The medical industry is constantly seeking out new, cutting-edge technologies to disrupt standard practices for the better. The industry is often using handheld 3D scanners for this, coming up with new ways to create custom orthotics and prosthetics. While these orthopedic solutions may be newer, the technology itself has a long, proven track record across many industries.
As such, the combination of 3D scanning and additive manufacturing has already begun to establish inroads throughout the healthcare industry. It’s quickly modernizing these practices, while improving patient experience and comfort.
The top benefits of integrating 3D scanning with 3D printing include:
In the past, the first step to creating a customized orthotic device for a patient required using plaster and fiberglass to make a cast of the body part being fitted. Once the cast was ready, tape measures and calipers would be used to obtain the object’s geometry—a time consuming process vulnerable to human error. The results of this process are passable yet lacking in accuracy. These hand-taken measurements are used alongside two-dimensional drawings and photographs to develop the orthosis or prosthesis. This traditional process is antiquated, and the casting procedure is known to be messy and time consuming.
“Many of our patients are elderly, and having to sit still for a cast is not comfortable for them,” said Warren Hagen, certified orthotist and pedorthist, and owner of Hagen Orthotics & Prosthetics. The company adopted Artec 3D handheld scanners. With this technology in place, the workflow has completely changed.
When a patient comes in for an orthotic device, it involves the typical physical exam and verbal patient history. But now, rather than using plaster, a patient’s arm, leg, or other body part is scanned using a professional handheld 3D scanner—a process that takes two to five minutes. The scans are captured directly in Artec Studio software, where they are stitched together and processed into a 3D model.
If the body part being scanned is a foot, the file is sent as an STL to Fitfoot360. For any other body part, the file is sent to Meshmixer. Following either of those programs, the model is exported to Aspire software to prepare the final 3D model to format it, so that it can be sent to a router for carving. After carving, the top cover is glued on and the product is then presented to the patient for fitting. Alternatively, the final model can also be sent to Simplify for 3D printing, rather than to a router for carving. This practice is regularly used for designing and creating leg, foot, wrist, and hand braces.
“The level of precision we’re talking about is unbeatable, and the fact that we can deliver it every time, without question, is something we just can’t ignore,” Hagen said.
Hagen’s practice also employs a technique called “Shell Offset,” which involves scanning a limb and mirroring it for the creation of a device. A situation where this is effective is when a patient breaks a limb. Let’s say a patient has broken her right arm. The left arm would be scanned, because it is the straight limb, and the 3D model would be mirrored in order to create symmetry.
Next, the model is modified to remove any defects or to add buildup in boney areas or near joints, to create comfort spots. From this point, the “shell” is created by making a digital copy of the arm and increasing the offset in size to whatever desired thickness is called for. The size of the 3D digital limb is enlarged in x, y, and z coordinates. Then both the modified limb and the Shell cover are selected in the software, to make the hollowed shell/brace cover by using the Boolean Difference edit command in Meshmixer.
Orthin Ltd. has been championing the use of 3D scanning technology for nearly two decades. One of the biggest advantages it found is the portability of the technology. The handheld scanner it utilizes weighs just under 2 lb (0.9 kg) and features a battery pack for power-cable-free scanning for up to six hours. The scanner integrates with a tablet so scans can be visualized in real-time. When patients are unable to visit Orthin’s office, technicians go out to see their patients.
“This is now the new way that we work: the client is scanned wherever this is needed. This can be done at any location possible, even at their homes, and next to the scan, we list the individual wishes of the client. Back in the office, the raw data is saved on an internal server. Then it is saved as an STL file. After that, we use our orthopedic software to create a mold, or the end-product can be milled or 3D-printed,” said Karel Wilbrink, orthopedic technician at Orthin Ltd.
If traditional plaster methods were still the order of the day, visiting patients at home would not be an option. With 3D scanning, there is nothing to clean up and virtually no direct physical contact. It’s clean, easy, and quick.
The combination of 3D scanning and 3D printing is also enabling the creation of personalized prosthetics at a fraction of the cost. This has made artificial limbs far more accessible to those in need within the U.S. and elsewhere. LifeNabled is taking advantage of this technology combination to provide prosthetics to underprivileged individuals in the rural area of San Benito, Guatemala.
Typically, the material costs for creating a prosthetic arm ranges from $800 to $1,200. With 3D printing, Brent Wright, a certified prosthetist and board-certified orthotist with LifeNabled, can do it for much less. Wright said that his organization can create an arm for about $4 in material costs as a result of 3D printing. Patients who could never otherwise afford a traditional prosthesis no longer need to suffer without one due to this technological advancement. With the use of 3D scanning, patients don’t have to sacrifice comfort with this low-cost option.
Only 0.5 percent of males and 3 percent of females suffer from Graves’ disease, also known as Basedow’s disease. One of the most common symptoms of this ailment is the protrusion of one or both eyeballs. This causes immobility of the eye, which results in abnormal or excessive secretion of tears, light sensitivity, and a narrowing of the visual field. Surgery can be used to help relieve this condition, but this can bring its own side effects—namely, potential damage to the tendinous tissue of the muscle that elevates the upper eyelid.
This very rare and specific sequence of events can lead to a patient who has trouble fully closing their eyes and thus has difficulty resting at night. Digital Maison, a 3D scanning and services provider, was tasked with helping a patient suffering from these symptoms. Handheld 3D scanners were used to create 3D models of the patient’s face in different positions, including lying down.
The model was used to create a custom eye mask that perfectly fit the contours of the patient’s face to fully block out light at night. The final step involved 3D printing the mask in Bioflex, a semi-rigid material that provides wearers a high comfort level.
In this situation, a generic eye mask would never have been able to relieve some of the patient’s discomfort. For lesser known diseases and ailments, 3D scanning and 3D printing can provide solutions that previously would not have been available.
It can solve problems for patients and groups of people mostly overlooked by large medical device companies, since the market size they represent is too small to cater to. It is these smaller, or orphan, applications that truly show the benefits of the technology.
For orthotics and prosthetics, 3D technologies are quickly becoming the preferred tools for industry-leading professionals. The accuracy, cost and time savings, portability, and flexibility of 3D scanning are unparalleled, and the benefits are hard to ignore. The overall learning curve for these technologies continues to plummet. Already, many physicians have quickly picked up the skills required to reinvent their practices for the modern age. It’s safe to say that it’s time to ditch the plaster and fiberglass for a 3D upgrade.
Andrei Vakulenko is chief business development officerof Artec 3D.
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