3D printing technology can streamline the process of fabricating a prosthetic limb, speeding up the time the prosthesis gets to a patient. As a result, patients dealing with limb loss can more quickly regain their mobility, and ultimately reach a higher quality of life.
Here, we explore the different phases of prosthetic care, the role 3D printing plays in the design of the prosthesis, and the advantages of 3D printing over traditional prosthesis design and fabrication.
Phases of Prosthetic Care after Amputation
After limb loss, patients will go through a number of phases before they can get a prosthetic limb. For example, to promote the proper healing of the limb, patients must undergo rehabilitation. This usually involves exercises for general conditioning and strengthening.
In order for the prosthesis to fit correctly, the stump or residual limb—the part of the limb that’s left behind after amputation—must shrink. Without shrinking, fitting and wearing a prosthetic would be much more challenging. This is because swelling from the incision can hinder the residual limb from forming the optimal shape for a prosthesis.
Below are the different phases of prosthetic care in more detail and what limb loss patients should expect during each phase.
Phase I: Recovery from amputation and full healing of limb (2-4 weeks)
In the first two weeks of losing a limb, patients might experience swelling and/or mild to moderate pain. During this phase, their treatment will focus on:
- Emotional support
- Pain control
- Wound healing
- Proximal body motion
Usually, this phase is also when the patient will have their first physical therapy consultation. While all phases of rehabilitation can be difficult, phase I is most likely the most challenging. Patients often have trouble accepting that they’ve lost a limb, and as a result, can’t perform certain tasks or participate in certain activities, without the use of a prosthetic. However, physical therapy during this time can help them regain and acquire critical mobility skills.
As patients progress through this stage, their physical therapist along with the prosthetist will focus on limb protection, shaping, and specific exercises to build endurance and strength and increase exercise tolerance. Also, their physician will prescribe what’s called a shrinker to help shape the residual limb and/or a post-op limb guard to protect them from injury. Each of these processes is vital to the success of prosthetic options in the future.
Phase II: Evaluation and scanning for the prosthetic limb
In phase II, also known as the pre-prosthetic phase, the focus of rehabilitation is still on increasing strength and flexibility in the affected area. Shaping the residual limb is also a pivotal process for preparing the residual limb to fit the future prosthesis.
A physician and physical therapist will closely monitor the patient for progress. They might also provide the patient with early walking aids to determine the best type of prosthetic limb for the patient’s individual needs.
Once the limb fully heals and the swelling goes down, the patient will have their first meeting with a prosthetist, who will take measurements and fit the patient with an appropriate suspension liner. The prosthetist will take a digital scan of the patient’s residual limb. This scan will be uploaded into a CAD system to make modifications.
This allows the prosthetist to capture the shape of the limb for custom fabrication of the prosthesis. During the evaluation, the prosthetist will also ask the patient about their daily activities. This will help them better understand the patient’s needs and aid in the design of the prosthesis.
After the scan is uploaded into the computer-aided design (CAD) software, the prosthetist will make modifications to the image to make relief for any bony prominence. When this is complete the prosthetic test socket is ready for printing.
Phase III: Test socket fitting for the prosthetic limb (3D Printed)
During this phase, the patient will have a fitting appointment where their prosthetist tests the fit of the prosthesis. The patient will stand and walk on the prosthesis to ensure a proper fit. In most cases, adjustments are needed. The prosthetist will make the necessary adjustments to achieve an optimal fit.
3D printing allows prosthetists to digitally capture the complex anatomy of residual limbs. This involves using a digital device such as a smartphone to capture the shape of the limb.
Ensuring the prosthetic is a proper fit for the patient will play a crucial role in comfort and functionality. A 3D printed prosthetic limb or 3D printed leg can help the prosthetist quickly determine if the length and alignment of the prosthesis are correct when both standing and walking.
Phase IV: Final prosthetic limb delivery
Once the test fittings are complete, the prosthetist will fabricate a final laminated prosthesis. The fabricated prosthesis will be lighter than the diagnostic prosthesis. During the final fitting, the prosthetist will verify the fit and function of the prosthesis and make any final changes to the design.
After the final prosthetic limb delivery, the physician and/or physical therapist will teach the patient how to use their prosthesis. Depending on the patient’s progress and the fit of the prosthesis, they may be able to resume physical activities such as walking up and downstairs, driving, and participating in sports and hobbies.
After a few months, the prosthetist will follow up with the patient’s progress. If needed, he or she will make adjustments, fittings, and replacements. It’s vital for the patient to follow up with their prosthetist at least every six months to address any issues. Doing so will be critical to the fit and function of the prosthesis as the patient’s residual limb will constantly change in size.
Challenges of traditional prosthetic design
To understand how 3D printing can be a better alternative to traditional prosthetic design, it’s important to note the challenges and disadvantages that come with manufacturing and customizing prostheses.
While prosthetic limbs have become highly useful devices for patients looking to regain mobility and use of their limbs, they do have their drawbacks.
3D printing is also an attractive option because it can help patients regain their mobility faster. This is because a prosthetist can print a limb in the fraction of the time it takes to complete the design of a prosthetic the traditional way. Therefore, the customization process is a lot shorter, which speeds up delivery to the patient. This also dramatically increases the number of patients a prosthetist can treat in a given year.
Benefits of 3D printing in orthotics and prosthetics
There are various benefits to implementing 3D printing into the prosthetic design. The key to truly appreciating these benefits is understanding the difference between the traditional building of sockets and the digital building of sockets.
Traditional build of sockets:
- The prosthetist gathers a patient history during the initial consultation.
- The prosthetist prepares the limb for shape capture.
- The prosthetist creates a cast of the residual limb using plaster-soaked bandages.
- The prosthetist makes modifications to the initial cast to ensure a correct socket fit and pressure distribution. This ultimately leads to the final socket fabrication.
- The prosthetist makes final adjustments and additions to the socket and ensures the proper fit on the patient.
The digital building of sockets is similar to this. However, the difference is part of the process is digital. For example, the 3D printing of prosthetics does not require casting or the use of plaster to create a mold, which can be quite a time-consuming process. Using plaster to create molds can also be unreliable as plaster is relatively easy to crack and fracture.
The process of 3D printing prosthetics involves getting the digital image of the patient’s extremity using a scanner. Then, the prosthetist would turn the image into a 3D model with computer-aided design (CAD). From here, the physician will modify and correct the shape of the residual limb electronically and send it to the printer for production. 3D printing takes place on site, eliminating the need to send the design for off-site fabrication.
The 3D printing process uses a combination of CAD and computer-aided manufacturing (CAM) by taking a 3D model and “printing” it through multiple extruded layers of material. This allows for faster socket production and better accuracy. This is because the process involves the 3D mapping of a patient’s anatomy.
Another key difference between traditional prosthetic design methods and the 3D printing of prosthetics is that the more advanced technology allows for the ability to change the thickness in specific areas of the prosthesis to achieve a higher degree of flexibility and performance. As a result, prosthetists can design a more accurate, customized prosthetic device for each unique patient.
Furthermore, printing a device also reduces turnaround time from design and manufacture to patient fitting and application. This is especially important as the shape and size of the residual limb change over time.
3D printing prosthetics can also be beneficial for children. Children are constantly growing, which means their prostheses need regular adjustments, which can be tedious when going the traditional route.
However, with 3D printing, the process is faster and more painless, giving parents the ability to ensure their child always has a device that fits without having to spend a significant amount of money. Another key advantage of 3D printed prosthetics for children is that they’re highly customizable, allowing children to choose the styles and colors they want.
Adopting an emerging technology to improve outcomes for patients with physical disabilities
3D printed prosthetics is a new technology—one that Alcam Medical Orthotics and Prosthetics specialize in. Through highly customized prosthetic design using our 3D printing technology, patients facing mobility and quality of life challenges can achieve an independent life more quickly.
Whether you’re a patient seeking a higher quality of life or a healthcare professional looking to improve patient outcomes with a 3D printed prosthetic leg or other limbs, we’re here to help you reach your goals. To create a new possibility, schedule an appointment for a prosthetic evaluation or refer a patient today.
