By the Blouin News Business staff

FEATURE: Prosthetic technology sprints ahead

by in Global Economy, U.S..

U.S. Marine Sgt. Angel Barcenas, who lost both his legs as a result of and IED blast in Iraq, runs with a parachute during a demonstration at Walter Reed Army Medical Center June 1, 2007 in Washington, DC. Patients and staff of Walter Reed were joined by athletes to demonstrate how amputees excercise to and learn to use prosthetic limbs while also showing the latest technology behind the prosthetics. Getty Images

U.S. Marine Sgt. Angel Barcenas runs with a parachute at Walter Reed Army Medical Center, June 1, 2007. Getty Images

The charity e-NABLE is backlogged with thousands of requests 3D-printed prosthetic hands for people in need all over the world.  Since they began operating in the spring of 2013, their network of volunteers has grown to over 5,000, who together have helped produce over 1,500 prosthetic hands that were given away at no cost to children, veterans, and the disabled. e-NABLE is now asking the 3D printing community to crowdsource the largest donation of 3D printed hands in the organization’s history: 1000 Raptor hands by September 15. (The design specs and assembly instructions are available for free online.)

The 3D-printed Raptor prosthetic hand: Source: 3Dprint.com

The 3D-printed Raptor prosthetic hand: Source: 3Dprint.com

Prosthetics are advancing incredibly, and they promise a better quality of life for people around the world, both rich and poor. Broadly speaking, there are two R&D routes. The high-price approach uses advanced technology to create the most life-like customized artificial limbs possible. For example, top-of-the-line prostheses incorporate microprocessors that work with onboard gyroscopes, accelerometers, and hydraulics to enable a person to walk with a normal gait. (Hugh Herr, head of the MIT Media Lab’s Biomechatronics group and a double-amputee, gave an insightful TED talk in March 2014 on this topic.) Since these prostheses can cost over $50,000, they are largely aimed at users in the developed world.

By contrast, the cheaper approach involves simplification and standardization, and increasingly relies on 3-D printing. In particular, amputees in developing countries will greatly benefit as functional neurologically-controlled artificial limbs become affordable for the first time ever. Children in need will reap major benefits as well. Currently, pricey prostheses are usually purchased for adults, since children outgrow them so quickly and multiple replacements would often be budget-breaking.

There are many promising developments occurring in both design and distribution within this lower-cost route, which has the most transformative potential on a global level. e-NABLE has have already received support from universities and businesses in fulfilling its latest goal. Florida State, Purdue, and Duke are pitching in, as are 3D printing firms Mind-to-Matter, Fargo 3D Printing, and 3DPrinterOS. “We challenge the 3D printing industry as a whole to take the time to print at least one hand to help e-NABLE meet their goals. Working with e-NABLE and utilizing our network of printers is a prime example of how 3D printing can affect real change and this is just the beginning,” said CEO of 3DPrinterOS John Dogru.

This builds on earlier encouraging support for the charity. Last fall, the University of Albany’s Department of Informatics began what was meant as a one-time volunteer event to 3D print and assemble prosthetic hands for e-NABLE. Each hand cost about $50 for parts and filament, and took between 4 and 6 hours to complete. The project was a huge hit, and took on a life of its own, with far more volunteers and support from local businesses than anticipated. After the lab reached out to Google for assistance, the tech firm enlisted 12 volunteers to help in the 3D printing. Then in May, Google’s non-profit arm pledged a $600,000 grant to e-NABLE, as part of its $20 million initiative called “Google Impact Challenge: Disabilities.”

Meanwhile, Dr. Ha Vo, an associate professor of biomedical engineering at Mercer University, has patented the Universal Socket Prosthetic, a highly durable prosthetic leg that costs less than $200 to manufacture. And he has helped lead students and faculty on 10 trips since 2009 to his native Vietnam (as part of the Mercer On Mission initiative), where they have fitted over 4,000 amputees with his invention. With 7 full-time Vietnamese staff plus around two dozen Mercer volunteers during the summers, the newly expanded program has the potential to fit up to 2,000 amputees each year at its three clinics in the south of the country.

The program has been so successful that the Vietnamese government recently requested its work be expanded to Hanoi and the northern part of the country. Dr. Vo, university minister Dr. Craig McMahan, and businessman Chris Sheridan (whose foundation has pledged over $1.25 million to the program), plan to return to Vietnam soon to explore the feasibility of establishing a new clinical base in that area, according to Mercer News. In addition to the Vietnam trips, the program traveled to Haiti after that country’s devastating earthquake in 2010. And there is more demand. In fact, the U.N. and other international agencies have had discussions with the university about expanding the program into other countries.

Similarly, Amos Winter, an assistant professor of mechanical engineering at MIT, leads a team that recently calculated the ideal torque that a prosthetic knee should produce for normal walking. Drawing on their results of their published paper, the group then built such a prototype, using only simple mechanical elements like springs and dampers. “We’re going after this disruptive opportunity. If we can make a knee that delivers similar performance to a $50,000 knee for a few hundred dollars, that’s a game-changer,” said Winter.

Winter’s team is testing the prototype in India, which has about 230,000 above-knee amputees. “In places like India, there’s still stigma associated with this disability. They may be less likely to get a job or get married. People want to be incognito if they can,” he noted.

And the results? “This was a quick and dirty prototype, but so far, we’re seeing good indicators of natural gait. I’m not ready to claim victory yet, but [this paper] lays out a roadmap that is very different than what’s been done before, which will enable us to achieve very high performance at low cost,” Winter stated.

With a more commercial focus, the firm Protesta, a spin-off from the Technological University of Mexico, is developing a low-cost artificial arm made from lightweight plastic. A novel added feature is that the arm will alert the user via vibration if it gets above 95˚F. The user will be then able to take action before the prosthesis is damaged, or before the heat radiates through it and into real skin. Project leader Carlos Perez Roque also claims that the arm is capable of lifting up to 8kg (17.6 lb), and that the entire arm should ultimately retail at $2,500, or $2,000 for just the hand and wrist.

But perhaps the most revolutionary prosthetic innovation for the mass market will be the technology developed by Oliver Armitage, a final year engineering PhD student at the University of Cambridge. The device being developed by Cambridge Bio-Augmentation Systems (which Armitage co-founded and now directs) would be permanently integrated into the remaining bone of an amputated limb via a one-time surgery, and would then function akin to a USB connection.

An illustration Cambridge Bio-Augmentation Systems uses to demonstrate its plug-and-play concept.

An illustration Cambridge Bio-Augmentation Systems uses to demonstrate its plug-and-play concept.

“On the outside any prosthetic can connect to our device via a standard plug-and-play connector,” Armitage explained, adding “what we’re going to release is an open, public, free-to-develop-for standardized interface, sort of a two-part male and female connector.” He also pointed out that “The device also includes the standard neural connection and provides a number of channels of neural data to control the prosthetic.”

The implications of a universal connection are game-changing for availability and cost. “Anyone can build a prosthetic for this device or can just buy their new prosthetic online. It means that really we can take the delivery of prosthetics out of the healthcare and hospital setting, where we need all this therapy and it needs to be fitted by a specialist, to a position where prosthetics can really be sold as a retail model, because technologically they can be attached very easily…” said Armitage.

“The overall cost to prosthetics can come down without us ever having to impinge on the prosthetics manufacturer’s bottom line, because the cost of a prosthetic is built into the socket and the device,” he emphasized. “The manufacturer who is making the device, their device is going to be the same price, but the total cost the patient sees has gone down.” This approach also means lower costs to healthcare providers, a selling point that is likely to be one of the biggest drivers of its adoption, wrote Tech Factor. “For a patient it’s a technological argument, for a hospital or a healthcare provider, there’s still the initial surgery, but then there’s a massively reduced cost in the follow-on care of the amputee,” Armitage said. Gone will be the expensive long-term care that is required to treat stump damage and reshaping caused by most current socket systems.

Cambridge Bio-Augmentation Systems was only incorporated in early May, and Tech Factor reported in July that the firm will be filing patents regarding the inside of the device “within the next few months.” Despite its early stage, the firm has already attracted substantial attention and support from startup accelerators. However, its clinical trials are still about three years away, and full regulatory approval for human use could take between 5 and 10 years.

To sum up, expect prosthetic technology to sprint ahead globally by the end of this decade.