that are advanced and have all of these fancy bells and whistles are not accessible to the greater limb-different community.

And the last thing: when I had my initial consultation, it wasn’t until 6 or 7 months in that I was able to see the actual device, the actual prosthesis. For something that’s really a part of somebody, it’s really important for them to be a part of making it.

And with 3D printing, we can come up with some really unique solutions and designs in a very quick time frame. Compared to 6 or 7 months, with the resources Form5 has now, we could create that initial prototype for somebody in under a week. And being able to include people in the process is something that’s really empowering.

Westbrook: Looking at the trends with additive manufacturing, I’d say it’s in the materials. So with Form5, for example, we’ve been collecting plastics from the community and from industrial manufacturers and recycling them into 3D printer filaments.

We’re looking at ways we can be sustainable in our operations, but also develop a really strong durable material made from recycled plastics. Addressing two social issues, prosthetics and the environment, and marrying them in a unique way that will have an everlasting impact.

Westbrook: Absolutely. That was one of the things I found through my high school research and in starting Form5. There’s a lot of waste that can be accumulated with 3D printing with companies that have large print farms. They accumulate a lot of printer waste. But there are also other styles of manufacturing that generate similar waste that could be recycled into material for future 3D printing.

We recycle a bunch of different plastics, and we’ve explored using some carbon fibers, but there’s more to it.

We often print our prosthetics in much denser settings because we want them to be strong and durable and weather the wear and tear of an average prosthesis. Especially with young kids. But they still outgrow their prosthetics. So sustainability also means that you take prosthetics that are being discarded and reuse that material for future prosthetics. That’s really cost-effective.

Traditional prosthetics cost tens of thousands of dollars. If we take the recycling aspect out of Form5, we’re looking at 250 to 500 dollars to create a custom application prosthesis. But if we can use recyclable material, that cuts our manufacturing costs. We’re not paying for filament for our printers, and it allows us to have an even more positive social impact.

Westbrook: No, it doesn’t. And as Form5 continues to grow and launch a second, for-profit entity – which will focus more on the manufacturing side of the process – we’ll be researching different materials for producing filaments. Ultimately the goal is to market the best and most sustainable material for medical device manufacturing. 

Westbrook: A print farm is just a building with 100, 200 printers A lot of large additive manufacturing companies are now using these print farms. That’s my ultimate goal. You’re starting to see it with automobiles, for example. Honda does a lot of printing on pre-production stuff, like the forms and jigs for putting car parts together.

Westbrook: I would say we already have. With prosthetics, we’re right on that precipice, and I think what will push us forward there, based on current trends, will be the development of a wide variety of materials. Materials will be another revolution in terms of what can be made with this technology and how much you can make with it. They can help us find a way to make prosthetics more accessible by making them more affordable.

And that connects back to sustainability, which is a no-brainer. I think everybody would agree they’d rather have plastics not in the landfill and recycled into a medical device that enhances people’s lives and improves their capabilities.

Westbrook: Absolutely, but we can also use other styles of manufacturing on top of 3D printing – CT scans, scanning residual limbs, CAD designs – so that we can create a custom fit for the individual. We can make a device that looks exactly how they want it, and does what they need it to do.

And obviously, with more printers, we’d be able to increase our output, but I don’t think we would change our style of working with the recipients and creating custom solutions. You could expand your repertoire of designs and commercialize them on a larger scale, but some of those parts would still have to be one-off and custom-built. Not everyone’s limb difference is the same, and not everyone has the same style.

One person might want a bike prosthesis, and the socket of the device is fully attached and locks them into it. Other people want to be able to pull out of the device if they need to. Sure, there are components of the prosthetics where having more printers would enhance the manufacturing. But with this specific industry, it’s so customized and personal that there are parts of it that wouldn’t make sense to be mass-produced.

Do you know about support material?

Westbrook: There are some openings or hollow parts, and the printer needs something in between so it doesn’t cave in on itself. If you had a cylinder, and you wanted to put a top on that cylinder, the printer needs something inside the cylinder to make the top. That’s support material.

It’s often the same material you’re printing everything else in. Some printers have technology that can toggle between the two, meaning you’ll have a material specifically for putting in support and taking it out. That’s called Breakaway. And we could find some more common materials to recycle into something like that for the manufacturing of the final, durable materials. But like I said, where additive manufacturing is headed, there’s going to be a wide variety of plastic material that people will be able to use and ultimately 3D print with less.

Westbrook: Yes. And I would even say that that possibility has already started. With the research that Form5 and others around the country have been doing, a lot of people have started to look at this as something they could be doing themselves, which I think is fantastic.

As an organization that supports the creativity of the community, it’s really cool to see people with limb differences coming up with their own solutions – seeing, for example, a family member’s dad print a prosthetic hand for his son. Those are experiences that really, if anything, demonstrate that the way traditional prosthetic manufacturers have been doing it doesn’t cut it anymore. 

Westbrook: Yes, but to an extent. We’re in a time when technology is moving so fast that we don’t always think about the best next steps. Everyday helper arms, or maybe some smaller-scale adaptive equipment could be printed from home. But there will probably still be a need for some of these custom-application, task-specific prosthetic fits. People at home may not have the knowledge or background to provide the proper prosthetics care for themselves or a family member.

Westbrook: You use different prosthetics for different things. So with prosthetic legs, people may have different blades just for running. Upper limb differences are where the lack of innovation is among traditional manufacturers, in the sense that they don’t provide multiple devices. But a helper arm is more or less for everyday activities: grabbing, grasping, holding, picking things up. These other custom-application devices are more or less for riding a bike, working out – something really task-specific. Much of the time the prosthetic isn’t even like a hand; it’s an attachment that goes on the handlebar of a bike, for instance.

None of Form5’s prosthetics are connected to nerve endings; they’re all body-powered, done by residual limb movement. So I use my elbow to open and close the fingers on the prosthetic arm that I wear. I’m working on one prosthesis arm for working out – like doing push-ups – and one to attach to gym equipment. 

Westbrook: I would say 3D printing has allowed for extreme mass production worldwide of PPE. 

At Form5, for example, our focus has been face shields. With the help of the committee and the medical professionals on our board, it took us four days to design one. We’ve been 3D printing face shields for about five months now. It’s been crazy, but we’ve printed about 6,000 shields with the goal of printing 10,000 by October to donate to the community.

When Form5 first started making shields, there were people in the maker community, with printers at home, who started printing out our designs and sending them into us wanting to help fight the pandemic. It’s been amazing to see people use their creativity, their passion – and their printers, of course – to come together and fight the coronavirus.

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