Digital Fabrication of Lower Limb Prosthetic Sockets

Dr Ben Oldfrey, Mark Miodownik, Dr Giulia Barbareschi, Dr Rhys Williams, Catherine Holloway, Global Disability Innovation Hub, UCL, Institute of Making
Dec. 16, 2020
Global

This innovation insight discusses current approaches to digital fabrication of lower limb prosthetics (LLP) sockets aimed at low resourced settings. Digital fabrication of LLPs sockets has been researched for a number of decades, yet these technologies are not widely adopted, and most of the activities within this domain reside in high-income settings. However, the majority of amputees are in LMICs where there is a severe lack of access to services. It is in LMICs then, that the advantages that digital technologies offer could be of particular benefit however little to no progress in digital workflow adoption has been made to date.

Highlights

Globally, only 5-15% of people who need a lower limb prosthetic have access.

· There is a lack of service access in LMICs. Digital fabrication of prosthetic sockets could decrease the burden on existing clinics in LMICs and overcome the lack of service points, however unanswered questions about the feasibility of this approach remain.

· 3D scanning is mature and has standalone clinical and technical benefits. It could begin to be introduced to P&O training as a first step in training for a digital workflow.

· An understanding of the training burden for a full digital workflow is lacking, and there is potential to do more than harm than good in attempting to alter the practices of LMIC clinics. It is crucial therefore to fully understand the challenges of large-scale implementation.

· If the reliability of print & material quality can be proven and accepted by the community, while still keeping cost low, then additive manufacture could transform service delivery models in low resource settings.

· Without larger scale trials & research on quality control and durability, the prosthetist community will remain sceptical. Consensus is needed on valid approaches to testing and scaling digital fabrication technologies.

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