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3D foot orthotic printing, BBC news item

Discussion in 'General Issues and Discussion Forum' started by Woodburn, Oct 22, 2012.

  1. Woodburn

    Woodburn Active Member

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    Dear colleagues,

    For those of you following the A-FOOTPRINT project led by Glasgow Caledonian University, the BBC have a news item on the work at:


    You will see some examples of selective laser-sintered concept devices and low-cost desktop printing. The patient featured was a participant in a phase II, 'first-on-man' trial.

    More on the project can be found at: http://www.afootprint.eu

    Best wishes,
    Prof Jim Woodburn
  2. Phil Rees

    Phil Rees Active Member

    Has the "printing" process speeded up at all? When I was exploring this process with a former employer nearly four years ago, a pair of orthoses took nearly eight hours to produce and the only material available then was ABS. The ABS we were using broke down relativley quickly when worn.
  3. Lots more materials now, Phil. Processing will get faster- depends on whether you are using fused deposition modelling or selective laser sintering. In terms of model building time, I think you need to look at a different model. You could have a lab producing 3D printed foot orthoses, which with the numbers being produced, the lab would currently need lots of printers. However, the model I predict to become pervasive is that the clinician will hold the printer, in which case the production time can be slower because the required throughput will be much lower. I wrote about this in the paper attached and available free here: http://fas.sagepub.com/content/5/5/334.full.pdf html

    Selective laser sintering is limited to printing in one material, whereas fused deposition modelling can employ multiple print heads (analogous to a colour inkjet printer), in which different materials are deposited within the device, allowing manipulation of load/deformation characteristics in specific areas. Of course, load/deformation can be manipulated via manipulation of the geometry of the device itself. Yet really this needs to be driven by finite element modelling, as I presented too many years ago now at PFOLA- time somebody with the resources of more than a private practitioner took this forward.

    Attached Files:

  4. Woodburn

    Woodburn Active Member

    Dear Phil,
    Thanks for your interest. There are a number of viable materials in use right now and an increasing number of technologies beyond FDM and SLS. We are running with powdered nylon just now and can provide full material specifications from ISO standard mechanical tests and FE data. This work is being conducted within the AFOOTPRINT project. The University of Newcastle are running full production cycle models within factory simulation/modelling based on a number of business models. We have a pilot production factory up and running (thats what a large-scale EU grant can provide!) with a large SLS printer. Whilst a single run might take ~12 hours we are developing optimisation routines that work to maximise the stacking arrangement of say 6 AFO's and 30 FO's within a single 3D build volume. In the production cycle modelling it looks like we can get close to current FO price structures with larger volume production but not lower cost as we were hoping for.
    We have also made good advances with hybrid materials exploiting freeform design but most of that is subject to IP so will emerge downstream.
    We have optimised FO's and AFO's based on our understanding of the mechanical properties of the sintered nylon and followed this up with cyclical loading, impact and destruction tests and FE modelling with excellent results. We have just completed our first phase I clinical trial of an FO and we are midway through testing an FO on stroke patients with drop foot. That trial compares an AFO optimsed to be 30% lighter without loss of stiffness properties.
    The AFOOTPRINT project will finish in Oct 2013. In March next year we have the final EU demonstration event in Newcastle. If you would like to attend then please contact me at jim.woodburn@gcu.ac.uk
    Best wishes,
  5. Anyone else get a "Mail System Error- undelivered" on that address?
  6. Woodburn

    Woodburn Active Member

  7. Phil Rees

    Phil Rees Active Member

    Jim / Simon thanks for your comments
    I think this is a really exciting use of a developing technology. Well done to all concerned.
  8. Money can buy many things, as we all know; but can it buy commercial success in this case? I guess the proof of the pudding will be in the growth in the market share that the pilot production facility and the other commercial partners see when the project funding ceases and they are left to their own devices; pun intended. Time will tell, from March 2013 it would seem...

    So, 15 pairs of foot orthoses in 12 hours, with one machine at a cost of? Obviously there is reduced staffing cost on this, but as Jim notes: "no lower cost" per unit has been achieved. So, potentially we have fewer people in employment, for foot orthoses that cost the same amount. OK, unless you are one of the people in employment making the foot orthoses! Human cost? To give a perspective though, when you were at Langer, roughly how many pairs of foot orthoses were produced in a twelve hour period, Phil?
  9. As an aside, what is the average time a practitioner currently waits from sending off a prescription, to receiving the finished foot orthoses for a patient? Anyone know how many devices a commercial lab typically manufactures in 12 hours and what the lead time to the clinician typically is?
  10. Phil Wells

    Phil Wells Active Member


    I can answer a few of your questions.
    We can mill 72-96 pairs of polypropylene orthoses in 12 hours - depends on the actual size of the end milling strategy. This could be doubled using post milling processes such as vibratory tumbling etc.

    We offer a standard 5 day turnaround - in house- but with postage etc this usually equates to 9 days before you get them back.
    However some customers who design there own insoles and use us for milling can get a same day turnaround - this equates to getting the orthoses back the following day.

    I think the AFOOTPRINT project could become a viable option as the design process allows for far more complicated designs - hollow shells with reinforcing beams, coils etc. However these designs will need to have some level of evaluation to ensure they do not cause issues with fracture/failure characteristics in use. (Everyone will want there own 'twist' on the design which could lead to incompatible design verse material properties)
    If we can couple FEA with the bespoke CAD process we could have something useful.

    However the question I have been asking myself is do we need anything more than the current type of orthoses. The cost/benefit analysis of new materials and processes always seem to come out in favour of sticking with the polypropylene, especially from a due diligence perspective.


  11. Thanks Phil,

    I think you hit the nail somewhere near the head. The real benefit of additive manufacture is that we can design foot orthoses differently using this manufacturing technique; if we are using additive manufacture but still producing foot orthoses which look the same as foot orthoses made by direct milling (which themselves, more often than not, look just like their ancestors, i.e. foot orthoses manufactured from vacuum forming) then why bother? The direct milling approach is faster and probably more economically viable on large scale production runs. Hence my point regarding the future commercial success of the partner providers within the project. There has to be a benefit in using the technology which puts them ahead of the competition using direct milling. As far as I can see, it can only (at this stage) be through new designs which the "milling labs" cannot emulate. Since the printers cannot compete on time or on price. As I've said before, I think the 3D printers do have a benefit if we look at the different delivery models. Obviously with an in-house printer system, there is no reason why a clinician couldn't print out the devices for a patient within 24 hours of sending the scan to the lab and I'm sure you'll agree they are less noisy and dirty than a desk-top miller.

    The question you asked re: do we need to, is a good one. I guess we won't know the answer to that until we have tried out the new designs to see if they provide superior outcomes.

  12. From the film: "The products are handcrafted in plastic. It relies on a template, usually made out of plaster. The process takes about four to six weeks, so that creates a significant delay in treating patients..."


    When I was writing my lecture on the history of foot orthoses which I presented in Belgium in March, this was the earliest reference to CAD/CAM of foot orthoses that I was able to find: Staats T.B., Kriechbaum B.A.: Computer Aided Design and Computer Aided Manufacturing of Foot Orthoses. Journal of Prosthetics and Orthotics 1989 Vol. 1, Num. 3 pp. 182-186 http://www.oandp.org/jpo/library/1989_03_182.asp

    Question: is CAD/ CAM now the pervasive technology within commercial foot orthoses manufacture, globally?
  13. blinda

    blinda MVP

    Anyone from here going to attend this?


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