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Powell SK, Cruz RLJ, Ross MT, Woodruff MA. Past, Present, and Future of Soft-Tissue Prosthetics: Advanced Polymers and Advanced Manufacturing. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2020; 32:e2001122. [PMID: 32909302 DOI: 10.1002/adma.202001122] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/23/2020] [Indexed: 06/11/2023]
Abstract
Millions of people worldwide experience disfigurement due to cancers, congenital defects, or trauma, leading to significant psychological, social, and economic disadvantage. Prosthetics aim to reduce their suffering by restoring aesthetics and function using synthetic materials that mimic the characteristics of native tissue. In the 1900s, natural materials used for thousands of years in prosthetics were replaced by synthetic polymers bringing about significant improvements in fabrication and greater realism and utility. These traditional methods have now been disrupted by the advanced manufacturing revolution, radically changing the materials, methods, and nature of prosthetics. In this report, traditional synthetic polymers and advanced prosthetic materials and manufacturing techniques are discussed, including a focus on prosthetic material degradation. New manufacturing approaches and future technological developments are also discussed in the context of specific tissues requiring aesthetic restoration, such as ear, nose, face, eye, breast, and hand. As advanced manufacturing moves from research into clinical practice, prosthetics can begin new age to significantly improve the quality of life for those suffering tissue loss or disfigurement.
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Affiliation(s)
- Sean K Powell
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| | - Rena L J Cruz
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| | - Maureen T Ross
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| | - Maria A Woodruff
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
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Cuellar JS, Smit G, Breedveld P, Zadpoor AA, Plettenburg D. Functional evaluation of a non-assembly 3D-printed hand prosthesis. Proc Inst Mech Eng H 2019; 233:1122-1131. [PMID: 31597553 PMCID: PMC6790990 DOI: 10.1177/0954411919874523] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
In developing countries, the access of amputees to prosthetic devices is very limited. In a way to increase accessibility of prosthetic hands, we have recently developed a new approach for the design and 3D printing of non-assembly active hand prostheses using inexpensive 3D printers working on the basis of material extrusion technology. This article describes the design of our novel 3D-printed hand prosthesis and also shows the mechanical and functional evaluation in view of its future use in developing countries. We have fabricated a hand prosthesis using 3D printing technology and a non-assembly design approach that reaches certain level of functionality. The mechanical resistance of critical parts, the mechanical performance, and the functionality of a non-assembly 3D-printed hand prosthesis were assessed. The mechanical configuration used in the hand prosthesis is able to withstand typical actuation forces delivered by prosthetic users. Moreover, the activation forces and the energy required for a closing cycle are considerably lower as compared to other body-powered prostheses. The non-assembly design achieved a comparable level of functionality with respect to other body-powered alternatives. We consider this prosthetic hand a valuable option for people with arm defects in developing countries.
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Affiliation(s)
- Juan Sebastian Cuellar
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Gerwin Smit
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Paul Breedveld
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Amir Abbas Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Dick Plettenburg
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
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Ribeiro D, Cimino SR, Mayo AL, Ratto M, Hitzig SL. 3D printing and amputation: a scoping review. Disabil Rehabil Assist Technol 2019; 16:221-240. [PMID: 31418306 DOI: 10.1080/17483107.2019.1646825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Three-dimensional (3D) printing is an innovative technology being utilized to create prostheses for individuals with limb loss. However, there is a paucity of research on the feasibility of using this technology to fabricate prostheses. A scoping review was conducted to map the literature on 3D printing and its applications in the field of amputation. MATERIALS AND METHODS Using a scoping review framework, a systematic literature search was conducted in three electronic databases (MEDLINE, EMBASE and CINAHL) for all indexed literature up to 29 June 2018. RESULTS Twenty-eight articles met the inclusion criteria. The majority of studies had small sample sizes (five participants or less; n = 20) and used a case study design (n = 17). The benefits of 3D printing technology include higher levels of customization and lower production costs. However, the functionality of 3D printed prostheses is lacking. There is also a need for more robust research designs to obtain a better understanding of the advantages and disadvantages of 3D printed prostheses and its impact on end-user outcomes. CONCLUSIONS The use of 3D printing technology has a number of benefits for improving the manufacturing process of devices for people with lower and upper limb loss. However, more research and technological advancements are required to fully understand the impact of this technology on patients and how it will affect their daily life. The long-term effects of this technology will also need to be investigated in order to produce a more sustainable alternative to traditional prostheses.IMPLICATIONS FOR REHABILITATIONThe use of 3D printing technology for the fabrication of prosthetics for persons with limb-loss has a number of promising features to improve the fitting and customization of these devices for this patient population.Although the costs of producing 3D printed devices is less expensive and burdensome than traditional approaches to manufacturing techniques, there is a need for additional technological advancements to improve the functionality of these devices.Future research needs to adopt more robust research designs with larger sample sizes to provide a better understanding of the viability of using 3D printing technology to improve patient outcomes.
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Affiliation(s)
- Danielle Ribeiro
- Department of Electrical, Computer and Biomedical Engineering, Faculty of Engineering and Architectural Science, Ryerson University, Toronto, Canada
| | - Stephanie R Cimino
- St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
| | - Amanda L Mayo
- St. John's Rehabilitation Hospital, Sunnybrook Health Sciences Centre, Toronto, Canada.,Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Matt Ratto
- Faculty of Information, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.,Faculty of Information, University of Toronto, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
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Mallet Finger Lattice Casts Using 3D Printing. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:4765043. [PMID: 31354931 PMCID: PMC6636505 DOI: 10.1155/2019/4765043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/04/2019] [Accepted: 05/29/2019] [Indexed: 11/18/2022]
Abstract
Currently, research based on the technology and applications of 3D printing is being actively pursued. 3D printing technology, also called additive manufacturing, is widely and increasingly used in the medical field. This study produced custom casts for the treatment of mallet finger using plaster of Paris, which was traditionally used in clinical practice, and 3D printing technology, and evaluated their advantages and disadvantages for patients by conducting a wearability assessment. Mallet finger casts produced using plaster of Paris, when incorrectly made, can result in skin necrosis and other problems for patients. These problems can be mitigated, however, by creating casts using 3D printing technology. Additionally, plaster casts or ready-made alternatives can be inconvenient with respect to rapid treatment of patients. In contrast, 3D-printed casts appear to provide patients with appropriate treatment and increase their satisfaction because they are small in size, custom-made for each patient, and can be quickly made and immediately applied in clinical practice.
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Lee KH, Kim DK, Cha YH, Kwon JY, Kim DH, Kim SJ. Personalized assistive device manufactured by 3D modelling and printing techniques. Disabil Rehabil Assist Technol 2018; 14:526-531. [DOI: 10.1080/17483107.2018.1494217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Keun Ho Lee
- Department of Occupational Therapy, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Kyu Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Ho Cha
- Department of Physical Therapy, Samsung Medical Center, Seoul, Republic of Korea
| | - Jeong-Yi Kwon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Hyun Kim
- Department of 3D Convergence Technology Center, Kyungpook National University, Seoul, Republic of Korea
| | - Sang Jun Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Nam HS, Seo CH, Joo SY, Kim DH, Park DS. The Application of Three-Dimensional Printed Finger Splints for Post Hand Burn Patients: A Case Series Investigation. Ann Rehabil Med 2018; 42:634-638. [PMID: 30180536 PMCID: PMC6129707 DOI: 10.5535/arm.2018.42.4.634] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/10/2017] [Indexed: 11/08/2022] Open
Abstract
The application of three-dimensional (3D) printing is growing explosively in the medical field, and is especially widespread in the clinical use of fabricating upper limb orthosis and prosthesis. Advantages of 3D-printed orthosis compared to conventional ones include its lower cost, easier modification, and faster fabrication. Hands are the most common body parts involved with burn victims and one of the main complications of hand burns are finger joint contractures. Applying orthotic devices such as finger splints are a well-established essential element of burn care. In spite of the rapid evolution of the clinical use of 3D printing, to our knowledge, its application to hand burn patients has not yet been reported. In this study, the authors present a series of patients with hand burn injuries whose orthotic needs were fulfilled with the application of 3D-printed finger splints.
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Affiliation(s)
- Ho-Sung Nam
- Department of Rehabilitation Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Cheong Hoon Seo
- Department of Rehabilitation Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea
| | - So-Young Joo
- Department of Rehabilitation Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea
| | - Dong Hyun Kim
- Department of Rehabilitation Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Dong-Sik Park
- Department of Rehabilitation Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
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Papagelopoulos PJ, Savvidou OD, Koutsouradis P, Chloros GD, Bolia IK, Sakellariou VI, Kontogeorgakos VA, Mavrodontis II, Mavrogenis AF, Diamantopoulos P. Three-dimensional Technologies in Orthopedics. Orthopedics 2018; 41:12-20. [PMID: 29401368 DOI: 10.3928/01477447-20180109-04] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
New 3-dimensional digital technologies are revolutionizing orthopedic clinical practice, allowing structures of any complexity to be manufactured in just hours. Such technologies can make surgery for complex cases more precise, more cost-effective, and possibly easier to perform. Applications include pre-operative planning, surgical simulation, patient-specific instrumentation and implants, bioprinting, prosthetics, and orthotics. The basic principles of 3- dimensional technologies, including imaging, design, numerical simulation, and printing, and their current applications in orthopedics are reviewed. [Orthopedics. 2018; 41(1):12-20.].
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Ankle-Foot Orthosis Made by 3D Printing Technique and Automated Design Software. Appl Bionics Biomech 2017; 2017:9610468. [PMID: 28827977 PMCID: PMC5554564 DOI: 10.1155/2017/9610468] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/20/2017] [Accepted: 06/21/2017] [Indexed: 12/19/2022] Open
Abstract
We described 3D printing technique and automated design software and clinical results after the application of this AFO to a patient with a foot drop. After acquiring a 3D modelling file of a patient's lower leg with peroneal neuropathy by a 3D scanner, we loaded this file on the automated orthosis software and created the “STL” file. The designed AFO was printed using a fused filament fabrication type 3D printer, and a mechanical stress test was performed. The patient alternated between the 3D-printed and conventional AFOs for 2 months. There was no crack or damage, and the shape and stiffness of the AFO did not change after the durability test. The gait speed increased after wearing the conventional AFO (56.5 cm/sec) and 3D-printed AFO (56.5 cm/sec) compared to that without an AFO (42.2 cm/sec). The patient was more satisfied with the 3D-printed AFO than the conventional AFO in terms of the weight and ease of use. The 3D-printed AFO exhibited similar functionality as the conventional AFO and considerably satisfied the patient in terms of the weight and ease of use. We suggest the possibility of the individualized AFO with 3D printing techniques and automated design software.
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