The Prosthetics and Orthotics Podcast
The Prosthetics and Orthotics Podcast is a deep dive into what 3D printing and Additive Manufacturing mean for prosthetics and orthotics. We’re Brent and Joris both passionate about 3D printing and Additive Manufacturing. We’re on a journey together to explore the digitization of prostheses and orthoses together. Join us! Have a question, suggestion or guest for us? Reach out. Or have a listen to the podcast here. The Prosthetic and Orthotic field is experiencing a revolution where manufacturing is being digitized. 3D scanning, CAD software, machine learning, automation software, apps, the internet, new materials and Additive Manufacturing are all impactful in and of themselves. These developments are now, in concert, collectively reshaping orthotics and prosthetics right now. We want to be on the cutting edge of these developments and understand them as they happen. We’ve decided to do a podcast to learn, understand and explore the revolution in prosthetics and orthotics.
The Prosthetics and Orthotics Podcast
The Future is Now: 3D Printing in Prosthetics with Katie Richmond
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What if the future of prosthetics could be completely transformed by a single machine? This episode of the Prosthetics and Orthotics Podcast kicks off Season 9 with an in-depth recap of the Rapid conference, highlighting the revolutionary Impossible Objects machine. Discover how continuous carbon fiber technology is set to change the landscape of 3D printing for prosthetics. We also shine a spotlight on an innovative elastomer from the Loctite Henkel Group, designed to mimic the comfort and durability of memory foam, opening up exciting new possibilities for patient care.
We then explore the intersection of technology and fashion with HP's MultiJet Fusion 580 printer, revolutionizing the eyewear industry. Learn how custom-fit, stylish glasses with wood grain finishes can be produced on-demand, reducing waste and meeting consumer demands more efficiently. Plus, we delve into the realm of metal 3D printing, discussing the accessibility and safety of newer, more affordable machines like the One Click Metal system and how they are democratizing advanced manufacturing.
Finally, we take you on Katie's journey through the evolving field of O&P. Hear about the shift towards 3D printing and CAD design, with practical tips for newcomers. We also examine the benefits and challenges of using lattice structures in orthotics and prosthetics, emphasizing the importance of design precision and material selection. Tune in to discover how small, in-house 3D printers are becoming indispensable tools for prototyping custom solutions, and the growing need for clinicians to embrace these technologies for better patient outcomes.
Innovations in Resin Printing Technology
Speaker 1Welcome to Season 9 of the Prosthetics and Orthotics Podcast. This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen. Our goal To share stories, tips and insights that ultimately help our patients get the best possible outcomes. Tune in and join the conversation. We are thrilled you are here and hope it is the highlight of your day, and I know you're all about the seasons thing, you know, but this is the first episode of season nine. So this is our 97th episode.
Speaker 2Okay, cool. I hope the residuals are good. Okay, all right, cool. So hey, my burning question, of course, is you went to Rapid, I didn't. What did you see there?
Speaker 1What was cool? Man Rapid was great, energy was high and I actually was talking to a few people and it was the most vendors ever. They had the most vendors ever, which was really cool. And there was some great machines Like, um, I saw the impossible objects machine. Uh, they had that run and that was really really wild Uh seeing that. And then, uh, they, uh, I'm actually working on a project, uh, with them that I'm very excited about uh, sharing with the world here soon, but it revolves around 3D printing rather than using prepreg carbon fiber, so I'm super excited about that.
Speaker 2That's cool. Yeah, impossible Logics is a continuous carbon fiber production technology, mostly used for aerospace and stuff like that. They've been working on this for quite a long time actually Very, very difficult, very, very complicated machine, but the technology has a lot of process or promise and, yeah, I'm being able to automate a lot of stuff that's been doing by hand, so that's very, very exciting. I think we got to work on that with them, so that's super cool, man yeah, so that was cool.
Speaker 1The other thing, though, I found very, very interesting and I'm going to have to give a shout out to uh drew bag, and he is with the Loctite Henkel Group and you know I have always said that I will never use resin for orthotics prosthetics and he made me eat my words because they released a new, I don't even know. It's an elastomer, it acts a lot like TPU, but it's a MedFlex one.
Speaker 2I looked at that too. Yeah, okay.
Speaker 1So they talked me into making a file for them. I made it. I actually put it on the patient and this patient has been an amputee forever, for her whole life and she said it was the most comfortable thing she's ever worn. I think that's cool.
Speaker 2I think these resins first off. I think we could do a whole episode we maybe should about these resins because if you're going to process them or you're going to have people working for you to process them, you need to know your thing, because a lot could go wrong with skin synthesis, sensitization, sensitization, uh and uh for your employees. Also, if you don't cure it properly, if you don't do that kind of procedure, then there might be issues for your, for your client. So, and these guys? The other thing is these things tend it's a thermoset, right, so it tends to break if, if it breaks, it breaks catastrophically, kind of like glass, you know, you know. So that also not wonderful. I think, um and uh.
Speaker 2But these things aren't getting better, like the double cure ones, and and and and uh are getting better all the time and a lot of interesting shoe companies is spurring on a lot of information, uh, innovation here and there are some problems with sheer stress, fatigue, lifetime holding up against certain solvents or creams that you might use and things like that. There are some issues there. But I do think, yeah, I do think that for a lot of stuff and maybe mechanical small stuff, I think we could start to consider this stuff and yeah, for this liner type of application, with high rebound and very, very high degree of softness, coupled with the right lattice structures, this could actually be a really cool solution.
Speaker 1Yeah, I mean, and it appears to be very durable. It went right against the patient's skin and there's no other way to describe it other than memory foam Like it feels like memory foam and the lattice just it was true to the way it was designed. So a lot of times, you know, I design and I love it with multi-jet fusion and either a BASF TPU or a Lubrizol TPU, but once you smooth it, you lose some of the detail of the lattice and that sort of thing, and with this it is the way that I built it and it was amazing. So there's definitely something there. I don't know what it is, but it's something that I want to explore. I'm not saying that I'm lining up to buy a resin printer right now. I can tell you that. No, I think that's good. I'm lining up to buy a resin printer right now. I can tell you that.
Speaker 2No, I think that's good and also it's important before people start using their Frozons and stuff, that Mahenko is one of the few players that are actually working on skin contact approval, medical device regulation approval, resins and stuff like this, and you have to follow the procedure correctly with curing it, washing it, all the stuff for it to actually work and otherwise. That's your responsibility and that's a bit different, I think, than fishing it out of a bunch of powder. You know what I mean. So it's a bit more of the onus, is much more on the producer here. I'm not trying to like, I'm not anti-resin right now, but I do think you need to be a little bit more like. For example, a friend of mine asked for some printer advice. I told him 13 year old kid, I told him not to get a resin printer, you know. Whereas I told him, you know, get a bamboo labs or producer research uh printer and that'll be. You know totally fine in the house, you know.
Speaker 2So yeah, there's just a little bit more uh risk with these things. But I think, yeah, you're right, the what hank goes doing is really awesome and it's uh for all the. They have a sterilizable resin as well, and they have this soft elastomeric resin as well, and I think it's really very, very exciting.
Speaker 1Yeah, well, what's interesting? And so the reason why and it really has stemmed from the discussion that you and I had with Jacob, who we had on the show, who does a lot of resin printing, and it really stemmed around this whole idea of how important PPE is when you're dealing with resin printers. And I'm like I'm really not interested in all that, but the what hankle and loctite are doing is they're getting rid of all that stuff. They have reformulated a lot of their stuff and they've even, if you want to uh clean it or whatever you do to wash it, they have their own um material for that. That is not as bad for you as the other stuff. So, like they've invested in this formulation, that's less bad for you.
Speaker 1I can't say that it's not bad. But I and I don't know enough about it, but enough to where the only thing that's on the bottle, instead of like skull and crossbones and a whole bunch of other things, is the, the hazard sign, with an exclamation point, which I believe just means that if it's in an uncured state you do have to um throw it out with hazard material, but if it's cured there's, there's no issue. So I uh, that kind of changed my perspective on what I'm interested in getting involved in, and definitely that company and it sounds like you're high on that company too.
Speaker 2They're doing it in a more responsible way and kind of leading the way with the resins, so I've gone there, for example, with a client and they had a high-value application like a medical device application, and you know what was really refreshing they kept saying no, you know what I mean. And that made me very, very happy, you know. They were like, well, no, or if only, if Only in this case, you know. And I like that Because, like we have too many people in 3D printing that have this kind of gumption go go, go thing. If I want an implantable medical device, I don't want go, go go. I want you to be very, very careful. There is no undo right. So I like that about them. I think that they're very kind of careful. So, yeah, I agree, I think it's a wonderful thing to have in our industry.
Speaker 1And the other thing that was a hit is I 3D printed some glasses on the MultiJet Fusion 580. And they're real glasses. I wear glasses all the time and so I put this wood grain on the glasses and it was funny. I actually um at the hp booth and somebody goes, oh, those are nice glasses. Uh, they are they wood?
Speaker 1and I go, no, I'm like, they're made out of hp and they could not believe it you know, and and I think, um, that's one thing that I'm proud of what our team does is we at Advanced 3D are really good at color. We make stuff good. It looks good on the back end as well, and I even ran into some optical guys that couldn't believe that these were 3D printed. They didn't even know you could print in color, and so that's going to be interesting, and I know you have always said and I don't know much about it is really eyewear is a new frontier for 3d printing.
Speaker 2Yeah, I mean I wear is a really, really, really amazing application like one of. It is like yes, you can get custom fit, I wear. It's really funny. It's the first thing that time my girlfriend says like, but I've never had a pair of glasses that didn't fit. You know what I mean.
Speaker 3So it's like.
Speaker 2It's like yes, we can customize them, but that's not exactly the problem for most people. Uh, you know you could get something that fits your face a little bit better, um, uh, but the real issue is that you can produce on demand and I wear is a really strange market where they, they, they destroy a lot of stuff every year and they throw, and they, they do a lot of heavy discounts. Um, because it's very style dependent a lot of fickle kind of consumers. It's very kind of like you buy sunglasses in the summer you're not going to all of a sudden buy well, most people wouldn't then buy another pair of sunglasses, you know, next december or something you know. Um, so it's. So it's a very kind of rapidly moving market and they end up up destroying a lot of products. So making on demand and making close to the style and close to the customer means it's a really good application and at the same time it doesn't use a lot of material. They fit in the printer really well and they tend to finish really well and there's a couple of people doing this at relative scale, some in resin, but mostly in PA11, pa for powder bed diffusion, some with mjf now and, uh, it's a really beautiful application.
Speaker 2It's a difficult market to get into because so style dependent. But you know, once you're there we can get cost competitive. We can make cost competitive glasses. Now, one-on-one maybe will be more expensive, but on the whole you don't have to order a hundred thousand these things in italy and then wait six weeks and then discount half of them and then you know, give away a quarter of them or destroy them. You know. So the economics are there for glasses yeah, yeah.
Speaker 1So I think that was, that was crazy. And and loctite's actually leading the way with some resins for eyewear too. So I mean it was really neat to really really neat to see cool and were there any new machines or things are?
Speaker 1you're a little bit tempted by or you saw really cool well, I mean, I think that there's a couple metal machines you know it's talking about ppe and, like you know, I I do like some of these metal machines that are all in one, you know. So, like the one click metal uh machine, it looks very, very cool and it seems to be, you know, fairly self-contained, to where you are definitely safer when handling the metal stuff. This stuff's expensive, the metal stuff's expensive, it's. It's interesting to me. But, um, I have heard, like, how do you make one metal machine go? You have to have two or three, know so, because one's going to be failing while your other one is printing, no, but also the economics of this.
Speaker 2If you want to like an M290 or something like that, this is a kind of the mainstays of the industry. Actually, yeah, I would always tell people to get two. Also the economics of your operator, right, you have one operator spread out for two machines. Also, the flexibility gives you with builds and it also allows you to reuse some of your finishing equipment stuff. So typically it's very difficult to impossible to make money off of one metal machine and then you need two or three and uh and a bunch of post-processing stuff as well. So the investment is like you're talking like three to five million, usually, um, for you to go anywhere, right, and it takes you about six to eight months to learn how to ride, learn how to do this. And we're not talking like aircraft parts. We're talking about something more or less the right size. Let's say we're talking something for a satellite. So it is there.
Speaker 2But one of the few options you do have is one-click metal, which is like you don't have the powder there, it's cheap, you know, you don't require extra gas stuff and all this. So it's a very affordable machine and, um and very interesting thing to look at. And there's alpha laser as well. There's some cheaper chinese machines coming along. There's exact metal. There's other players in that space, uh, but you're right, the one click metal like and you know it's, and they went really far in trying to make it less dangerous with powder that can explode and stuff like that. So I think that's a really exciting option. Just how many more people can afford to invest like $200,000 to get into metal as opposed to having to invest $5 million? That's like the amount of businesses that have $200,000 lying around as opposed to those with $5 million lying around. That's a lot.
Speaker 1That's like hundreds of thousands more businesses. So I think that's really exciting, yeah, and I would say, lastly, it was super cool, chris Bascuk from Point Design.
Speaker 2So we've had him on and Levin on the fingers the partial fingers.
Speaker 1They won an award at Rapid for the shoulder socket. It's the one that he placed, also first at a mug uh in the technical competition so it was. It was really cool to see him and his team uh get that, and I mean they're just doing amazing stuff over there, so uh super proud of uh seeing that and and the award, and the award going to somebody in O and P. I mean that was really cool.
Speaker 2Cool man. All right, so we have a guest, long suffering guest, poor guest. We should get back to her after telling you that the show is brought to you by advanced 30 and that is a 3d printing production company, your partner in design, production and fulfillment of 3D printed goods for orthotics and prosthetics. So if you want a 3D partner to do anything from getting a file designed, getting something invented and made or doing serial production, then you can talk to Brent and his friend at Advanced 3D. But anyway, so we have a long-suffering guest, the most patient guest in the whole world. Who is it?
Speaker 1Well, I'm really excited to introduce you to Katie Richmond.
Speaker 1Uh, she is a prosthetist and orthotist and a designer for advanced 3d, and so, um, uh, we've been talking to, or we had been talking, for a long time and I've seen, you know, what she is able to do and was able to do with her previous job, and I was like, wow, there is. She was one of the first people that I really thought got the not only the clinical side, but then also the design side and where the advantages of additive manufacturing came into play, and so, yeah, I'm really looking forward to hearing her journey. I don't know that. I've heard the whole thing, definitely bits and pieces, but I'm super excited to have her on board at Advanced 3D. But I'm super excited to have her on board at Advanced 3D and she has been helping us a lot and on some of the stuff that you're passionate about productization, automation and you have always told me, brent, there's got to be a way to automate this, make it faster, make it more accessible to people and she's definitely leading the charge of that for us.
Speaker 2Okay, awesome Congratulations. Hey, welcome to the show, katie, thank you. So, first off, how did you get involved in OMP?
Speaker 3So I was born and raised in Indianapolis, Indiana. Um, from the time that I got an American Girl doll, I always was asking for ace wraps and was making splints for my American Girl doll, to the point that I had to get the one set that they sell that has crutches and a cast. I got the one where it's a wheelchair for your doll, so I've always been interested in it. I did not realize it wouldn't be until high school that I figured out that this was a full-on career and I am a huge fan of the Olympics. I realized sometimes there's good and bad and ugly and all of that, but I was able to go to the 1996 Olympics as a seven-year-old. My parents took myself and my sister and it. It was an incredible event that I really became passionate about and kept following. And then when you want to make braces for your dolls and you love the Olympics, at some point they crash together.
Speaker 3And I learned about the Paralympics and I said, whoa, that's yes, that I'm, I'm about that. So back in the day, before they had any televised coverage of the Paralympics, you could go onto YouTube and they had the daily recap. They showed the best of who won medals and what event all that? So I was watching that and it was the summer between my junior and senior year in high school and the little it was the Academy um that was describing what a career in O&P looked like, and I distinctly remember watching it through twice and then going downstairs to find my mom and her garden and said you have to come up here and watch this because this is what I'm going to do with my life, Um, and so that would have made me 17 at the time 18 and haven't looked back since.
Exploring Design and 3D Printing
Speaker 2That's cool, that's cool. And then your education path. In what did you end up doing? First education-wise and later on?
Speaker 3Yeah, that was also pretty easy because I knew where I wanted to end up. At the time I did not realize it was going to be a master's. That was the first year that was required, so I thought I was going to be able to sneak in with a certificate. But my undergrad is in kinesiology. Prepared me so much. I had a lot of classmates who struggled the first semester with some of the like before we got into the O&P stuff biomechanics, just how we move and I thought it was pretty easy. Not everything, but you know, being well-versed in that helped me flow through that first semester.
Speaker 2So I'm going to go out on a linen hair Katie and say that someone is operating a drill or a kind of belt sander.
Speaker 3I'm getting a new uh hvac system, so, in addition, you're probably going to start hearing a puppy bark when she's ready to get out of her crate. So nope you are correct.
Speaker 2Congratulations on a new hvac here in time for summer. Very good purchase, I would think. Yep, very timely. Okay, okay, let me know. I hope uh brendel managed to edit out. If we don't, then everybody is uh, uh understands why. Um, okay, so, and and when? How about the 3d printing stuff? When did that first, uh, when did you first start to grapple with that?
Speaker 3I mean, I've always thought it was cool. I'd say probably 2020. 2020, one of my friends got a little tabletop. I mean the print volumes maybe five inches, no, maybe four inches by four inches, and that had me like, oh, what could I print in there? So I hopped on and did a little bit of online designing just to see what I could do.
Speaker 3And come September of 2022, I was kind of charged with a research project that involved device development and in taking out human error, and in taking out human error, I took a product that was conceived and attempted to modularize it if that's a word so that it could be put together in a way that was foolproof. Um cause, for those who know the examples if you try and bend a pair of uprights for, like, aluminum knee joints, you need somebody who's really good at that. But once you bend them, do you want to bend them again in case it breaks? No, in order to reuse things and make it so that it was efficient, I needed to take out our human error part. So to do that, it seemed like, hey, you know what would make this a lot easier? Cad would make this a lot easier CAD, and that really, once I started doing it for that. I saw what it could do and then had to start designing for some of my patients after I knew what was possible, and Brent helped me help me out with that.
Speaker 2That's cool. That's cool. And now do you spend most of your time designing career wise? Are you designing most of the time, or what are you doing most days?
Speaker 3I am designing every day, all day.
Speaker 2Okay, super cool. And then, and what's your workflow design wise? What tools do you use from, let's say, idea to finish product?
Speaker 3Well, kind of depends. Finished product well, kind of depends. Um, you know we we have omp partners with advanced 3d who send us scans. And I'll tell you right now, as, as things move forward and digital workflows become more commonplace, the quality of a scanner is is very important Um cause we get some scans from some companies that use great scanners and it's easy, you know, you see all the detail, and then others you're like, ah, we're going to. It was more of a ballpark situation, so get a raw scan. I am mostly working within free form now. I did not have that until starting to work with Brent. It makes my life incredibly easy compared to some free software I was using before. But I also enjoy parametric modeling and reverse engineering and I mostly use a fusion 360 for that. But I was also I was teaching myself that before I met Brent, so something I felt comfortable with. I'm sure there's other good ones, but that's what I've been using.
Speaker 2Would you, would you, would you recommend to someone who's like maybe I don't know anything right? Would you say, hey, you need to understand one CAD thing first. Or would you say, shop around, or you should have two to three things in your arsenal? What's your, what's your strategy for learning this whole CAD thing?
Speaker 3Well, I can only speak for myself, but if you, if you had to learn one before you learn another one, I would still be on my first one. I constantly am learning new tools and ways of doing things in every software. I started with Mesh Mixer. It's incredibly powerful, despite being a little janky at times and crashing my computer, but I would highly recommend getting that playing around with it and the free Fusion 360,. You can do a lot with the free version. I liked both of those and that's where I would recommend to start.
Speaker 2And how about designing for 3D printing? I mean, I think you know, do you jump in there? Do you do start with something easy? How would you, you know, how would you advise people to kind of get come to grips with that?
3D Printing Innovations and Applications
Speaker 3It depends. What are we printing? How are we printing? Because that was another thing. I have a bamboo lab, carbon X1, that I absolutely adore and I mean I make stuff for my house and I've even made some partial hands for some patients. But it really just depends on knowing where you're headed. And if you're headed to an FDM machine, you know I gotta get a nice flat base so I can anchor it to the plate.
Speaker 2I have overhang all of that and it is a very fun new playground to design, not totally but essentially with gravity removed and being able to use MJF okay and then, yeah, I think I think the first entry point for most people is likely to be FDM, but essentially with gravity removed and being able to use MJF. Okay and then, yeah, I think the first entry point for most people is likely to be FDM, material extrusion type of stuff. So, yeah, big, flat build plate, that's nice. Yeah, rounded edges. Yes, no, maybe. So some more things you think people should look out for if you're doing FDM.
Speaker 3I mean, I feel like I haven't. I've been doing this for over a year what, maybe two and a half years? Um, not with Brent, but playing around myself, and I still will print things and be like, well, that was, that wasn't the smartest way. I should have done that. So I don't know that I have any sage like ta-da save yourself from this error advice other than be prepared to fail and then use that to figure out what you do next.
Speaker 2Totally, and I have the Bambu Labs Carbon at home as well Same printer. I love it. Is there anything else you've used before you would also recommend or would you just say to somebody like, just get a bamboo labs. Was that the current state of things?
Speaker 3I mean, yeah, right now I would for sure. When I first started they had not come out yet. It was like right before I think they did they do a Kickstarter or some sort of funding.
Speaker 2Yeah, point is, I didn't need to, but I was not ready to.
Speaker 3It was my first one. I was looking for more in the hundreds of dollars range, not 1500. So I got an any cubic Cobra Go or Cobra Tiny Build Volume and I worked that thing to death and I used that for about six months and it was great. But now Bamboo has one that is probably haven't tried it but probably better and it's as cheap.
Speaker 2So I'd probably just say do that yeah, this is it used to be, like it used to be when people would ask me, like, what printer supply would be like if she's left-handed, then you get. You know, and it was really complicated. Now it's just like get a bamboo labs and then either get the expensive one or get the cheapest one, and then, yeah, it's okay, you know, so it's. It's. It's insane what they've done to our industry. I think, uh, difference, uh for, for consumers and stuff, and they've just made everybody work harder. So that's actually going to be good, but I think, yeah, these other players are not going to be super happy with them. And how about, like filament wise, do you use like one filament, lots and lots of different styles? What are you doing?
Speaker 3I really am only doing PETG, pla and TPU. I have no, this is my basement life and I do not need any toxic chemicals or needing a ventilation system, anything that because I know it's, you know it's all set up to be able to do that with the bamboo, carbon x1 and getting a filter. But I'm like, nah, I don't need that in my life now are you doing mgf?
Speaker 2there's a lot changed. There is that. Is that very exciting to you right now to to look, yeah, like you said, more design freedom.
Speaker 3Yes, I am going to botch this metaphor, but Brent has heard me botch it a thousand times, so I really feel. I felt this before I joined the Advanced 3D team, but I didn't know you could get more into it, but you can. It just keeps snowballing. Um, in the matrix, when Morpheus is like do you want to take the pill that makes you see everything or stay the same? I took the pill where you see everything and I can't unsee it and I don't want to go back. And now it's pretty crazy, but especially with Brent's encouragement and his attitude of wanting to find out the answer. Not how is this going to be morphed into something that we can make tons of money off of? No, it's like I need to know the answer. Because I want to know the answer, I feel like we can almost do anything. I realize that sounds maybe crazy, but no, it's, it's pretty incredible.
Speaker 1I think that's one of the things that I, you know, I really appreciated.
Speaker 1Having Katie come on board is, like, you know, not only the experience, but like where, where she seeks um kind of inspiration.
Speaker 1So, uh like, I'm not an Instagram user, she she is, so she'll be taking screenshots and that sort of thing, and then she lives and dies by this uh like journal, and she's a really good sketch person and so like she'll have shapes and and different things that she may want to try or what have you, and then we kind of we have these, you know, the ability to get this stuff printed.
Speaker 1So not only can you go from this concept to the design in the final material that you're looking at doing, and you can say, hey, we're going to take some of this that we like, but now we thought it was going to work this way but it didn't, and how do we change the geometry proportionally to that? So I think that's one of the neat things is that Katie is opposite of me in that I don't write a lot down, probably too much. I keep in my head and she writes a lot of stuff down, catalogs it, and that's part of the stuff that you have always said to me, joris, is hey, you've got to know what you're doing, exactly what you're doing, and that's how you create a process, that's how you create an asset as well, and I think we have definitely been moving in that direction, and a lot of that is thanks to the way Katie thinks and documents.
Speaker 3The other thing, yours, that I. My first job in ONP was at. At the time it was called the brace shop, which was inside Riley Children's Hospital. Before they sold to an outside contractor they used to actually, you know, you were employed by Riley, so I did one summer there as a volunteer, one summer as an intern and then the next two summers they created a paid technician job for me. So I have a lot of hands-on. I've I've never not modified my own sockets.
Speaker 3I there was a period at one of my jobs five, six years ago where we didn't have a technician and every single thing that I put on a patient I had made myself from a buyback check socket to the final laminations. I got really familiar and was helping everybody else with their click medical. You know how to do the panels and I think that I could not do anything what I'm doing now if I didn't have an idea of how it would be done if 3D printing was not an option. And it is in knowing how I would do it that makes me realize oh gosh, wouldn't it be nice if you didn't have to worry about blank and if that is taken care of through CAD or 3D printing, then it's really easier To me. It stands out and it's like oh, that's where we need to change.
Speaker 2In your day-to-day work life. How does 3D printing actually help you?
Speaker 3Well, just to be, you know, uh, I wouldn't have a job right now if I didn't have advanced 3d Um. So you know, it helps me a lot in that sense. I think as a prosthetist I have a lot more years as a prosthetist than I have experience as an orthotist, so I speak mostly to that. I mean it helps me. It kind of is the same answer as previously. Like I drank the Kool-Aid, I ate the pill. If you come to me and you're like this is a problem, I'm like cool, Well, let's just try and fix the problem. I'm like cool, well, let's just try and fix the problem. And this is one more tool that I have that allows me to be like yeah, you don't need to settle for that problem, we'll fix it. I don't know how, I don't know when. It might take 10 iterations, but I'm not going to quit.
Speaker 2And are you looking at any more new technologies, new materials? What are you looking for on the new 3D printing things?
Speaker 3I mean, I'm along for the ride and I have the benefit of getting to talk to Brent at least five days a week, so he is definitely pulling me along with them. Like on the 3D printing side of things, let's say for patients and such, where have you seen or have you seen? You know, obviously we can had something 3D printed that you know could otherwise not. Loved working with him very much along the lines of you know who cares. If it's hard, we're gonna.
Speaker 3We're gonna do it anyway, or at least we're gonna try. And what really got me doing the with you was printing in TPU for distal cups, for double-walled sockets, and the reason that 3D printing seemed like the easy decision was in talking to our central fab. I mean, they hated those. You know in it was built in to the cost that they would charge us a cost of an extra sealing sleeve because they were going to put one on and then cut it off with the lamination. They they actually anticipated having to restart once every single socket. They did like totally scratch it Cause something leaked.
Speaker 3And I think when I started they were like yeah, that'd that'd be a four week turnaround. I'm like no, that's not okay and I don't have a. I didn't have't have a lab and honestly I probably would have gone in and showed them how I would have done it. But it's really nice to be able to for me. I have trouble letting other people do what I know how and know exactly what I want to do. Um, but with CAD I don't need a giant lamination room or grinder or anything like that. I can make it exactly what I want and know that it will be that when it comes out of the printer and I definitely had that, that experience with the double-walled sockets and just started to dip into latticing um before I stepped out of that job and and joined Brent at Advanced 3D. So I'm looking forward to, in the future, being able to be seeing patients while while working alongside Brent.
Speaker 1So you mentioned the lattice side of things. What are you so, what are some of the challenges? And then you know and you can kind of speak in kind of generic terms like what are some of the challenges. And then you know and you can kind of speak in kind of generic terms like what are some of the things that you do for lattice structures, or where are you seeing it be the advantage for patients? And then you can talk about some of the difficulties in designing lattice structures too, specifically for O&P.
Speaker 3Yeah, I mean, the easiest one is weight. I mean you, you, the materials we're working with are already light and then you remove excessive and it's great. The other thing is the, the cushion, and you and under your direction, I've I've played around with, you know, the beam, radii and the inner beam versus the outer beam. It's a it's still clear as mud to me, but I used to do some, uh, I liked Excel for my inner flexibles it. Just I liked working with it and I would do like pads on the outside before I did a lamination, essentially building in an area of cushion but allowing for total contact and, you know, still, um, being able to achieve suction. And this is this, is the, the, the easy way of doing that. Because, again, trying to explain to someone, possibly in a different state than you, if you're using a C-fab, when I was not able to have my hands on the model and laminate it myself and create that pad in the way that I knew I wanted it.
Speaker 1that was difficult, but in 3D with latticing, I can put things exactly where I want them to be well, I mean, I think, I think one of the cool things about, uh, the the lattice structures is yeah, so there's, there's a few things that we have to consider when, when making these. One is the material. You know, what material are we going to do? How are we going to do? How are we going to post-process, are we going to smooth these and and then do, does the lattice structure go all the way through? So, you know, one of the things that we look at doing is creating a membrane, a membrane structure on the inside that's very thin, but then having you, but it needs to be thick enough to smooth, and then your beam size needs to also be wide enough, or your cell size needs to be wide enough so the smoothing can go all the way in and smooth on the other side of the membrane.
Speaker 1And so it ends up being a pretty technical issue, and I think, especially with Katie's help, we have been able to start characterizing some of these lattice structures to the point of production rather than, hey, this feels pretty good, now we're at, this feels pretty good, and we can get repeatable results, and we can turn that into an automated process and if we need tweaks here and there. So I think that's one thing. When people are looking at lattice structures, it's one thing that it looks good, feels good, and then there's another thing that can you do that a second time and that is super important is the ability to be able to characterize it and be able to do it a second time and repeat it thereafter and understand why it's doing it. So I think that's uh, that's pretty interesting.
Speaker 3You know I I feel like I'm still maybe not daily, but almost sometimes I feel like I'm learning new, new ways to use programs I have had or just got access to, to like it's just so much is out there. That to me. Yeah, of course I want more things, but have I have I completely searched what's out there trying? But it is a never ending job. And just kind of being aware and you know Brent and I have talked about LinkedIn is great. I use Instagram and you know that is a way for me to see things that I didn't know were possible. So I might wish for it. But what if it's already out there?
Speaker 2So do you think having a small printer in house is worthwhile? Is that a place to start?
Speaker 3The benefit of having a small bamboo like printer in an area where you don't have access to big fabrication. You know to to do a custom wrist hand orthosis is nothing. Uh, I like the idea of having it be more involved from the beginning in the process. I myself, because I love prototyping, you know it's, you don't? You shouldn't have to need a half a million dollar printer. You get yourself a bamboo lab printer and you start messing around with it and it's like oh, like, oh, yeah, no, of course, for that partial hand.
Speaker 3Why wouldn't we do a check socket? It takes a couple hours to print and you get to try it on and the cost is is barely anything. So upper extremity, both orthodontically and prosthetically and pediatrics, all of it. It's just about getting it. I'm torn because the barrier to entry is high and there's a fine line between automating things to the point where the practitioner just plug and plays on the iPad and doing all the design themselves, and I think it it depends. I'm idealistic and I want to do everything myself, so I don't want things to become so easy that it's like here this is by numbers, just throw it on, it's good, but maybe we can get it to be that good.
Speaker 2Okay. Do you think we are at the point where 3D printing has to be top of mind for clinicians and practices?
Speaker 3I guess it depends. I think that it is not optional in the sense that you I mean anymore. It feels like it would not be smart to at least dip your toes in to scanning. And if you have zero intention of making definitive mjf sockets, you should still probably be printing, even if it's only BK sockets, like oh, I don't want something that's so big that I could do 8Ks. I think it would be stupid to not. Because the other thing that worries me is, you know, by the time some of the big players in 3D printing and O&P, by the time they get to be so good and things are made pretty easy where the clinician doesn't need to really know the printing techniques as much I don't know, it's a fine line well, but I do think like, uh, you know, to your point though, it being a fine line, I think it definitely needs to be a tool in everybody's toolbox.
Speaker 1So I think the the other part of all this is there is times, uh, to do use traditional fabrication.
Speaker 3Oh 100%.
Speaker 1But if you are only limited to what is available in traditional fabrication and you have completely closed off the 3D printing side of things you're not doing right by your patient and I'll die on that sword Like you should try to make every tool available in your toolbox and if you take a part off that potentially can help your patient, to me that's a problem.
Speaker 3It does depend on the clinician, on how much they want to be involved, but I think you're going to get outstripped in your field if you are not at least okay scanning and being open to these things, because now, with social media, patients are going to come in and be like well, why, why can they do that and can I get that from here? And if you say no, then they'll just go find someone else, as they should. You know as much as they are patients, they are consumers and they're the ones that need to be happy. So if this is part of it, I think you should definitely jump on board.
Speaker 2Katie, thanks so much for being here and for the discussion. This was really great.
Speaker 3Of course, thank you.
Speaker 2Brent, of course. Thank you for being here, as always.
Speaker 1Oh, this is cool. And, Katie, it was good hearing the story. I did not realize the one about the dolls. I knew a little bit about the Paralympic stuff but kind of that where everything kind of collided for you yours, things will collide again, because I am.
Speaker 3I am living out a lifelong dream and my husband and I will be going to uh, the paris paralympics this year. So we are psyched mostly me, but he too is okay with brands.
Speaker 2That is so cool, Katie. Best of luck to you and thank you, our listeners, for listening. This is another episode of the Prosthetics and Orthotics podcast. Have a great day.
Speaker 1And that wraps up another episode of the Prosthetics and Orthotics podcast. A big thank you to Katie for sharing her expertise and insights today. If you enjoyed today's episode, make sure you hit the subscribe button so you never miss out on future episodes. Thank you for listening and we'll catch you next time on the Prosthetics and Orthotics Podcast.
