The field of prosthetics fabrication is a unique mixture of art and science. “I’ve spoken with prosthetists who were cabinetmaker, artisans,” said Blake Teipel, co-founder and CEO of Essentium, Inc., a 3-D printer and materials manufacturer in Pflugerville, Texas. “On the other side are the academic clinicians, from schools like Baylor.” (The Baylor College of Medicine hosts one of the country’s top programs for orthotics and prosthetics.) The academics have driven vast improvements in prosthetic function in recent years, while the artisans help guarantee the all-important fit to the remainder of the limb that’s being replaced. Now 3-D printing is helping with both sides of the equation.
Teipel’s company is positioning itself to be at the forefront of that additive manufacturing (AM) challenge. Originally founded as Essentium Materials in 2015, the company added its 3-D printing arm and became Essenium, Inc. in January 2018. This past January, Essentium raised over $22 million in a Series A round led by BASF Venture Capital.
“The prosthetics application is the heart of the company,” Teipel said. “Aerospace and automotive are the head.” Providing solutions for those who’ve lost limbs is certainly a work of mercy. It’s a burgeoning profit center as well. The global prosthetics market was worth about $1.8 billion in 2016, and is forecast to grow to nearly $3 billion by 2025.
It’s the technical challenge of getting it right that led Essentium to partner with Vorum Research Corporation of Vancouver, Canada. Nearly three decades ago, they pioneered the use of 3-D scanning combined with computer aided design and manufacturing (CAD/CAM) for orthotics and prosthetics design and fabrication. The company’s digital capabilities have streamlined and improved the legacy processes of fitting prosthetics to the users.
“The original method was to take a plaster cast of the patient’s limb, pour plaster of Paris into it to form a positive model to work on, and then have experts modify it to get the final shape,” said Carl Saunders, Vorum’s founder and CEO. “About four years ago, practitioners who had already embraced CAD/CAM started looking towards 3-D printing as a means to bypass the intermediate plaster positive. This was facilitated by the general marketplace availability of 3-D printing, and by the hype – patients were seeing it and asking about it.”
A typical lower limb prosthetic device consists of an artificial foot, a metal pylon, and the socket that fits the patient’s limb. Because of its custom design, the socket is where the new technologies hold the most promise. “When the medical professionals design the socket, they look at the specific intended use,” Saunders said. “It’s designed so the parts of the body that will tolerate pressure are loaded, and those that won’t are relieved. Every one is unique.”
“Prosthetics is the first area where we brought all the pieces together,” Teipel said. “Scanning, digital modeling, printing, and new materials.” But it’s still early days for the use case. “There are about 100,000 amputations in the U.S. alone each year,” he explained. “We’ve been able to ship about 2,000 prosthetics the past couple years, but we still have a long way to go.”
But he sees tremendous potential. “It’s been a small volume so far, but it’s helped us prove the concept and the technology,” said Teipel. “The opportunity is to drive costs down and access to prosthetics up. Our technology will play a big role there, just like with [dental] aligners and hearing aids – almost every one of those is 3-D printed now. Prosthetics are headed the same way.”
“Essentium’s printer is really fast,” added Saunders. “I see the potential to produce devices even faster than legacy methods. And Essentium is an innovative materials company, so I also see us evolving to better and better materials for the application.”
Reassuring medical field partners will also be part of the challenge. “Imagine that you’re a prosthetics and orthotics practitioner, and people are telling you it’s all going to 3-D printing,” Saunders said. “You’d be scared as hell, thinking, ‘Will I be able to do this?’ Vorum’s approach is to offer a Surepath to success for all practitioners that engage in our CAD/CAM solutions. Our customers share with us their business objectives, whether that be to produce custom devices cheaper, faster, or better. We then provide digital solutions to achieve those improvements, and help them reach their ultimate business goals.”
Improvements over existing manual fabrication methods will be key. “We intend to deliver the desired custom orthotic or prosthetic device exactly as designed,” said Saunders. “When we print it, it will be right, with consistent fit and finish and durable materials. Every print will only need to be done once, as the Essentium machines are dialed in to deliver.”
Teipel agreed. “Some clinicians feel they can’t be successful with the digital tools,” he said. “Once we show them what we can do with 3-D scanning and printing, they get excited about the potential.” For him, it’s about education and building partnerships. “The entire industry is headed to digital. Essentium has the material sets and can work with the medical professionals on strength testing and certification. We bring the digital twin to the party so the clinician can digitally reshape and tweak the design to fit the particular patient. And we’re partnered with BASF on material flow and traceability.”
It’s the opportunity to improve people’s lives that plays a big part in driving both Saunders and Teipel forward. “3-D printing is so exciting because it has the potential to produce custom orthotic and prosthetic devices faster, cheaper and better,” said Saunders. “There’s no question it’s gonna come, but it will take a whole lot of work to get right.” Teipel added, “3-D printing is impacting lives behind the scenes right now. And we’re going to see it doing that more and more.”
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