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Bespoke custom orthotics vs 3d scanned cadcam

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Bikeflipper, Oct 5, 2013.

  1. Bikeflipper

    Bikeflipper Welcome New Poster

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    Has anyone done any research on the cost effectiveness of moving over to a system such as Delcam's and a comparison of bespoke/custom orthotic against milled?

    are there any papers out there?

    Thanks in advance
  2. Craig Payne

    Craig Payne Moderator

    There is no research.

    One method uses more costly technology. The other method use more costly labour. There is probably a cross over point based on volume where one is more cost effective than the other.
  3. seanpincus

    seanpincus Member

    As a podiatrist who made (aka I was the plaster chucker, moulder cutter person) for 23 years, I firmly believed that I was a machine. This year I moved over to 3d cad cam, (I have the sensor medica system) and it has made a huge difference to my practice. The speed that you can return orthotics to a patient, the greater tolerance and acceptance of a milled device (my subjective view) out weigh the cost of the setup. Best benefit of all, I rarely have orthotic lab work over weekends, and am always up to date with lab work
  4. Chris Gracey

    Chris Gracey Active Member

    The benefit in both time and cost is revealed when patients report immediate relief and return to function because I not only did the eval but I made the device. My hand-made orthoses are infinitely adjustable so the cost/labor benefits are also experienced upon return visits by persons who do not find relief with the initial prescription. Oh yeah, what was that algorithm the cad/cam software is based on to determine appropriate support and relief? I know the answer. So I'll take mistakes of the hand-made over computerized guess-work any day. Hard work is hard for a reason. Quality is found in the pride of workmanship.EOS.
  5. CraigT

    CraigT Well-Known Member

    While I agree with your sentiments, it depends on the system and how it is used.
    I am now manufacturing orthoses where I have essentially the same amount of control over the finished product as i would if I was using plaster... yet it is fuly digital and the devices are machined. In addition there are design options which allow more variability than you can get using traditional methods.
    I have been using Delcam for the past 2 years and I know they are redesigning their software... I hope they will be able to keep the level of customisation that they have now!
  6. IMASS Si

    IMASS Si Member

    Hi bikeflipper,

    We are a new company in the UK using the 3D pin measuring system from Switzerland to measure and manufacture custom foot products. When looking at numbers it becomes much more efficient to have a measuring system with total digital control, the ability to adjust corrections and a turn around time of 72 hours.

    Although the above posts are correct in stating there is no research out there at this point, but in my opinion this will only be a matter of time. Most countries in Europe have progressed onto using some form of CAD/CAM measuring and milling systems. Even so popular that they are being used in multiple shoe shops in small towns and in ski/sport shops in Switzerland and Germany throughout. My question is why does the UK seem 'behind' in this respect?

    Any thoughts anyone?
  7. CraigT

    CraigT Well-Known Member

    Which is a copy of an American system that has been around for at least 20 years I believe...

    It is not research, it is a simple cost calculation and would vary depending on circumstances.

    I would suggest that what you are describing is not what many people on this forum would consider custom foot orthoses, rather more like tailored insoles. They are a copy of the shape of the foot and then (sometimes) have additions added on like a metatarsal dome. I believe these are also avaible in the UK though are not as common. This is not being 'behind'... in fact I would suggest the opposite.
  8. joejared

    joejared Active Member

    The cost of a system is one factor, but it's not the only one. Whatever the fees are, that will be the first factor to consider, meaning some minimum number of orthotics is recommended prior to making such a purchase, accounting for the loan payments. For my own system, I recommend no less than 60 pairs/month.

    Many of the new people I'm working with aren't just considering the cost of technology. The ability to operate from home has also proven to be a big cost saver, both for my clients and at least one of my client server sites. For one new client in Canton, he's making the switch from a wet lab to cadcam, and stops by once a week to restock supplies, such as wood and plastic, saving considerably on shipping expenses. Already, labor cost reductions have paid for his scanner in the first month.

    Operating from my garage enables me to be able to keep his costs so low that he has the same benefits of owning a mill, for that reason. Another client/server site recently picked up an LC4896 and is also operating a lab, with a total investment cost for technology at just over $10K. Again, and because of a considerably lower overhead both in shop expenses and a lack of debt, he's able to actually have a higher quality of life to go along with a higher profit margin and more personal service. When you think about it, isn't that the objective for all of us, to actually live life well?

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