3D printed objects are achieved using additive processes. In an additive process an object is created by laying down successive layers of material until the object is created, this is called slicing. A 3D printer can make pretty much anything form ceramic cups to plastic toys, metal machine parts, stoneware vases, chocolate cakes and in the future potentially human body parts.
Orthotics is the greek word ortho ‘to straighten’ or ‘align.’ Orthotics is a speciality concerned with design, manufacture and application of orthoses - an externally applied device used to modify the structural and functional characteristics of the neuromuscular and skeletal system. They can be anything from a simple finger splint, foot insole, to more complex spinal braces and complex full leg orthotics. Orthotics are useful in various ways, restoring the ability to walk, run and jump by reducing pain and swelling and increasing the stability of unstable joints and providing improved support.
Orthotic devises are generally made of light weight materials which range in complexity from simple shoe inserts to custom made devises which require impressions, casting, and computer technology to create.
Orthotics were traditionally made by tracing the extremity with measurements to assist in creating a well fitted device, this then led into the use of creating a plaster of paris mould of the body part in question.
The main issue is patients feeling uncomfortable with their new orthotics, and they never match perfectly. There is lots of guess work in making orthotics leading to a poor fit. The mass produced, ‘one size fits all’ orthotics cost less but do not always properly correct the problem and can sometimes do more harm than good.
3D printed orthotics can be individually tuned to each prescription with unprecedented levels of customisation, fit and control reducing or removing completely this issue. Patients can now receive a bespoke fitted orthotic which is perfectly suited to them within millimetre tolerances. In relation to foot orthotics this means individuals can now choose their footwear first and their orthotics second, whilst still receiving the full range of health and wellbeing benefits that orthotics provide.
The cost of fabricating orthoses using 3D printing technology is 3-4 times more than the cost of traditional orthoses but allows for custom shapes, better compliance and devices can be made six times faster , are easier to modify, reproduce and a permanent digital record is generated for all future orthoses . And they can be personalised ! With any art work and material. In short technology is offering more bespoke and sophisticated products for individuals who wear orthoses.
Sports wear companies are now debuting 3D printed shoes, providing the best all round trainer for the individual and the sport they participate in. Several shoe companies are using 3D printing technology to custom make shoes for customers in the store on the spot. With 3D printed shoes there is no more trying on of shoes from shoe box after shoe box, information about the individual’s feet allows the computer to create an accurate 3D model of the person’s feet which is combined with details around height, weight, and activities they engage in, trainers are then personalised and tailored exactly for the individual.
The therapeutic aspect of this is using the 3D shoe printing to make orthotic shoes that alleviate a patient’s foot pain and improve comfort. Diabetics are one group that would really benefit from the new technologies due to ensuring the shoe fits properly and does not rub – a diabetic may be unable to feel this discomfort and quickly the sore can turn into an ulcer which in turn can lead onto more significant problems ( due to peripheral neuropathy – see our previous blogs on diabetes).
Pre ulcer offloading and biomechanics using foot orthotics as a prevention and management are highlighted in the NICE guidelines in the UK for Type 2 Diabetes foot problems. So watch this space – 3D printing is certainly here to stay and breaking new ground.