In a previous article, Are prosthetics Obsolete? Priced out of The Heal Game, we took a look at the state of the prosthetics industry, which is in a state of disrepair due to costs. Particularly in countries such as the USA, or UK, where an individual's healthcare is determined more by beancounters than it is by doctors, prosthetics that can truly help a patient, are rarely given to them, as there are cheap and nasty, mass produced fittings which, although they have often been proven to do further damage to the body, are simply more competative pricewise, than their advanced bretheren.

Why give a patient a new knee for example, which allows their leg to bend and flex naturally, restoring full mobility to them when you can fit them with a non-functional, purely cosmetic, steel rod for less than a quarter of the price? This pricing war has driven the most advanced prosthetics to the margins for decades. Yet, there is now some hope. A technology which is beginning to revolutionise prosthetic manufacture and other niche industries where mass production is simply not an option, is finally here.

3D Printing

When the Are Prosthetics Obsolete? article was published, in mid 2005, 3D printing was much cruder, and had never been used to make medical devices. At the time, it was only advanced enough to print out clunky electronics. To quote our findings at the time:

3D printing - also known as "rapid prototyping" - transforms a blueprint on a computer into a real object by building up a succession of layers. Recently as of writing (June-August 2006), 3D printers have been able to print moving parts accurate enough to churn out cheap UAVs (Unmanned Arial Vehicles). Whilst nowhere near the precision engineering of a knee, the ability to 3D print UAVs demonstrates how quickly 3D printing is maturing. Within a decade it may very well be possible to 3D print limb prosthetics, slashing the cost apart.

It seems that our estimation of "within the decade" may have been a little conservative. Whilst limbs are not being printed yet, we are getting surprisingly close, just six months after publication.

Cheap 3D Printers

Last month, acheap, self-assembly unit, costing little more than a new PC, was unveiled. The Fab@Home "fabber" (pictured below) was made by Hod Lipson and Evan Malone from Carnegie Mellon University, in the USA. It drastically dropped the cost of a commercial-quality 3D printer, from a previous range of $20,000 - $1.5 million, right down to $2,400 (£1,100).

The Fab@Home "fabber", assembled ready for use

The standard version of their Freeform fabricator ? or "fabber" ? is about the size of a microwave oven. It can generate 3D objects from plastic and various other materials. Full documentation on how to build and operate the machine, along with all the software required, are available on the Fab@Home website, and all designs, documents and software have been released for free.

Medical 3D Printing

The timing of this event could not be better, as this month sees the first concerted effort to use 3D printing techniques to produce prosthetics - completely revolutionising their production.

PhD student Domenic Eggbeer, presently studying at the National Centre for Product Design & Development Research, in the UK, has made use of rapid prototyping technology to advance the science of making facial prosthetics, by about forty years, overnight.

Because every face is different, mass production techniques have never been possible for facial prosthetics, and the techniques used today throughout the world, have not changed in four decades.

To begin with, skilled sculptors work with wax, to create the shape of the prosthesis. The wax is then used as a template to constriuct a mould sealing in every contour and crevice of the wax, and finally that mould is used to create a silicone implant, which is finally implanted. This whole process can take three or four days to complete, and the patient has to be present for nearly all of this time, as the sculptor constantly has to refer back to their face, whilst making it.

The skin texture is the most important part, and to make it look realistic, the wax is combed with toothbrushes, indented with orange peel, anything to try and impress the look and feel of skin. Machine vision can analyse a face in the time it takes to perform a CAT scan - or even a series of mugshots, and produce an accurate replica virtually, even down to the texture of the skin.

What they have lacked until now, is a way to make that virtual model, flawlessly physical. Enter Domenic, and a 3D printer.

References

Are prosthetics Obsolete? Priced out of The Heal Game

Fab@Home

The National Centre for Product Design & Development Research, UK

Rapid Prototyping from CT Data Wins Award - Domenic Eggbeer
Permalink sadly not available due to site design, look for title "Prestigious IMPT Award for PDR?s Medical Applications Group"