Re: Responses to Re: Partial Hand Prosthesis
Jeff Erenstone
Description
Collection
Title:
Re: Responses to Re: Partial Hand Prosthesis
Creator:
Jeff Erenstone
Date:
10/8/2014
Text:
*Initial Post*
Hello All,
There is a group of 3D printers who are building prosthetic hands
for children with partial hands. They are claiming that most
prosthetic hands cost $40,000 and that their hands cost $50. There example
is a person who received a myoelectric arm (much like a
transradial myoelectric arm) for a partial hand amputation and posted about
it on Youtube.
I am wondering if you think this is the standard of care and if the cost is
accurate. If not what type of prosthesis would you design?
What would you say the average cost is for that device?
link:
<URL Redacted>
Quote: Dr. Graboyes says, What's really interesting is the professionally
made FDA approved prosthetic hands cost on average about $40,000. These
things (points to 3-D printed hands), $5, $10.
Youtube link: <URL Redacted>
-Jeff
*Response #1*
2k-4k cost for a hand I'd make. My thought is the 3D hand will be lucky to
last a day through a kids play.
*Response #2*
I asked a similar question a few weeks ago because it concerns me that it
makes our profession look like anyone can do it and also that we look
incredibly over paid.
The very few responses I got were a couple of people saying that these 3-d
printer prostheses have little durability and no clinical experience to go
with it. But as an outsider, why wouldn't normal Americans say I can buy
a $40000 arm or I can do a new $100-300 arm every month if I needed and I'm
still ahead cost wise. So I don't feel that is a good answer/ response.
I think it's cool that some college kids have made some hands that have
helped people but boy do I feel like it made our job look bad. I
personally have had at least 15-20 people ask me if we do stuff like the
kid that 3d printed an arm, boy that looks easy, and say aren't you
worried about your profession now.
How do we as a profession acknowledge how this has helped people but show
we aren't taking advantage of people as a profession. Sorry for the slight
tangent but I'm glad you are asking this because it upsets me.
Please do not include my name if you forward responses.
Feel free to contact me though
*Response #3*
I think you raise a good question regarding the presentation of the $ cost
of a 3-D printed prosthetic versus a traditional device. When these
assertions are made the report is typically considering only the cost of
the plastic material.
The capital cost of the printer is rarely discussed. Printer costs vary
considerably based on a number of factors including material choices, the
method of layering, the size of the item to be produced, etc.. Good
printers for industrial and business applications can easily run upwards of
$100,000. Beyond materials the valuable time of a fully trained and
licensed professional needs to be included. Finally there are the real
costs of operating a facility: rent, utilities, overhead, admin staff,...
If one is able to work for free and borrow someone else's expensive 3-D
printer it may well be possible to produce a rudimentary prosthetic arm for
$50. Similarly, the cost of plastic in a foot orthotic or an AFO
represents a fraction of the total cost to evaluate the patient, produce
the device and dispense it properly. 3-D printing technology is wonderful
and promising and I believe it will be an important addition to the array
of tools and methods already available within the profession.
*Response #4*
1) Isolated 3D printing cost depend on actual material and device
precision. If you get a rough print and sandpaper it manually then you can
go very cheaply. High quality 3D prints can cost hundreds of dollars. As 3D
printing is an emerging technology, prices are maybe often times reduced in
a pro bono sense and do not reflect any competitive market when cited
with 3D hands made for kids. Other than that, there is a competitive market
in industrial 3D printing.
2) Isolated 3D model design can range between cheap (using a pre-made cheap
or free 3D model with no or litte adaptation) and very expensive when
account for true expert work hours; here, spawning businesses will try to
push individual adaptation of 3D models under 1/2 hour if ever possible
(scaling, ..) and bill some 1000 USD give or take, so that is good money
then. Anything else is a waste of resources - spending 5000 USD on a
plastic 3D print is just as much a waste as giving free 3D models away that
took several days or even weeks to build. If a friend, neighbour or dad
designs some 3D hand for a congenital amputee that has a bit of a hand to
move the prosthetic fingers, and if that 3D model is made freely available,
one cannot apply competitive market sense to interpret that phenomenon.
2) Commercial myoelectric prostheses usually are totally overpriced items
built on often times relatively old if not outdated patents and - component
wise - mostly cheap parts. Here in Switzerland, a normal myoelectric arm
might cost 45'000 CHF, an iLimb prosthesis all in all around 80'000 CHF. -
So figures like 40 000 USD do not represent actual competitive market
driven prices but what the insurance and monopole protected prosthetic
component industry achieves.
*Response #5*
I once had a passive 3D arm / hand scanned for 3D print here (no moving
parts or assembly, so more contiguous material to be printed), and a
realistic figure for good quality and substantial material amounts in a
competitive commercial 3D printing environment would cost 800-3000 USD
depending on the type of plastic and the precision. That price is on par
with, say, a passive arm made by a prosthetist manually. It would also be
technically mostly equal, with little differences overall that can be
identified and explained if necessary.
The potential to totally devastate existing businesses is not to be
underestimated. The fast food / burger industry only took off like meat on
crack once the single work steps - raising cattle, slaughtering cattle,
processing meat, making burgers, frying burgers, selling them - were
separated into their own little industries. Same in computer industry:
nowadays, fans, motherboards, wifi and lan cards, power supplies, computer
enclosures, and also the type of Linux or other operating system you want
to run, are all produced in separate and highly competitive industries
which massively pushes prices down while slowly increasing quality in a way
where the market dictates it. Here, we see a first and hesitating
separation of the 3D model design and the actual fabrication process. Once
some businesses align themselves with that new type of separation, you will
see the most profound shattering of manufacturing seen ever with a possible
change in pricing as well. As long as the same providers offers 3D scan, 3D
model design and 3D fabrication, there will be not much of a change.
*Response #6*
I have both a 3-D printed partial hand prosthesis for a patient. While it
was easy and cheap about $300 total and material, durability is the biggest
issue. The material choices available that's far very brittle.
When I compare this to a similar function device, the M fingers by
liberating technologies, but here's what I have coded out right around
$8000.
The functionality of the 3-D printed devicewas okay, but it was really
neat to embrace the technology and utilize it as a learning resource
almost like a check socket for these M fingers.
I hope this helps, also check out the group on Facebook and other social
media streams called the e-nable they are at the forefront of this
technology and movement.
*Response #7*
Thanks for your posting on the listserv. I am a 2nd year MSOP student with
Eastern Michigan University who is actively exploring the applications for
3D printing in prosthetics. It's interesting to hear the various
perceptions of the technology, based on career experiences. The e-NABLE
community has some great goals, but many of their prostheses are just not
realistic to be worn by patients. 3D printing lends itself to one-off
manufacturing. If you are going to make any more than a few models of a
particular part, there is no reason to 3D print any more than the first
one. Time, material, electricity, and machine wear and tear all play a
factor in this. Thus, 3D printing would apply to the custom areas of
prosthetics, such as sockets, but would not apply to components, because
they can be sized to accompany a wide range of populations.
As for this particular piece, it is very possible that the 3D printed hand
was more applicable for this patient when he is performing tasks like
carrying boxes, relative to his myo, and I think that's okay. There is
more to our field than one particular test, and I can imagine he would
still wear his myo for cosmetic reasons as well as his body powered arm,
which sits on the table and isn't mentioned in the video. I think that, in
the long run, the publicity surrounding 3D printing prosthetic devices will
push our field further and increase patient care.
*Response #8*
The costs are really misleading. A digit patient would approach that amount
because the electronic digits wholesale for about $36K but the child was
fit with a mechanical hand and appears to have a transact pal or similar
amputation so he uses wrist flexion to close the fingers. A more comparable
cost would be under $10K for a comparable prosthesis.
This is another example of technology racing ahead of our ability to
effectively harness it. State licensure would effectively force these folks
to work alongside Prosthetist's instead of vilifying them for the costs of
prostheses.
Hello All,
There is a group of 3D printers who are building prosthetic hands
for children with partial hands. They are claiming that most
prosthetic hands cost $40,000 and that their hands cost $50. There example
is a person who received a myoelectric arm (much like a
transradial myoelectric arm) for a partial hand amputation and posted about
it on Youtube.
I am wondering if you think this is the standard of care and if the cost is
accurate. If not what type of prosthesis would you design?
What would you say the average cost is for that device?
link:
<URL Redacted>
Quote: Dr. Graboyes says, What's really interesting is the professionally
made FDA approved prosthetic hands cost on average about $40,000. These
things (points to 3-D printed hands), $5, $10.
Youtube link: <URL Redacted>
-Jeff
*Response #1*
2k-4k cost for a hand I'd make. My thought is the 3D hand will be lucky to
last a day through a kids play.
*Response #2*
I asked a similar question a few weeks ago because it concerns me that it
makes our profession look like anyone can do it and also that we look
incredibly over paid.
The very few responses I got were a couple of people saying that these 3-d
printer prostheses have little durability and no clinical experience to go
with it. But as an outsider, why wouldn't normal Americans say I can buy
a $40000 arm or I can do a new $100-300 arm every month if I needed and I'm
still ahead cost wise. So I don't feel that is a good answer/ response.
I think it's cool that some college kids have made some hands that have
helped people but boy do I feel like it made our job look bad. I
personally have had at least 15-20 people ask me if we do stuff like the
kid that 3d printed an arm, boy that looks easy, and say aren't you
worried about your profession now.
How do we as a profession acknowledge how this has helped people but show
we aren't taking advantage of people as a profession. Sorry for the slight
tangent but I'm glad you are asking this because it upsets me.
Please do not include my name if you forward responses.
Feel free to contact me though
*Response #3*
I think you raise a good question regarding the presentation of the $ cost
of a 3-D printed prosthetic versus a traditional device. When these
assertions are made the report is typically considering only the cost of
the plastic material.
The capital cost of the printer is rarely discussed. Printer costs vary
considerably based on a number of factors including material choices, the
method of layering, the size of the item to be produced, etc.. Good
printers for industrial and business applications can easily run upwards of
$100,000. Beyond materials the valuable time of a fully trained and
licensed professional needs to be included. Finally there are the real
costs of operating a facility: rent, utilities, overhead, admin staff,...
If one is able to work for free and borrow someone else's expensive 3-D
printer it may well be possible to produce a rudimentary prosthetic arm for
$50. Similarly, the cost of plastic in a foot orthotic or an AFO
represents a fraction of the total cost to evaluate the patient, produce
the device and dispense it properly. 3-D printing technology is wonderful
and promising and I believe it will be an important addition to the array
of tools and methods already available within the profession.
*Response #4*
1) Isolated 3D printing cost depend on actual material and device
precision. If you get a rough print and sandpaper it manually then you can
go very cheaply. High quality 3D prints can cost hundreds of dollars. As 3D
printing is an emerging technology, prices are maybe often times reduced in
a pro bono sense and do not reflect any competitive market when cited
with 3D hands made for kids. Other than that, there is a competitive market
in industrial 3D printing.
2) Isolated 3D model design can range between cheap (using a pre-made cheap
or free 3D model with no or litte adaptation) and very expensive when
account for true expert work hours; here, spawning businesses will try to
push individual adaptation of 3D models under 1/2 hour if ever possible
(scaling, ..) and bill some 1000 USD give or take, so that is good money
then. Anything else is a waste of resources - spending 5000 USD on a
plastic 3D print is just as much a waste as giving free 3D models away that
took several days or even weeks to build. If a friend, neighbour or dad
designs some 3D hand for a congenital amputee that has a bit of a hand to
move the prosthetic fingers, and if that 3D model is made freely available,
one cannot apply competitive market sense to interpret that phenomenon.
2) Commercial myoelectric prostheses usually are totally overpriced items
built on often times relatively old if not outdated patents and - component
wise - mostly cheap parts. Here in Switzerland, a normal myoelectric arm
might cost 45'000 CHF, an iLimb prosthesis all in all around 80'000 CHF. -
So figures like 40 000 USD do not represent actual competitive market
driven prices but what the insurance and monopole protected prosthetic
component industry achieves.
*Response #5*
I once had a passive 3D arm / hand scanned for 3D print here (no moving
parts or assembly, so more contiguous material to be printed), and a
realistic figure for good quality and substantial material amounts in a
competitive commercial 3D printing environment would cost 800-3000 USD
depending on the type of plastic and the precision. That price is on par
with, say, a passive arm made by a prosthetist manually. It would also be
technically mostly equal, with little differences overall that can be
identified and explained if necessary.
The potential to totally devastate existing businesses is not to be
underestimated. The fast food / burger industry only took off like meat on
crack once the single work steps - raising cattle, slaughtering cattle,
processing meat, making burgers, frying burgers, selling them - were
separated into their own little industries. Same in computer industry:
nowadays, fans, motherboards, wifi and lan cards, power supplies, computer
enclosures, and also the type of Linux or other operating system you want
to run, are all produced in separate and highly competitive industries
which massively pushes prices down while slowly increasing quality in a way
where the market dictates it. Here, we see a first and hesitating
separation of the 3D model design and the actual fabrication process. Once
some businesses align themselves with that new type of separation, you will
see the most profound shattering of manufacturing seen ever with a possible
change in pricing as well. As long as the same providers offers 3D scan, 3D
model design and 3D fabrication, there will be not much of a change.
*Response #6*
I have both a 3-D printed partial hand prosthesis for a patient. While it
was easy and cheap about $300 total and material, durability is the biggest
issue. The material choices available that's far very brittle.
When I compare this to a similar function device, the M fingers by
liberating technologies, but here's what I have coded out right around
$8000.
The functionality of the 3-D printed devicewas okay, but it was really
neat to embrace the technology and utilize it as a learning resource
almost like a check socket for these M fingers.
I hope this helps, also check out the group on Facebook and other social
media streams called the e-nable they are at the forefront of this
technology and movement.
*Response #7*
Thanks for your posting on the listserv. I am a 2nd year MSOP student with
Eastern Michigan University who is actively exploring the applications for
3D printing in prosthetics. It's interesting to hear the various
perceptions of the technology, based on career experiences. The e-NABLE
community has some great goals, but many of their prostheses are just not
realistic to be worn by patients. 3D printing lends itself to one-off
manufacturing. If you are going to make any more than a few models of a
particular part, there is no reason to 3D print any more than the first
one. Time, material, electricity, and machine wear and tear all play a
factor in this. Thus, 3D printing would apply to the custom areas of
prosthetics, such as sockets, but would not apply to components, because
they can be sized to accompany a wide range of populations.
As for this particular piece, it is very possible that the 3D printed hand
was more applicable for this patient when he is performing tasks like
carrying boxes, relative to his myo, and I think that's okay. There is
more to our field than one particular test, and I can imagine he would
still wear his myo for cosmetic reasons as well as his body powered arm,
which sits on the table and isn't mentioned in the video. I think that, in
the long run, the publicity surrounding 3D printing prosthetic devices will
push our field further and increase patient care.
*Response #8*
The costs are really misleading. A digit patient would approach that amount
because the electronic digits wholesale for about $36K but the child was
fit with a mechanical hand and appears to have a transact pal or similar
amputation so he uses wrist flexion to close the fingers. A more comparable
cost would be under $10K for a comparable prosthesis.
This is another example of technology racing ahead of our ability to
effectively harness it. State licensure would effectively force these folks
to work alongside Prosthetist's instead of vilifying them for the costs of
prostheses.
Citation
Jeff Erenstone, “Re: Responses to Re: Partial Hand Prosthesis,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/236837.
