FEDERAL COLLEGE OF ORTHOPAEDIC TECHNOLOGY

COURSE CODE /TITLE: LOWER LIMBS ORTHOSES POT 123

3 DIMENSIONAL PRINTING IN PROSTHETICS AND

ORTHOTICS
GROUP 3;
ND/POT/2023/391
ND/POT/2023/355
ND/POT/2023/377
ND/POT/2023 /344

ND/POT /2023 /364

ND/POT /2023 /362
ND/POT/2023/349
ND/POT /2023/346
ND/POT /2023 /362
ND/POT/2023/360

ND/POT/2023/359
ND/POT/2023/356
ND/POT/2023/372
Nd/POT/2023/380

Lecturer’s name: MR Salami

Table of content

• Introduction

• Steps involved in 3 dimensional printing

• Materials Used in 3 dimensional printing

• Computer aided device and Computer aided manufacturing in

3d printing technology

• Types 3 Dimensional printed prosthesis

• Benefits of 3d printing in prosthetics and orthotics world

• Challenges and limitations in 3d printing technologies

 INTRODUCTION
Prosthetics is the field of healthcare that deals with the design, manufacture, and fitting of
artificial devices that replace or support a body part, known as a prosthesis.

Orthotics is the healthcare profession that deals with the design, manufacture, and fitting
of external devices, known as orthoses, to support, correct, or protect a part of the body.
Orthoses can be used to treat a variety of conditions and conservatively manage such as
congenital deformities, injuries, neuromuscular diseases, or posture problems.

Three-dimensional printing technology(3D) also known as additive technology is a

technology that enables the creation of physical object from digital designs by layering
materials such as plastic ceramics and metals. This innovative technology has
revolutionalized the manufacturing sector, thereby enabling rapid prostheses and orthoses
production and mass customization

Steps involved In 3 dimensional printing

Step 1: Scan and Optimization
Before the design process of the wrist brace can start, the affected limb has to be
scanned. The scan is a digital representation of the upper extremity and can be converted
into a 3D model. After importing the 3D model file into special CAD software it can be
optimized and sculpted if needed.

Step 2: Design Process

When the scanned model meets all requirements, the design process can start. The first
step is to sketch the brace structure/topology onto the digital model.

The sketch is then thickened and turned into a solid model. To adjust further details, the
limb can be removed from the wrist brace model. After the design process is fully finished,
the model must be exported as a printable .stl file.

Step 3: Simulation
After the export, the structural analysis of the designed part starts by using Finite Element
(FE) simulations. The goal behind this is to determine how well the design of the brace will
support the injured appendage by simulating stress distribution and deformation in the
overall range of movement. The simulation will be custom to the customers’ mechanical
loading and resistance requirements
Step 4:Printing
If the simulation results are within an allowable range, the 3D printing process of the wrist
brace begins. Forward AM offers various certified materials for skin contact that can be
used for orthotics and prosthetics. After the printing process, the brace can also be
optimized with post-processing options like coating.

Step 5: (Optional) Post-Processing

After the printing process, the brace can also be optimized with post-processing options
like coating.

MATERIALS USED IN 3 DIMENSIONAL PRINTING

Materials for 3D printed prostheses orthoses;

Additive manufacturing materials for prostheses must be strong, flexible, and highly
customizable. It’s vital that a finished product matches its user’s anatomy, fits them
comfortably, and works effectively.

Thanks to their strength and flexibility, UV-curable (SUV) elastomers are among the most
common materials used for 3D-printed prosthetic devices. In 2017, researchers developed
the world’s most stretchable 3D printable elastomer, a material that can be stretched by up
to 1,100%.Plastics, such as polyethylene, polypropylene, acrylics, and polyurethane, have
similar properties and are also commonly used in 3D prosthetic printing.

Exciting technological advancements are seeing 3D printers accommodate a much

broader range of materials, including carbon fiber, titanium, chrome alloys, cobalt, living
cells, and other biocompatible materials

When used in 3D printing, these materials produce mesh or lattice structures, which
promote better osseointegration – the structural and functional connection between living
bone and the surface of a load-carrying implant – and reduce rejection rates. The field of
prosthetics and orthotics (P&O) utilises a wide variety of methods to provide custom
devices to patients. Similar to how thermoplastics revolutionized a field mostly grounded in
wood carving, leatherwork, and metal bending digitisation introduced a new strategy for
fabrication.

Computer-aided design and computer-aided manufacturing (CAD/CAM) is an umbrella

term for many technologies that use computer software to design and manufacture both
prototypes and definitive devices. In Prosthetics and orthotics CAD/CAM technologies
include:

• 3D scanners
 • 3D visualisation softwares
• CAD software
• Slicing software
• 3D carvers or subtractive manufacturing (SM)
• 3D printers or additive manufacturing (AM

History of 3 dimensional printing

CAD/CAM was introduced to P&O over three decades ago. One of the first reports of
CAD/CAM, published in 1985, described a “software package” for the manufacture of
transtibial sockets. The second author of this publication went on to develop Vorum, the
first and longest-standing CAD/CAM company dedicated to P&O. Vorum was initially
focused on 3D carvers, which uses a milling machine to carve a foam block based on a
CAD drawing. The first attempts of 3D printing in a Prosthetics and Orthotics specific
application were reported in the early 1990s, about a decade after the first published
patent of any 3D printing technology. These studies described the fabrication of transtibial
socket using stereolithography (SLA), and fused deposition modelling (FDM) with the
Squirt-Shape™ printer.

The prevalence of CAD/CAM technologies in P&O has grown over the past decades with the
advent of new scanners, modification softwares, 3D carvers, 3D printers, and printing
materials. Though many view 3D scanning and printing as a way to reduce costs and
increase access to P&O devices, CAD/CAM is not always synonymous with lower cost.

Current literature indicates a steady increase in adoption of CAD/CAM technologies. A

2021 study indicates increased interest in CAD/CAM from both developed and developing
countries. However, developing countries have faced challenges in adoption such as
accessibility, resources, qualified practitioners, and gaps in knowledge.In the United
States, the 2022 Practice Analysis indicates that 30% of prostheses incorporate CAD/CAM,
increasing from 23% in the 2015 study[7]. Relative to prostheses and orthoses made with
CAD/CAM are entering the field more slowly. However, they show promise as far as
comfort,and optimised material properties.

The Traditional Approach

Before delving into the role of 3D printing, it’s essential to understand the traditional
approach to creating orthotic and prosthetic devices. Historically, these devices were
handmade by skilled artisans, a time-consuming and costly process. These artisans relied
on plaster casts and manual measurements to create custom-fitted devices for each
patient. While effective, this approach had limitations, including the potential for human
error and limited design flexibility.

ADVENT OF 3D PRINTING

The advent of 3D printing has brought about a paradigm shift in the field of orthotics and
prosthetics. This technology allows for the creation of highly precise and customized
devices with unprecedented speed and efficiency. Here’s how 3D printing has transformed
patient care in this context:

Customization: One of the most significant advantages of 3D printing in orthotics and

prosthetics is the ability to create highly customized devices. Scanning technology can
capture precise measurements of a patient’s body or residual limb, ensuring a perfect fit.
This level of customization is crucial for comfort and functionality.

Rapid Prototyping: 3D printing enables practitioners to create rapid prototypes of orthotic

and prosthetic devices. This means that adjustments can be made quickly, reducing the
time it takes for patients to receive their final devices. Patients can also provide feedback
on prototypes, leading to improved outcomes.

Complex Geometries: Traditional manufacturing techniques often struggled to produce

complex geometries. 3D printing excels in this regard, allowing for the creation of intricate
and anatomically accurate designs. This not only enhances the aesthetic appeal but also
improves the functionality of the devices.

Material Innovation: 3D printing has led to innovations in materials used in orthotics and
prosthetics. Materials can be chosen for their specific properties, such as flexibility,
strength, and biocompatibility. This flexibility in material selection ensures that patients
receive the best-suited devices for their needs.

Reduced Costs: While the initial investment in 3D printing technology can be significant,
the long-term benefits include reduced labor costs and material waste. Customization and
rapid prototyping also lead to fewer iterations and less material wastage, ultimately saving
both time and money.
Several real-world examples highlight the transformative power of 3D printing in orthotics
and prosthetics:

Enable Community Foundation: This non-profit organization utilizes 3D printing to

produce low-cost, highly customizable prosthetic limbs for underserved populations
globally. The 3D-printed prosthetics have significantly reduced the cost barrier, making
prosthetic limbs accessible to more people.

Exoskeletons: 3D printing has enabled the creation of exoskeletons and orthotic devices
that assist individuals with mobility impairments. These devices provide users with
increased mobility, independence, and an improved quality of life.

Patient-Specific Orthopedic Implants: Orthopedic surgeons now use 3D printing to

create patient-specific implants tailored to an individual’s unique anatomy. This approach
ensures a better fit, reducing the risk of complications and improving postoperative
outcomes.

TYPES OF 3 DIMENSIONAL PRINTED PROSTHESIS

The four most common types of prosthetic implants are;

• Transradial: A transradial prosthesis is an artificial arm that attaches below the

elbow. It could be active, which means the wearer can control its movement, or
passive, which means the device serves only a cosmetic purpose.
• Transhumeral: A transhumeral prosthesis is an artificial arm that attaches below
the elbow. This is typically a more challenging device to produce, and proper socket
fit is essential.
• Transtibial: Transtibial prostheses are artificial limbs that replace missing or
amputated limbs below the knee.
• Transfemoral: Transfemoral prostheses are artificial limbs that replace missing or
amputated limbs above the knee. As with transhumeral implants, this type of
prosthetic leg is more challenging to manufacture
 Benefits of 3 dimensional printing

• Customization: 3D printing enables the creation of customized prosthetic limbs

and orthotic devices that match individual patients’ needs, providing a better fit and
improved comfort.
• Increased accessibility: 3D printing makes prosthetic limbs and orthotic devices
more accessible, especially in remote or resource-constrained areas, by reducing
production costs and time.
• Lightweight and durable materials: 3D printing allows for the use of lightweight yet
strong materials, such as carbon fiber and titanium, which improve the overall
functionality and comfort of prosthetic limbs and orthotic devices.
• Rapid prototyping: 3D printing enables rapid prototyping, which streamlines the
design and testing process, reducing the time and cost associated with traditional
manufacturing methods.
• Improved aesthetics: 3D printing allows for the creation of prosthetic limbs and
orthotic devices with personalized colors, patterns, and designs, promoting patient
confidence and self-esteem.
• Reduced waste: 3D printing is an additive process, producing less waste compared
to traditional subtractive manufacturing methods.

Challenges and limitations

• While 3D printing has revolutionized the field of prosthetics and orthotics, there are
still some challenges to overcome:
• 3D printed prosthetics and orthotics I created by thin layers of hot plastic so when
pulled the wrong way they can break very easily.
Solutions: Develop new materials with desired and improved qualities
• Cost and accessibility: While 3D printing can reduce costs in some cases, it can
also be expensive, making it inaccessible to some individuals.
Solution: Government’s intervention by providing funds for people who cant access
it.
• Training and education: Professionals in the field need training and education on
the use of 3D printing technology.
Solutions: develop training programs for technicians, offer workshop and
conferences
 CONCLUSION
Three-dimensional printing technology has transformed the manufacturing
landscape of prosthetics and orthotics offering unparalleled flexibility, speed and
customization capabilities. As this technology continues to evolve. We can expect
significance advancement in prosthetics and orthotics leading to increased
efficiency, innovation and sustainability. Therefore by leveraging 3D printing
technology, the prosthetics and orthotics industry can improve patient outcome,
increase accessibility and maximize effectiveness, ultimately enhancing the quality
of life for individuals with neuromuscular and muscular disorders
 Reference
• Anon(2024)3D Heals https://3dheals.com/courses/3d-printed-orthotics and
prosthetics.
• Anon (2023)TechMed3D https://techmed3d.com/blog/evolution-3d-printing-
orthotics-prosthetics-patient-care.
• -Anon physiopedia https://www.physio-pedia.com/Computer-
Aided_Design_(CAD)_and_Computer-
Aided_Manufacturing_(CAM)_in_Prosthetics_and_Orthotics#share
• Guillaume kouyoumdjian(2021)Forward AM Technologies http://forward-
am.com/gain-knowledge/blog/3d-printing-workflow-orthotics-prosthetics-
professionals.
• Heidi Reidel(2017) PreScouter.com/2017/07/3d-printed-prosthetics.
• Ross Laura(2023)3D Printed prosthetics: Manufacturing process, Material and types