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
Bonus Episode: Lessons Learned in Additive Manufacturing for O & P and Looking towards Formnext 2024 with Joris and Brent
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This episode examines the evolving role of 3D printing in prosthetics and orthotics, focusing on advancements in additive manufacturing. Joris Peels and Brent Wright discuss Formnext and hop into the weeds about some other things.
The conversation highlights collaborative robots (cobots) as tools for creating body-specific parts like scoliosis braces, offering safer and more cost-effective solutions across industries such as aerospace and specialty vehicles. Bambu Labs' developments in material extrusion are also explored for their potential to set new industry standards for personalized manufacturing.
The episode concludes with a discussion of the intersection of technology, design, and market trends, focusing on companies like Zellerfeld and Nike. Topics include custom foot orthoses and footwear innovations, as well as the potential for luxury applications in prosthetics and orthotics, signaling a shift in industry possibilities.
Special thanks to Advanced 3D for sponsoring this episode.
Future Innovations in Prosthetics and Orthotics
Speaker 1Welcome to a special episode of the Prosthetics and Orthotics podcast. Today we're reflecting on the past season and we discuss the latest advancements in our field. Joris then foreshadows some of the things to come in form next the leading event for additive manufacturing and advanced technologies. Whether you're a professional or just starting out, stay tuned for a discussion on the current state and future of prosthetics and orthotics. Let's dive in.
Speaker 2Hello everyone, my name is Yoris Pils and this is another episode of the Prosthetics and Orthotics Podcast with Brent Wright. How you doing, brent?
Speaker 1Hey, yoris, doing well, man, it's been fun. You know, I did this stuff with Duan at the CDFAM and then I had done some stuff with Maya Mosa traveling. But now it's your turn to travel because you're heading to go to Formnext. And I'm a little jealous about that because I know that there's a lot of people going there and from my understanding, there's going to be some uh, a pretty good omp presence there. I don't know who all is going there, but you know hp always has a great booth.
Speaker 1Uh, I'm sure form labs is going to uh doing that and they're making a smash, a splash with some of their their newest news coming out with the open materials and and that sort thing. And the 4L looks pretty awesome too. So there's so many things that are going to be coming out and I just feel like Formnext is a big place to release stuff, right.
Speaker 2Sure, yeah, it's the biggest show in additive. What I say is that the Formnext exhibitor party is bigger than the next biggest show in additive. What I say is that the Forum Next Exhibitor Party is bigger than the next biggest show in additive. Right, that's what. That's the. So to give you a little bit of an idea of the scale of, like, the people that go to, the Exhibitor Party is one of the biggest shows in additive. So it's in Frankfurt, which is horrible, but apart from that, it's the definitive show for our industry. So it's the show. It's the definitive show for our industry. So it's the show. It's the only show where you get people from asia, from north america, from europe, coming from all over. So if you're there and I would recommend, if you want to, if you're really deep into 3d printing, do go there. But the added advantage some people go for two days or something and then from the states. It doesn't, it isn't really worth it. But if you go for five days, right, then you'll be able to meet so many people and and see so many things that it really is worth it because it saves you on going to two to three different shows. Okay, you can meet ceos from uh, whatever the chinese, big chinese companies, the big us companies, from big german service bros, everyone. So that's the real advantage and because it is the biggest show, it is a you know there's an overwhelming part of of news releases there and a lot of people like to uh meet resellers, uh meet people to do big deals there as well, kind of like ink big deals as well. So it's that kind of show. Uh, it's I don't know I forgot how many people go there, but it's, yeah, it's definitely the definitive uh 3d printing show at the moment and well, it's also far so far bigger but the head than than I don't think that other people are, um, getting anywhere close really, um, so what is big stuff? The big stuff is okay. It's kind of already been announced. I think it's form labs. I think has the most impact for the market, omp market, form labs decided.
Speaker 2Form labs used to be a closed ecosystem. You know we do the software, we do the materials, everything works perfectly or you can go home, that's it. You know the hacking do it in your spare time, you know, and that has given them a really excellent experience On the software. It's fantastic. I really like them. I use them a always, like you know, cleaning the parts, getting supports off is annoying, but apart from that, the software and all that is really really works really really well.
Speaker 2Um, but the problem is, if you want to manufacture, you're kind of stuck in some some really uh you know high price materials and then you want to change something and then they can't. So what they've done now is they've opened up the ecosystem to an extent that they you can now well, first of all, bulk buy materials at much lower cost. You can get your own open material settings and do your own material at much lower cost as well, or do materials that Formlabs is never interested in or never wants to do, and this is also for their whole ecosystem right. So they're opening up the powder refusion printers, the fuse or the VAP polarization system, and this would be great for OMP people making components for the hearing aid industry, for lots and lots of people in dental as well, and there's real cost of some money. And again, some people experiment and stuff, but I think a lot of people will just continue to go with that closed ecosystem. If you're working in an architectural office and you have a fuse or whatever, you're printing buildings, you don't care. Like you know, you don't want to experiment, you just want to work, all right. Uh, other people may leave them or something, but they'll still buy more of the printers and stick to that ecosystem rather than going to cheaper chinese printers that don't work as well. But hey, they have a you know the materials half the price and so far the material pricing is very attractive as well. Uh, it's kind of really close to the pricing you would see on industrial systems and stuff. They're still making money on it, but a lot less than they were and it really, yeah, it's brilliant, brilliant news. That, I think, is wonderful.
Speaker 2The 4l you said as well the, the that seems like a big, big system that could be really relevant for omp. Again, we were both a little bit nervous about the shatter potential of of that polymerization parts. So they're finer, they're great for molds. If you need a silicon mold or something you know you want impression mold, you want some kind of new silicon soft thing. It's a fantastic technology. But for end-use parts, yeah, I mean the. You know powder fusion and and material fusion are likely to fail safer, say, or fail in a less catastrophic, less kind of. You know, you hit your head on the table kind of way. So still, yeah, I'd be hesitant using it, but I think for molding, I think it would be really exciting to use now, looking at like molded components and kind of cushions and all that other stuff. So that's going to be really relevant. What's also relevant like I can't tell you a bunch of stuff because we're doing before all the embargoes and stuff, so I can't tell you a lot of stuff's coming out what's also relevant is we're seeing new powder bed fusion materials, stronger powder bed fusion materials, more filled materials, which are good for the whole market. And we're seeing also some kind of more innovation in the pp space, which you guys use a lot, and tpu, so reinforced polypropylene, different TPE, tpa, tpu variants which may be lighter weight or maybe even work better for that. And we're seeing more kind of like semi-industrial material extrusion systems, kind of like what Filament Innovations is doing, kind of people that are doing that.
Speaker 2You know, so far the news seems interesting. It's like it's actually like you know, we know that that the, the economy is kind of complicated. Let's put it that way. Hesitation is the new normal. Let's say so. Capex is down. Uh, you know. The U S presidency was uh, uh, you know, was resolved and then there was a stock market run. But you know, know, companies still don't really know what to do with this result and the the talk about tariffs has got a lot of people really scared at the moment. As well as spending, uh got a lot of people looking at maybe spending to circumvent tariffs to a certain extent, or buying printers. I know people that are buying uh kind of chinese type machines now because they anticipate that tariffs on those machines will be higher. So they're running to buy these things and while they still can and do so affordably. Now, the fact that you know money hates uncertainty, right. So we don't know. So that's a bit of a more of an impact.
Speaker 2But, given that we're seeing a lot of releases, we're seeing a lot of inertia in the industry and we're seeing a lot more application thinking. So you're right about like, like the hp was the example there's people that had applications on their booth. We're seeing a ton more of that from arbor. We're seeing a ton more of that from people and omp wise, whereas, you know, if there would be like a kind of an omp ish thing on the booth, it would be those kind of like those cat the lattice casts right, everybody loves the lattice cast. That's something that people want to into existence, no matter how much it doesn't make any sense, but at one point that was super popular.
Speaker 2But now we're seeing real parts, right, we're seeing actual parts that people use. Hp was really really great in doing this. Ultimaker tradition has been really great at doing this as well, and now we're seeing a lot of other companies Arburg and a lot of other of the, the, the powder perfusion companies come up with like parts actually makes sense, right, that actually show. This is Bob made this and this is an actual part that's going in a in on with a person. Instead of a couple of years ago foremost, everybody had like these fake kind of parts and they weren't like actually. You know they weren't actually used, and so I'm looking forward to that.
Speaker 2I think if you should, if one of the people here going uh, I would actually go next year because the, the hotel rooms are super expensive, so you have to plan ahead um and uh, uh, so that that's kind of expensive, you would do that on your own dime, let's say, and you kind of have to plan your visit because there is an awful lot to see, an an awful lot of people to speak to, but one of the things I do always is to look at all these booths. Stratasys, by the way, also had really good application things, and I always go to the Stratasys booth, even if they have no news whatsoever. I look at all their applications and all the things they show, because there's always something that showcases Like one thing. The reason I do this is one part, and that was like 10 years ago or something. I don't know something like that, eight years or whatever, something like that. I was at Formnext and the strategist showcased the part that was essentially using the support material. So they printed the support material, then they made a carbon fiber hand layup thing up over it and then they washed away the support and that alone was worth like all the time I spent looking at all these parts, all shows since then. Right, because that is something that is like, on the one hand, super obvious and I and it turns out that people in the drone business in aerospace have been doing this for a really long time, but I had I had never seen this, and it turns out that for a lot of like kind of hidden cavity, kind of uh, uh, kind of really complicated carbon fiber type of stuff. This is a great tool. It's not for everyone because support material for 3d printing quite expensive, but this kind of material, this kind of thing, is a really great idea for a lot of people making super complicated, complicated hidden mold type of thing. So so you know, that alone for me like really got me worrying and I was able to help like two customers with this and and uh, and then we we started doing with other print technologies as well and and maybe for omp. That's a great inspiration. So you know why should you go? I think for omp people. I think the us shows are more relevant, I think, and we have a ton of 3d print stuff there.
Speaker 2If you are like a filament innovations or you're a Mitsubishi or you are a service bureau, then you need to be here, you need to be at FormX. There's no choice because everything is there and that's where everything kind of coalesces around what the future is going to be and the sentiment of the market, what's available, like, for example, three years ago, all of a sudden there were like occasional 30 really large filament innovations, like fdm machines, right, and now there are two of them left over that are really doing kind of well and everybody else is like kind of dead. So it's that kind of trend that you see really magnified uh, and you can see like these really big machines, like the cms machines, which is like it literally is like it's a couple yards by a couple yards, giant thing, yeah right. And. And you, which is like it literally is like a couple of yards by a couple of yards, giant thing, yeah Right.
Speaker 2And and you see, or you see construction. There was like a construction, pavilionized construction. That's something you maybe don't think about, uh, uh, but that could be really inspiring. So so, in the kind of like seeing random things, that's the real value of of of format where you see something. I present a format where you see something I presume I didn't know. Well, I knew that 2pp is like this technology, whatever that existed, but then I found out that there was an electro optical kind of way to do electro optical interconnects with this. I would have never found out if I wouldn't just randomly talk to this guy. So the randomness is really the reason to go and over the omp. Yeah, I think if you're a 3d printing person, expert, whatever, then totally need to be here, because this is like the, the, where it all starts yeah.
Cutting-Edge Innovations in 3D Printing
Speaker 1So question for you on some of that stuff. So I know you talked about some of the large format, uh, fdm, and it does seem like, especially with the advent of advent, I mean, bamboo has been around for a while, but there's been a um, uh, I mean I I didn't read the article all the way, but it looks like nike might have a shoe that's maybe FDM or that partnership, so it's like FDM is being brought back into the spotlight, which I think is very interesting. What is your thought on some of the robot stuff, so like the arm, you know so large format stuff, so like the the arm, you know so large format, but then I think that they're. Do you ever see a time where, like the cartesian or or the delta, printers are just replaced by an arm with a with an effector on the end, or is that just way too expensive?
Speaker 2it depends. I mean these cobalts. So there's now there's a movement which is real this is going to be relevant from be a little bit faster, as cobalts, which are relatively safe, robots that stop automatically hitting them and stuff they're meant to be used in kind of like packing boxes next to the worker and all this. So a robot arm is a super dangerous thing. It doesn't know where you are and whatever, and if it just sweeps and you're there, you're dead. So these cobalt systems, cobalt-driven systems, cobalt prices are coming down and cobalt-driven systems are becoming available now, and that is for these socket-type of things, brace-type things. That's going to be quite interesting because you can make it on a dummy, for example, or you could make it on a surface. The big example is, if you need something that's conformal to the body, this six-axis type of approach is much more interesting, actually, than an fdm cartesian box approach, right. So if we need a brace scoliosis brace my favorite example of this we could print this, perhaps free form in air, which would save a ton of time compared to any other solution, right, but we'd have to go really slow and we'd have to write material mix and all this, but anyway, we could make it much more conformable to somebody with their breasts or their contours of their arm or the contours of the side of their thing, which is much, much easier to do this much faster. So, definitely, the scoliosis braces is the one where I'm thinking. That's the one, I think, where the robot arm approach would really win out in a day Doing that same part on an FD printer but will probably require a lot of support material, which you'll have to then remove in a separate step and will require an awful long time, compared to other things where and you're not laying down, so that's on the sockets you have to lay down a lot of material to support the person. So it's okay, right, and you can probably do it without support. So then you're saving that time. It needs to be strong and tough with the scoliosis brace.
Speaker 2If you're doing like a pa11 stuff like this or a pa11 cf or something like this, I don't know if it's good on the skin, but let's just say something like that a carbon fiber, uh, polyamide and uh there, uh, well, it could be really strong enough to make this in a relatively little material. So there's no reason to put this giant thing. But if we're going to be putting our weight down on this thing every single day, all day, we might get a very different calculation. So I would expect, in the lower extremity stuff, the under load stuff for a material extrusion to be a big, big part of that, and then regular material extrusion. If we're looking at the robot arm stuff, these robot arms are quite pricey, right. We're talking 10K, 50k, 100k. You can get a secondhand one quite attractively actually. So we're expecting we're actually seeing a lot of people innovating in okay, we bought this hand and we put an extruder on it, we're doing it.
Speaker 2But we're not seeing a lot of these people come up with products that are relevant, safety, relevant for really people-based things. If people turn to the large, medium format, they're doing aerospace tools right, really large thing for carbon fiber, for windows, for aircraft is a big example. Or they're doing stuff like a tub I love this like horses and carriages, carriages for horses, that kind of stuff, or fire engine components or stuff like this, and that's quite profitable in and of itself. And then you're really using the fact that you know why should you always get the bigger pizza? Because the diameter makes the thing much bigger than you even think, right, and that's when that really starts to add up cost-wise. And if you're looking at a specialty vehicle market, there's a lot of manual labor there, a lot of dudes riveting stuff. So if I'm, if I'm going to be like making that component with the printing, I actually save a lot of money and weight and time and loss. So so there, we really see these guys find a ton of applications, so are they going to be focused on on on omp? Not really.
Speaker 2If I, if you came to me and said, hey, I want to make a scoliosis brace company, I'd be like, okay, let's see if we can make it with a robot arm, right? Um, same thing with all these organs that people are talking about printing. Why would you do that onesian system? We need to figure out how to do it on a robot arm next to the patient or in the patient. That would be the most obvious thing. You know what are we going to do? Put it in a car and drive it across town. Yeah, I'm not seeing this.
Speaker 2And then what I do think is really relevant generally in material extrusion is this idea of bamboo labs. I do not hold stock in Bamboo Labs. They don't pay me. I actually bought my Bamboo Labs printer, paid my own money for it the first one and, and I think it's going to change everything.
Speaker 2I think it's really really very important, and I talked to their European guy, like Cedric, and he told me they were an experienced software company. That's very similar to Foreign Labs, right? But whereas Foreign Labs is all about that workflow right, they're all about that workflow it's a file to part. You know Bamboo Bamboo Lab, by the way, everybody says it wrong, but Bamboo Lab I do too. Bam Bamboo Lab, by the way, everybody says it wrong, but Bamboo Lab I do too. Bamboo Lab is much more about the experience overall. So they have their own little thingiverse in the app, they have their own little slicer, which is probably built on other people's stuff, but I think we'll change that soon A lot of people hated it for that and they made their own slicer kind of, but now they're updating it.
Speaker 2But now, for example, they have a selfie tool. This might seem stupid, right, but they have this tool where you could take a picture and upload it to their cloud solution. All that stuff is cloud, except if you buy this E printer which you can run offline and then it'll turn it into like a little statuette. Now that's like a silly tool, but it might be cute, right? Somebody's going to make money off of this. You know might just set up a booth somewhere and selling these things, you know, um, but you know it might not seem relevant.
Speaker 2But imagine if they get more into like scanning and stuff and these guys start to make a scan your foot type of thing or a scan your body type of thing. Uh, that's, that's a real. They're really going to be a really relevant player and they're really wiping the floor with, like, almost everyone in their segment and about and much, much above it. They're. They're causing havoc for statuses for companies like Ultimaker, for companies anything in between, anything up until large format or regulated industries where they're not comfortable with it being a Chinese company, everything else. They're wiping the floor with them.
Speaker 1Well, and I think that what you said is interesting, and I mean, this is quite a few episodes back, but one of the things like you mentioned hey, you know, yes, you've got this like statuette thing potentially, but what does that actually mean? So they're actually taking a photo, creating some sort of digital something and creating this 3D thing and creating this 3D thing. Okay, so a logical next step would be hey, is there something that we could do for watch bands or foot orthoses? There's already a lot of people using the bamboo lab stuff for foot orthoses and throwing on their own top cover and such. But what if they were to do that?
Speaker 1And you've always said that it's these bigger companies that have yes, they have more capital resources, but they also have very creative engineers, software programmers, and this stuff is just math to them. And so when you say, hey, I want to use my bamboo lab printer to make foot orthoses, some guy is going to be like, hey, that's cool, I did the selfie thing, I've just got to change around some ones and zeros and boom, you've got foot orthoses, which would take any of these other large, even O&P, companies like at Autobach or Hanger or whatever. It would take them a lot of their resources and talent to do that, and a company like Bam bamboo lab has it right there, local, and it makes a big difference, uh, right away, and they've done it for very minimal cost, effort and that sort of thing. And so that's where this stuff gets. Pretty exciting to me is is there is a sense and I've talked to many of, like, the application engineers and such that I've worked with that love the O and P side of things. And so they they like hey, it's pretty cool that my stuff, you know, went on a jet or on a car, but man, how cool is it that I got this, uh, you know little kid up and walking, and that means a lot to them. And so if you can bridge the gap between the two, it's like hey, yes, you can do the car widget, but guess what that same program or effort that you're doing can also help people walk.
Speaker 1I think there is a lot of disruption and I hate that word, but I think that is true in this case that can happen. That is out of the control of the traditional, orthotic and prosthetic side of things. Now, with all that being said, you and I have gone back and forth on the out of control thing, I think both of us can say, especially like when it comes to the prosthetics or any of the custom stuff, it's very important to have somebody that this is what they do, to be involved, but it doesn't take that same person to actually create a solution so we can be users of the solution and it can make a difference for our patient. But but those engineers want to involve people to make sure the stuff is safe when it goes on.
Speaker 2Yeah, totally. That's also why maybe that won't happen, because bamboo has been like we can make a million statuettes and we'll never get sued, and if we make this orthotics thing then you know. So it may not happen, but it's interesting to see this as a trend. But I do think they're going to have a huge impact on this industry, just in people making it. So now the 1PE or something like this, people complain because everything went up to the cloud and they wanted external firmware and they thought that printers would phone home. There's indications this is true, by the way so they have the cloud-based one. So now, on the one hand, they kind of gave up that control which they really wanted to be able to slice all these models, to be able to know what's going on, to be able to improve their print results. This also means that I or we could now make a software solution for the bamboo lab e-printer and sell it and bundle it all right, and that, I think, is going to be very interesting as well. And also it means that if you now want your own, you know you're on your own print farm, that you can get these things, run your own software on them or run extra software to truly kind of uh, help you out. So I think that's going to be a very, very interesting kind of uh development if we're going for it.
Speaker 2And you also mentioned the nike sneaker, right. So that's, that's okay. So this is like a recession of mine. There's a guy called zellerfeld or it's a company called zellerfeld, right? Yeah, and essentially they use like the farming tpu from um color fab and then print shoes and there was like 20 people doing somewhat similar to that. Some had pellets, some had filament and whatever. And the interesting thing is that technically, on their merits, everybody was kind of similar, uh and being very cagey and cagey to the point where, you know, they didn't have a technology, but okay, but they managed to create this mystique around them that made the brands believe that they were able to fill the 3d printing dream, where we were like they're not doing much different stuff than what I'm doing at home, and they didn't solve the fundamental problem, the fundamental problem of having a TPU foot, which is everyone has tried to make that kind of a fully inclusive 3D printed shoe. You end up kind of I don't know, I call it like it's like kind of getting a Ziploc bag of hamburger and then putting it around your foot and just walk around. After 10 minutes it's just going to be like Like this. You know it's horrible, it's horrible and that's what a couple of years ago I concluded like the TPU 3D print shoot is not going to work right.
Nike Air Max and 3D Printing
Speaker 2And now he's making it work because he has his mystique. He's got the brand he apparently is good in a small room on our conference call, you know what I mean and he got louis vuitton to make a share with him. He got um range the brand, like a bunch, a whole bunch of brands. And now nike is making an air max. Now we don't know if it's going to come on the market. Um, we do know that nike is kind of a little bit in trouble. They don't know how to play defense, so they're a bit panicky because they've always been the challenger or the cool one and now they're like the genius company that all of a sudden is kind of missing. You know they're kind of right, they're. They're not doing well and they just don't well. We've been ahead of the pack, you know. Imagine, like resilience is a really important skill and they just haven't played much defense. You know these guys, so they're panicking, so it may just be some marketing thing. They do a lot of stuff for marketing sake. Maybe they just make the show for this presentation and it never comes out right. Maybe it only comes out with collectors because of a huge $10,000 thing at one point, and that could also happen or it could go into some kind of level of production.
Speaker 2Now I personally believe in slides very, very much. Brent helped me try to make some slides. We're so busy with that. We have a design tool for slides. I like slides because slides are open and they're actually quite comfortable to wear and you actually have a lot of less of that slip and slide kind of stuff you have. You can close the shoe. So I believe in slides. So I would be more excited if they were making a nike slipper, whatever, uh. But the fact that nike now, uh, after essentially every other shoe company in the world, every other big shoe company, is doing this, means that it's now going to be something that everyone's going to do and that's going to have huge impacts on the soles and the insoles and all that stuff.
Speaker 2And one thing they did showcase, which is kind of funny the only thing that Nike actually physically makes, except for hot air and designs is that little air cushion. They have literally a production site I think it's Portland, I guess and they make the little air cushions. Everything else goes to Vietnam and China. Whatever they make it there and outsourced companies make it. They don't have their own factories, except for one factory which makes little air cushions. So what do they do? They stop the print at one point, popped in this little air cushion and then print it over it.
Speaker 2And I think this, as a design thing, is going to get a lot of people thinking wait a minute, can I put a sensor in there, which Echo tried before as well? Can I stop the print to put another component in there, maybe a textile component or something? So that, I think, is really interesting that they did this, because it's kind of stupid, because of course, the idea of 3D printing is that you don't need these little air cushions anymore and you could do an air cushion for you and for me and my left foot my right foot could be different, but so it's kind of funny of them to do it. But but at the same time I think it'll get a lot of people thinking yeah, yeah, jump and, and this could be huge for us. I mean, I think I think it could be huge and and and also it's really interesting that I found it.
Speaker 2I made I made a list. Like 20 people are doing shoe things, right, people that had like literally some kind of 3D printed shoe the Zellerfeld guy was on it but you couldn't really tell. There was not anything in design or whatever. The designs were nice, right. That was interesting. They were the most the shoes you most wanted to wear. That was one thing, right. And the ones that were 100% 3D printed. Those are the only two things that he had. But there were some other people that had the good design, but then they weren't 3D printed. But what they?
Speaker 1managed to do is cultivate this mystique and maybe that's enough. That'll be huge for us, yeah, well, and I think that there's a lot of interesting stuff that's going to be coming out. The speed of 3D printing when I was in Guatemala and did the partial foot for the little pediatric patient, or both of them, I was printing really fast with TPU and you know it's not the fifth, we're not talking about 15 millimeters a second. Like you know the old days, like I'm, I'm pushing hard, like really hard. Um, I like I'm trying to think of the actual 50, 100?.
Speaker 1Yeah, I would say between 50 and 100 that I was pushing and getting the results that I still wanted. You could go more, but you could definitely tell you were degraded.
Speaker 2But that's in Facebook, isn't it?
Speaker 1No man, oh my goodness, I cannot believe you brought Facebook up, so how are you doing that? Then it was on just the bamboo. The thing is is that you do have to tweak that profile, so bamboo throttles everything through their volumetric management and stuff and I use a bigger nozzle, so I was using a 0.8 millimeter nozzle and so with that no, I mean, it was the bamboo 0.8 millimeter nozzle, yeah, and so with that I mean it was the bamboo 0.8 millimeter nozzle, yeah, and so with that you don't have as much pressure like the rebound pressure, and so you're really able to push more filament through.
Speaker 1So you're not only able to heat more, but you're able to go faster at the same time. But you lose a little bit of resolution, but it's not crazy. So if you haven't used a larger nozzle on your bamboos, I'd definitely suggest it.
Speaker 2I've nodded. I've just been trying to get TPU out of the thing in a bit kind of like printing repeatability stuff yeah, which is okay, but it's worse for TPU than for almost any other material, so it's a bit annoying for me, yeah.
Speaker 1Well, and that's where I'd say I always tell people if they're really serious about printing TPU is to go to a larger nozzle and you'll find that your problems will go away. Oh.
Speaker 2Yep, you did mention that before, but I was thinking literally die design kind of stuff like high flow kind of boom boom stuff. I didn't think it was literally 0.8.
Speaker 1Yeah, yeah, it's just their 0.8 millimeter nozzle. And don't be like me and try to figure out how to uh change the nozzle without reading the directions. I think I about had the whole bamboo printer apart and all you have to do is unsnap a cover and flick this bracket out and I have screws everywhere and all that stuff.
Speaker 2That is one thing like don't think think ikea, right, don't think ikea where, like, oh, I'll do that myself, no, no, no, no, this has not been designed like that, right, it's been designed exactly like the ikea stuff. You do what they tell you to, exactly how you tell you to, yeah. So that's one thing we've noticed as well. My, my girlfriend had a thing where we were printing and it snapped film. It snapped in the uh, in the uh, what was that? Yeah, around the nozzle, uh, beneath the break, let's say, and then it oozed out so we couldn't pull it out anymore. She had to take apart the half, the half the printer, right, and again, yeah, she, there was. No, I could kind of see, uh, how she could do this, but also, at the same time, it wasn't like it wasn't intuitive at all, right, it was very much kind of slow and you had to move this and this.
Speaker 2So that's one thing. Like, dude, there's a lot of videos out there and stuff, and they do put a lot of videos out. I like the qr code system, yeah, where they give you a qr code, you do the qr code on your phone and you see the video. I love that, but it's not like, don't think of this as a fixable device in the sense of like. You should just like oh, this is why, or does this? No, no, you should do, step by step, whatever they tell you to, and some of that stuff is not. That's one thing. Is a weakness of the machine is, uh, everything has to go to the cloud for a lot of the stuff you need to do, except if you buy this other machine. That's one weakness. The other thing is support is weak, depending where you are.
Speaker 2Um, that's another thing. So you do have to kind of be like the kind of person that will google support, like bamboo labs, nozzle block, right, and everything you have to do is just do exactly right, just do exactly like they tell you to, because there's no, I'm used to, yeah, I'm used to kind of like. I'm kind of like a you know rep, rep huxley kind of dude where it's like oh, I'll just like, do it myself, or I used to be like that, right, and and so it's very different. That is a very different approach than this where you're trying to like you don't repair your tv right, or you wouldn't just open your tv and just be like I'll figure it out right right, at least I wouldn't.
Speaker 2But yeah, you know, uh, but this is kind of the thing you know. This is like um, yes, it's a different kind of thing, but it works really well. I have really high yield, really high uptime with it. But if it does break, it's gonna like, uh, it's gonna be kind of more complicated to to repair than other systems, I think and take you more time so if you were doing this in production, I would really get like I would never get one for manufacturing relying on, and even a small business.
Speaker 2If you want to print some, some stuff, some stuff.
Speaker 1I've got like two, yeah you know, and that lift isn't super heavy. So I do want to just kind of um, we got a few minutes left here, but we'll take a little bit of a right turn. I'm super excited about all the new stuff, but I do want to take a time just to just to reflect back on the last few seasons, uh, or even the last season, and I know you love the season thing, right but you know some of the things that we've learned, um, along the way, and I know I mean you're you're definitely invested, you know we've been doing this.
Speaker 1Now I mean this was I mean we're past the two-year mark and so we're almost on to three and I think it's may of 2025 will be three years. But, yeah, give me like a couple, just lessons, I would say, of the over the last season or two that you've learned, or some impressions that you've had about the orthotic prosthetic industry.
Speaker 2Oh, I don't know uh, oh, my goodness, like what? What of episodes are we on now?
Speaker 1So we finished up 108. So this will be 109. Okay.
3D Printing Industry Innovations and Trends
Speaker 2So 109 episodes, looking back, wow, that's crazy actually. So I think, first off, the industry is. I don't want to repeat all the stuff we've said. We have done this before. I don't want to repeat stuff we've said before.
Speaker 2But one thing I think is it's a very fragmented industry where digitization is really making dollars and cents. For people. It really makes sense here, and for us in 3D printing, that's interesting because a lot of places it just doesn't. You do this all exercise the guy's like, yeah, six pounds of color, but we're seeing in sockets and small components and invention of new devices and commercializing new advice. It really doesn't make sense. And we're seeing people from like one stop like sarah wants to invent something to the largest companies in the industry. Everyone's playing with it, yeah.
Speaker 2So this is, uh, an industry where industry-wide people are negotiating or engaging with this technology, not because because they think it's cool, not because it's like the future or whatever, but because now it makes financial sense. So that's good, because we didn't know that when we started out, right, right, when we started out, we were like kind of, maybe this is going to be like dental. That was our theory, right? Maybe like dental, all the shops in the world, all the dental labs will deploy this technology and now it's looking like that is happening right. We're seeing more software. Uh, we saw a lot more software in the beginning being bandied about than the ones that are now successful and being continued right, so there's been kind of a slowdown on the software front. We're seeing more engagement by the really large players, more public engagement. We knew secretly they were doing stuff before, obviously, um, more public engagement, the big players, and we're seeing a lot of engagement, individuals like, or individuals, omp clinics or small networks doing this. So I think it's a fundamental engagement that's really going coming like it's very material, extrusion driven, which we always expected, I think.
Speaker 2Um, what I didn't expect is I expected that more like equal has a really cool machine that they that they use to make orthoses. I expected a lot more of that. I saw a lot more people making, like, an orthosis software solution, everything like one-on-one you rent or buy this thing, I'll get you a software, the scanner, the printer, the material. Here you go. There's a Dutch company that does this, I think I forgot the name, but there's very few of that happening really, whereas in dental we see that a lot. So these kind of integrated bundle things. We don't see that that much. Also, I expected I did not expect MJF to become this prominent this quickly. I always expected it to be half FD. If you would have asked me a couple of years ago when we started this, I would have said maybe a third MGF, a third regular SLS kind of stuff and a third Chinese SLS or powder refusion.
Speaker 2That's not what I would have guessed, because I would have guessed the Chinese to be more aggressive on rolling out the technology, more aggressive on pricing and better at executing frankly, the technology, more aggressive on pricing and better at executing, frankly, and I would not have and I expected also iOS to be more gung-ho and more out there and better at printing TPU, frankly. So I think the rise of MGF and how quickly that's gone is absolutely stupendous for me. I would not have expected that and also I would have expected much more, um many more people doing what you're doing, like actually being like a specialized service bureau for the business. You guys are doing this, and is there anyone else? I don't know, I don't think so. You know what I mean. That's kind of weird. The, the we saw that a lot in other people where there was a bunch of people in dental trying to do this. There's a bunch of people in dental appliances trying to do this. There's a bunch of people in dental appliances trying to do this. There's a bunch of people in bicycles trying to do this. You know what I mean. So, whereas a lot of people want to make inventions or products, there's not a lot of people wanting to serve the community that much. So that's kind of interesting. I didn't know that. I wouldn't expect that. I would expect a lot of people to do this.
Speaker 2And one thing that has really positively surprised me is the amount of people inventing new stuff with this technology and taking it to market. We've had a bunch on the show already. There must be a lot more out there and they're going to be a ton more. And I think as that becomes like a norm, we're going to see lots more cool products emerge where somebody doesn't have to give up their day job, somebody doesn't have to bet their house and their business on this. They could just make a side gig kind of product In addition to their practice, could launch this, put it on the market, whatever they sell it to a month Okay, whatever, it's fine. That is something that is really very encouraging because that will increase the pace of innovation in this market.
Speaker 2And the other thing which we talked about a ton, which is this general movement of the whole idea the anathema thing where we get a nice person who doesn't make anything. They just have an office in a mall or something. I don't know if that exists anymore, but they have an office somewhere in a high traffic area. They do the scanning and the file management stuff. The CAD goes to India and the manufacturer goes to Mexico. We are seeing that, but we're both so into that as a wow. That could be great for the industry. It could let a lot of people focus on customer care and outsource everything.
Speaker 2But it could also be an anathema of somebody. Just like you know, a hanger just uses that to roll over everybody, you know, because the Chinese or the Indian guy will be better at just doing that. Cancel off day in and day out and it'll be cheaper. And the dudes in Costa Rica or Mexico or whatever is going to make that cheaper than you could ever do. And we just saw that the digitization kind of like that digitization anathema thing hasn. Digitization kind of like that digitization anathema thing hasn't really happened and we haven't even seen that many signs of it. And then the other thing which I think is really strange is this whole like equal. And also the other thing Embla, yeah, embla. I still think it sucks. They're great, they're a great company. The name is horrible. Anyway, the whole idea of them going into the clinics market, it's just a bit weird to me.
Speaker 1Yeah, autobuck has done it, yeah.
Speaker 2Also, like the Autobuck started with the clinics. So maybe they're like, I don't know, we always do this, but I think, just generally, I don don't know, that to me is really strange because you don't really expect that in a lot of these other industries, you know, you don't expect them to be that vertically integrated, you don't expect them to then also want to do retail. But look, saltica did this. Actually, if I'm thinking about it right now, exaltica, uh, is this giant company that makes most of the sunglasses, you know, and a lot of the regular glasses and it says Ray-Ban on it. But it's that and they do it for brands as well, like some fashion brand or something will launch sunglasses and they'll actually make it for them. And they have a very similar approach. They do retail, they do Sunglass Hut belongs to them they do glasses to a certain extent, they do frames, they do the manufacturing every step of the way.
Speaker 2So you know, there are other industries where, where this the the soup to nuts kind of thing is happening, um, but still it feels a bit strange that you're like, oh, we're going to be a, compete to you and sell stuff to you and also make components. You know, it just feels a bit a little uncomfortable without, yeah, but that would yeah, so and that's those are things I'm kind of noticing at the moment. And oh yeah, and also like I think, if you were to ask me at the beginning, I would have expected that robotic arm stuff to get cheaper, much, much faster, yeah.
Speaker 1I think that's great insight and I 100% agree with you on that. And I know you've been kind of hammering the thing don't buy a machine. Don't buy a machine. Use the capacity, use your creativity to design. And I'll tell you that one of the things and I just actually had the discussion with somebody today they were doing this very complex arm thing and the guy was like you know, could I design it? Maybe Would it look as good as what you've done? Probably not. Would it have taken me three what you've done? Probably not. Would it have taken me three days to design? And it still not be right? He's like why would I not Like I know what I want.
Speaker 1Why don't I go see another patient, let you do the design, get the print and go fit the device. He's like I'm going to save myself time. Yes, it's going to cost me a little bit of money, but what does that really cost me In the end? It's probably going to be cheaper with a device that works, and so I think that's what's exciting. And I wasn't expecting to be here 108 episodes in and be like you know what I think, fdm.
Speaker 1I think there is a real answer there for some things. And then two is doubling down on how do you free up your time? So that can be one of two ways you outsource, outsource, outsource right To somebody that can do it better, cheaper than you, or you automate, and so doing a little bit of both, I think, is important. But I think gone are the days of the idea of like, as a clinician, I want to sit down and design all my stuff, do the fitting stuff, all the clinical relevant stuff, and outsource, outsource the rest and and and free up some of your time. And I think that's that's to me. If I could have told myself that you know 10 years ago things, uh, you know all all the lessons learned is has got me to where I'm at now, but if I was starting today, that's what I would try to tell myself. So, uh, yeah, those are the things, yeah.
Speaker 2I think that's a great point. Great point, I mean specialize, do what you're good at. Maybe the manufacturing is the part you're good at, or the design, you know what I mean. Maybe, like, people should get together and I'm great at the customer service stuff and patients love me, you know, they think I'm the best thing ever, but I just I'm not a good fabricator, I'm not a good materials person. I just don't do that. Maybe it's more about specialized. Maybe you have three clinics. I would love to see this. Just don't do that. Maybe it's more about specialized. Maybe you have three clinics. I would love to see this. I don't know if this is ever going to happen. Let's say, you're the good manufacturer guy, I'm great with patients, and then Sarah's a great engineer on the design front. Imagine, like we just did all of our patients work together. You know what I mean, yeah, and that kind of a collaboration kind of way. I think that to me, is very exciting.
Luxury Prosthetics and Orthotics Discussion
Speaker 2And the other thing we didn't see and I remember we talked about this in the beginning a couple times is his whole idea. If Bill Gates would have an industrial accident, I'm not sure how he would get an industrial accident if he would get his legs trapped between his yacht or his boarding or something. He would have the same prosthetic that you would have and I guess he could get the best myoelectric whatever thing with like a brain control whatever. But that's it. Meanwhile, if he wants to buy a sweater, I was just in Milan and they were like don't shop in Milan, this is great. And then you're looking at the sweater. You're like this is a nice sweater. And you look at the price it's like $1,400 for a sweater and I'm like, okay, did they get the models to make the sweater? How is this 1400? This is a sweater. Like imagine having a 1400 sweater. Dude, you've been drinking coffee but scared for your life, but I guess, that's not the point.
Speaker 2The point is that these people, for whom a 1400 sweater makes no impact on them, either emotionally or financially yeah yeah, and for those people, there's still no rolls royce of this. Right, you know what I mean. There are expensive solution arms, there are expensive things, but there's no rolls royce armor, this or something you know yeah, yeah, that's true cool, all right, all right. So I, uh, I hope you love this kind of freewheeling, free spilling kind of episode of the prosthetics and orthotics podcast with brett.
Speaker 1Yeah, this was great. Actually, a lot of insight, and I always like reflecting but then looking forward, so this, this was great, awesome.
Speaker 2And thank you again for listening to the prosthetics and orthotics podcast. Have a great day, thank you.
