The Prosthetics and Orthotics Podcast

Big Deal: AMS, Breakdown of Proteor Aquiring Filament Innovations, and More with Joris and Brent

• Brent Wright and Joris Peels • Season 10 • Episode 10

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This episode explores the transformative shifts in additive manufacturing within prosthetics and orthotics, highlighting key insights from the AMS conference. A focus on open manufacturing options and investor relationships underscores the challenges and opportunities for enhancing patient care in this evolving landscape. 
• Discussion on reflections and takeaways from AMS 
• Emphasis on the importance of open manufacturing systems 
• Insights from industry leaders about consumer demand for flexibility 
• Analysis of the investor's role in driving innovation 
• Examination of Proteor's acquisition of Filament Innovations 
• Exploration of the potential for global consumer markets 
• Reflections on the future of 3D printing in O&P 

Special thanks to Structure for sponsoring this episode.

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Brent:

Welcome to Season 10 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. Hello everyone.

Joris:

My name is Joris Peebles and welcome to the Prosthetics and Orthotics Podcast with Brent Wright. How are you doing, brent?

Brent:

Hey, man, I'm doing well. I got to tell you I really enjoyed AMS. You guys did an amazing job, and I think the other cool thing is it was the first time we met. Yeah, I really enjoyed AMS, you guys did an amazing job, and I think the other cool thing is it was the first time we met.

Joris:

Yeah.

Brent:

In like three years. How crazy is that.

Joris:

I don't know, it was super weird. I thought it was super weird, dude, because I'd known you so much. We talked for hundreds of hours Like uh, and to see you first and be like let's do dinner or something, it was really strange. It was really strange. It was really very, very strange, um, but really nice yeah.

Brent:

So that was funny because it was like I roll in. It was later at night. You were like I don't even know if I'm gonna be up, I still have jet lag and all this stuff. You come down and you're like, let's go get korean. I'm like, okay, I've never had korean food before, but it was good. Right, it was great the flavors were were great okay, good, good so but yeah, I mean, what was your biggest takeaway?

Brent:

I know last, last year we talked a little bit after you finished up with the ams and you were like, hey, this is a little bit of a reality check. It was actually a little bit of a downer. Um, last year I wasn't there so I can't confirm, but I believe, believe you, and you know so now this year I would say spirits were up, still real. But what was your overall take on it?

Joris:

I agree with you. I agree with you. It was like again reality check, but everyone was doing saying useful things, like useful things looking at barriers to 3D printing, looking at at removing them, looking at how to industrialize the technology further, how to work with clients better, how to collaborate and not to join some organization to be all best friends or whatever, but to really work at the software companies alongside materials companies to distribute the burden of industrializing the technology. So, so generally, it's like we're feeling our way towards an exit kind of, and, like last year, felt like an escape room. We built this really beautiful palace, you know, and we, everything was wonderful, and we told her we sold everybody on the dream. And then it ends up being in prison, all right, because all of a sudden you're held to the standard of the stuff we sold. We need to accept responsibility for that too, uh, uh. But then it became very, very confining and now it's much more like okay, we're, you know, like we're, a finicky machine tool. Let's accept that and and and let's accept how we march forward is to make it more accessible, so easier for clients to adopt the technology, easier to implement, easier to do, uh things, and there's a lot of stuff that was new but older, as in it's been said before but it hasn't maybe been said enough.

Joris:

And so we were really happy that we had Stefanos Bosch, for example, for BMW. He was there. It's always nice to have customers, right. And he's a customer and he's saying, yeah, we have additive processes that produce tens of thousands of parts already and that's all automated. And he's saying, yeah, we have additive processes that produce tens of thousands of parts already and that's all automated, that's all introduced. Those are actually kind of ceramics processes for them.

Joris:

Um, you know, but a lot of the normal technologies are the more familiar technologies for us, like powder bed fusion and material extrusion. We've never adopted because you guys are overcharging some of the material, right, and you guys aren't inhibiting the industrialization of this. So so that kind of reality check stuff was, I think, very, very fundamental, very important. So so I thought it was good. And then, yeah, generally I think we had a good share of leadership. We had people talking about submarines, flights, everything in between, kind of essentially. So so I think that was good. It was good. There was like 400 ish people or something you know, nearly everyone in the industry and everyone you know either a vendor from 3d printed electronics to, um, you know, metal components to polymer, and a bunch of users, bunch of investors, that kind of thing yeah, I mean I, you know.

Brent:

So there was a couple things just struck me as interesting. I love the, the guy from BMW, so I think that one definitely was a home run because he, so it was real right. So it's like he could talk the shop, he knows the stuff, he knows how to buy machines and all that. But I think he really hammered home the point to the, to the OEMs is like y'all, we, we want to have options, options for materials. Do not sell us a black box anymore. And that came through loud and clear. And you know the lady that talked about the train stuff, stephanie, she also had some of that to say and even the healthcare people, the same sort of thing.

Brent:

It's like this boxing in is inhibiting the ability for people to make choices, because these CapEx expenditures are massive and if you only have a choice of a couple materials, we may not end up using that. So that's one part. The second part that hit hard is and I forget who said it, it was on one of the panels, but they said everybody forgets the word after additive, it's manufacturing. I didn't know that. That was beautiful, dude. They were like additive is a form of manufacturing and we have to come to the realization of. That is, most people don't care how the products are made, you know. So some of the nerves get in, so manufacturing, and it just happens to be that we use additive technologies for that. Yeah, that's a good point that I thought that was good.

Brent:

And then, lastly, on the investors, and I thought it was very cool to have the investor track. So whoever thought, of that it was.

Brent:

It was so great because it you know. So it was two things. One is you have the VC guys. The private equity guys are like, if you can do it without us, do it Right. So it was. It was a little bit of honesty there. It's like hey, cause, if not, you know you're going to get money, but there's going to be, it's going to be faster, you're going to have to meet these milestones. There's a lot of pressure, all that stuff. So there was that part. But I think the other part and I forget which person on the panel that said it was it was the guy from Lightforce.

Joris:

Yeah, yeah so.

Brent:

I'll come up with a second. He talked about how the first aligner was done in 1946 by this dentist, and it was amazing, but he couldn't scale it because he was trying to keep all the property to himself. And so he's sitting on this amazing product but no way to scale it. And so for me that hit hard, because it was like what are some of the things that we're sitting on, bringing it home advanced 3D, some of the things that we do that we're trying to kind of hold on? It's not quite a product, but it could be a product. And so it really inspired me to be like okay, let's plant a flag in the sand and let's create a product out of this, and then we have something to sell and scale. And so that meant a lot to me.

Joris:

I'm so I'm trying to look up this guy. I forgot the name. I'm terrible, I feel terrible. I'll look it up later, but anyways, the guy, yeah, the guy was great and I remember that and I think no but, I, think it's really beautiful.

Joris:

I think a lot of investors always say, like the ideas are nothing, it's execution, it's everything Right, and we always forget that a lot of these concepts are nothing without like the scalability, without the cost and the amount of customers, I have to turn away because, or turn away from additive because, like the materials too expensive, machine or that combination is just insane.

Joris:

And that's kind of a lot of those artificial. A lot of that is because somebody wants to show some other corporate titan that they can make money and add it. It's not like, and what I keep saying to people is like everybody's looking at like, for example, the toner and printer, like for paper printing, right, and they're looking at that market. But what they never don't forget is that inkjet ink is super expensive and the printers are relatively affordable, but the paper is cheap, right, so all in all, the individual print of a page we don't even know what it is, but it's a couple of cents or less or something, even though they're making a ton of money on the inkjet ink, right, and what we're doing is we're making the screens expensive, no-transcript than it needs to be much smaller so I think, though you know ams, I mean it was big, big crowd, probably your biggest yet, right?

Joris:

for us, yeah, but it's meant to be a small event, right it? It's like 400 people. That's the thing I mean we wouldn't See. The thing is, everyone needs to be accessible to everyone else.

Brent:

That's right.

Joris:

And that works. And you can have people like Yoav Zaif there, scott Crump is there for the whole week, you know that kind of stuff, and then they're accessible to everyone else. And if we double it, because then it wouldn't work, nothing would work anymore right.

Brent:

Well, and I think I think it's important, like before, everybody just drops everything and be like I want to go to AMS, like AMS is different than AMUG and that sort of thing because it's additive manufacturing strategies. So it's the business, it's the reality, it's not. You don't get super technical, you get to see a little bit of the future, you get to see some of the leaders. So, like, meeting Scott Crump was pretty amazing, and one of the things that I thought was interesting is I read this quote and one of the things that I thought was interesting is and I read this quote that some of the smartest people in the room are the most curious, and Scott is always curious. So it was interesting.

Brent:

When we were talking he was like hey, man, we tried to do the prosthetic and orthotic stuff and it was some of the most fulfilling work I ever did, but it was super hard. He goes, you can have that and I thought that was. You know, that was. That was funny. And it was also funny that he's like I'm not doing any podcasts. I don't care if it's the 3d pod or the broadcast podcast, and then we've been asking him for.

Joris:

I've known him for a really long time and I've been asking him for like years and it's not working. It's not going to work no-transcript yeah, no, I agree, agree.

Joris:

And I think if you want to buy a machine, for example, if you're looking to expand your services, you want to find out which machines are good or whatever, then I advise you, go to amonk, right? If you want to see everything that's happening in the industry, then form next right. So so it's a very different thing. But if you're also, if you're not only like a business leader, but if you're a startup person as well, then I think it's really valuable as well, because you know what startups work, what doesn't work, what everybody's already kind of priced in, if you will. So I think for definitely for people in startups or investing in startups, people want to do that. It could be really great as well. Yeah.

Brent:

Yeah, so anyway, great job to you and your team. I thought it was. I thought it was great I had glad I had the opportunity to not only meet you but meet this. It was definitely something that I learned a lot. I had my little notebook journal thing, took a bunch of notes.

Joris:

It got a lot of soundbite type of things and overall concepts, and so that was. It was just really great, awesome. I'm glad you liked it. Yeah, it was like a ton of things and we're a really small 3Dprintcom, really small teams. You know, we start. We're going to start in a couple weeks already on organizing the next ones, so it's pretty crazy that this and the people actually like Marilyn and Missy, for example, are the ones that actually make it bring together and they did an awesome job. It was really amazing.

Brent:

Yeah, they did so. We have a new sponsor, yours.

Joris:

Super cool.

Brent:

So we had Ravi on last episode and they were like hey, you know what we really like, what you're doing, and we'd like to sponsor the next few episodes. So they're going to close out season 10 for us and you know, we think that scanning is the foundation of creating an orthosis and a prosthesis, and so it is a massive barrier to get outcomes. And so and I know you've been saying, scanning needs to be easy, and I think that is part of what they're trying to do is create a low-cost, high-accuracy, high-precision for our field, to democratize the scanning process so everybody can get a quality prosthesis or orthosis, and I think that's pretty neat.

Joris:

Yeah, I think that Structure Scanner does.

Joris:

I think the cool thing is okay. Definitely, if you are making an app or if you're doing like trying to get you know a bunch of offices to use scanning to digitize your whole workflow, or if you want to put an orthosis thing in all every foot walker or something, you know something like that, then definitely talk to them because this is a solution that uses just off-the-shelf hardware that you can also use for your Pulse or whatever other kind of systems to order things, and they use that hardware to let people scan stuff. Just Apple hardware we all have on us probably already, and I think it was a very, very powerful package for that. And especially if you're also looking at, you know, maybe having a scanning app or doing that as a really big part of your practice, everyday thing, I think it's a really exciting kind of idea to have a scanning Lego block, if you will, that you can integrate into lots of different workflows, solutions, products and companies. So, yeah, really happy they're sponsoring. I'm really, really a huge fan of what they do.

Brent:

Yeah, and just a lot of people say, well, I have this phone, why don't I just use this? And I think Ravi shared exactly why. It's like, the main consumer of the front-facing camera of the iPhone is the iPhone. They don't really care what you think you can use for it, they are going to make it to make their product the way that they think it should be made. And he was just talking about the updates and the different hardware and that sort of thing. And that's why it's important to have the extra separate, separate piece of hardware that is standardized, and so I think that's a neat way to think about it and a neat way to go definitely definitely all right.

Joris:

What else you want to discuss?

Brent:

man, so had a little bit of a surprise. I think you actually shot me the link too and, uh, I, I I saw it come through my feed that, uh, you know we're we're big fans of FDM, we're big fans of high flow. Um, you know you love vase mode and so, like every time we talk to the team from film innovations, I mean you just, I mean, had a lot to say about what they were doing. And, um, and Protear, a French company, found that they had a lot of value and a value that they can bring to the O&P field. We already knew this, right, we had much of their team on and they bought them.

Brent:

And so I want to just discuss through like, okay, what does that mean? A very small nimble team. Right Now you have a more of a corporate-esque type of thing where the ship can be harder to guide, but that team probably is going to be a smaller team within Proteor. That has a great latitude. But you also have to now make for the masses, because when, when they send these machines out, they need to be ready to go for a long period of time or you're going to be on the hook supporting them. So I'd like to just find out, you know and talk through some of that of pluses and minuses, pros and cons of of this acquisition okay.

Joris:

So, first of all, the surprising thing about this was that usually when people are looking to build their own like end-to-end tool chain and they want to buy hardware even though not a hardware company, right they tend to go for shinier stuff Like what I mean, you know what I mean. They tend to go for more form, lens looking stuff, you know it's. It's more whiz, bang and shiny and and, like you know, built for in-office use out of nice bits of plastic and stuff like that and it's more convenient. And you know, filament innovations is big, huge, like drop it out of an airplane type machines. So it's a very different thing, right. Having said that, also from there's a value perspective from in a US manufacturing context, a general US manufacturing, also US defense manufacturing. There could have been a lot more options for for filming innovations on that front as well. Now, they're kind of, you know, I think that way is blocked right, because I think, as a, as a French prosthetics company, I'm not going to sell to Lockheed, I mean, I don't think that's a that's going to happen, or they're definitely not going to try and do it. So that's the missed opportunity, if you will, the missed value, as opposed to just a hardware manufacturer or something like that.

Joris:

Having said that, I mean I think, especially for the high flow stuff, the high lay down stuff, the really big sockets and test sockets, I think we love the platform, we love the printer, we love the company, we love the printer, we love the company, we love what they're doing, we love their attitude. It's kind of like can-do kind of attitude and the way they make their machines. Nothing's too fancy Like. It's the kind of machine where you know you got simple tools you can make it runs, keeps on running. So I think from the pro tier perspective, you know, it feels a lot like the prosthetics market as well. It feels like the kind of rough and tumble machines. So if somebody could put in a backer workshop, it'll keep on chugging away for years and years and you won't have to worry too much about it, you know. So it feels like it's a good acquisition. From their point of view. Especially, we had Equal on the show. Equal also has its own machines right. That's another French company. They have their own machines already. So from a French perspective maybe it even makes even more sense. We're like, well, wait, wait, why don't we have our own machines right? And what better to do that in the US, where we have a unit and we have this big US market open to us?

Joris:

At the same time, there may be there's all sorts of talk internationally about tariffs and problems and stuff like that. In that context tariffs and problems and stuff like that in that context, it could be really smart to get a machine, because you could wake up tomorrow and some liner or some part of your afo whatever could be, you know, stuck in vietnam, 80 more expensive, not available, whatever that kind of stuff, right. And if you're printing a lot more components, well, you have to filament in the machine. That's that's relatively straightforward. So so it kind of, especially in that kind of political and if you're printing a lot more components, well, you have to have filament in the machine. That's relatively straightforward. So it kind of, especially in that kind of political volatility context, it totally makes sense. It's a really smart move for them, as a French company, to buy a manufacturing unit in the US. That could give an individual prosthetist more manufacturing resilience.

Joris:

Now, at the same time, another cool thing is well, maybe Filament Innovation is quite a small shop, which we loved, right. But if they were going to go to Hangar and say we're going to make 200 machines for all your stores or whatever. Hangar would have been like oh I don't know. And Proteor is much more like the kind of place that could be like hey, we're here, you know us, we're good for it, we have the finances to do this. So they could, on the one hand, get bigger customers they can use their existing channel distribution to to to get the word out that you have this printer. They could develop end-to-end solution and also they can play in this kind of integrated space which I think you and I both think is weird. It's a space where it's like we make devices, we make machines that make devices, we make the service you know, like OSER and all these guys are playing in already. It's kind of integrated space where we're not seeing that in a lot of other businesses. Right, we're really seeing that in a kind of prosthetics. Apparently, the client having that client makes so much sense that you can just tack on whatever the hell other service or business you want and they'll take it, even though you're competing with them. So that's like something that could pay off really handsomely for them if they could just with that established network and stuff like that. They could do it.

Joris:

At the same time they're going to have to figure out how to do national or maybe even international service. You know, with a printer I always advise companies with desktop printers just put up a pool work with a logistics company. It's broken, we collect it, we'll repair it at our own leisure, you know. But with these film innovation machines it's like, you know, shipping containery kind of more. You're going more towards pallet and multi-pallet kind of size things. You're going to have to figure out a way how to support that. Now, do you support it in Portuguese? You know in, you know local. Are you going to try and import these things into Brazil? Don't, by the way. Are you going to like what are you going to do? You know? So that's actually quite complicated and given also the yeah, the type of machinery 3D printing is, it's much more complicated than if it would be a milling machine or carver.

Joris:

There's much more finicky stuff going on that maybe in Brazil would be more humid and all of a sudden the results are different or they nobody told them about material storage and it's wrecking havoc on the results. You know this kind of stuff is very much more difficult. So that could be. The downside is that the extra complexity of that device and I don't think you know, I don't think it was too expensive. I don't think, you know, I don't think it was too expensive. I don't know much about the finances, this, you know, I can't, I can't imagine. I think it is a well-managed kind of exit for them and for both parties. I think it'd be good. The team's so small enough. It's not like they're going to kick anybody out because there's like there was like like 12 guys or whatever. Yeah, we have like 80 percent of the company we had on the podcast.

Brent:

Yeah, yeah, so I mean I think it's interesting. So I look at what Proteor gains right, Mike's been at this since 2015. A bunch of knowledge around his experience of many different types of clinicians, with FDM right People that bought his machines didn't buy his machines. The other thing that and he never totes this is that he's a PhD in finance. Not only did he run a tight ship that way, but he brings a lot of that information to Protear. So, like the human capital right, these are like super experienced, super specific skill people to bring this to the market.

Brent:

I think what's interesting, though and you know, this is kind of the first acquisition of its kind with 3D printing and O&P, so you kind of mentioned it, you know. I wonder if Equal was ever in the mix. Was Hanger in the mix? Was Oster in the mix? But I think one thing that we didn't touch on is Proteor is not in patient care that I know of, whereas Autobach Hanger, that sort of thing they are, and so I think this kind of like uber, focus on this, the technology stack of okay, we create components, we also make sockets. Now we do test sockets and we can do to Autobach Hanger all these people that have patient care facilities. I think is a very interesting move and it makes a lot of sense. I think your point on the USA side of things, especially since US is a big market as far as the financial side, makes a lot of sense for Proteor.

Brent:

One thing that we don't talk about is they had a couple materials like they have two or three extrusion lines. So he's doing this, the like modified. He calls it CPX. I think it's a polypropylene with some sort of additive in it that they co-did with Mitsubishi. So that's that is an asset for sure. And then they also extrude their own PETG, which is an asset for sure. So now you have material, machine and some know-how to put it in.

Joris:

I'm glad you mentioned that because I was just looking, rereading the press release. They literally put the machine is one part and the next thing is the look of these materials they have. So that is really something they did consider. It's like their main pitch is also about the materials. I think that's also interesting that 90% of the open material vendors they don't have that they don't have, or the material vendors don't have the machines, or the other way around, so that customized material could actually make them look at this acquisition and say, oh, that's much more profitable than if it didn't have that material stream.

Joris:

I think the model you were talking before about we need open machines that was one of the conclusions from added manufacturing strategies. Before about we need open machines, it was one of the conclusions from added manufacturing strategies. Yeah, but you know, filament innovation was open. But they're like, yeah, we're going to do our best to develop the definitive material for test sockets or whatever. And I think that culmination, like from an acquiring party, is like oh look, this is recurring revenue. Yeah, that's nice, we can keep on getting that forever and ever.

Brent:

Yeah, so I think the other part, though, is you have this US manufacturer and the standards to put this stuff internationally. You have the EU stuff and the what's the other standard, the UL that's. That's big, because protea FDA was. Whatever you have to have, like electronics wise, it's that, that stamp of CE. Yes.

Joris:

That's OK. That's really scary, that stamp of CE.

Brent:

Yes, that's okay, that's really scary Easy to do, by the way. Well, no, a hundred percent. But the cool thing is is that now you have a corporation that is behind it that will do that for you, and then you can already sell. So I think that's that's also interesting. And I know, you know Mike was doing a lot of stuff in the Ukraine, so not developing world, but developed world, and then Katie Leatherwood, who we had on, also had one of the machines and was just really pushing hard into that.

Brent:

But I think, to your point on the pricing, I would say it was definitely on the high end for an O&P machine, but when you flipped it on it was going to print every single time, and so there's a lot of value to that. There. I think what's going to be interesting is what is Protea going to do about the pricing? Right, so now you don't only have the 10 mouths to feed, now you have a whole team that's going to be sales team and that sort of thing. And what I would hate to see happen is something like what happened with Titan Robotics you have a $150,000, $200,000 machine and now 3D Systems has it, and you can pay a million dollars for an FDM machine. That is a little bit nutty, and so I just hope that sort of thing doesn't happen and I don't know that it will, but I think it is something that you have to keep in mind.

Brent:

It's like, obviously, or does it go kind of like what you were saying is hey, we've got this recurring revenue in the materials, let's really discount the machine. We know we're going to make it up over the next five years and you start, you, you start becoming the machine of choice because you've got this whether it's a subscription model or whatever to get this machine in, or maybe you can even. Who did we have on that talked about? When you buy quote unquote a leg in a box, if you buy it from all of one place, you know, when you take into consideration shipping and overhead, it actually costs the company like significantly less, but their margins are much bigger. You know that might be something that they look at doing. Is this this idea of hey, we will ship you the foot, the pylon, the parts and a test socket or you know, fdm socket, and you get it all in one at a super reduced cost and you just like literally cut the knees out from a lot of the competition because you control that whole vertical.

Joris:

Yeah, I think I agree with you. I think on the machine buying side, I don't think they're going to be that much more expensive. They know that a lot of people in this business are cash constrained and also they know a lot of people in the business. It's a one family business or you know several key employees. You're literally talking about, like you know, opportunity costs here. You're not talking about somebody going to the public markets lending $10 million to buy a machine. This is different. So I don't think they would do that, given the market space.

Joris:

I think what they could look at was things like subscriptions, which you mentioned as well, where it's like you get the machine plus the material and the service for X per month or something like that. They're reducing that caEx but keeping that. Maybe you'll end up paying more, but a lot of people would just hate to part with that money on something they maybe don't even understand. That kind of more of a subscription model would be nice and, yeah, I like that idea just them using us to become more vertically integrated or to offer a compete. So I like that as well and also, or to just say, hey, you know what? We are going to get crushed by this. If we fast forward 10 years, let's get ahead of it. So then it's only like a strategic thing.

Joris:

So for all these reasons, it makes sense, and I think they still have the maneuverability to to try out these things subscription models for the machine, the material, making more and more of their own product themselves, or, you know, making new versions of their own product themselves, or you know, making new versions of their own product as well. So I think there's a lot of stuff there, but it's again. It's all the below the knee where all the innovation is right. All these hand people sitting on their hands like is that just this test socket, the socket thing Is that really what shook these guys up? Is that? Is that why this is where the money's coming from, not like somebody else.

Brent:

Well, I so I think it is been, I think, one or two white papers for the CPX material that it performs very well in testing. But each of those people that had the test have their own invested interest in why they want to make it work right. You know, yes, it passed. But you know I posted a meme the other day that a lot of people point to 10-3-2-8, iso 10-3-2-8, as a test protocol for prosthetic sockets. There is a massive warning that says if you use this protocol for anything other than components, you may harm patients, and so, while it provides good guidelines, it's like I don't know, but there are people working on those test standards and that is another reason why somebody like Proteor that is like an ISO 9001,. They also do the ISO 13485, which is the medical side. They have these kind of guardrails in place already and they are in a great position to create research around not only the material but the ability to print it and make sure that it can be used in a definitive setting. You know we talk about the definitive sockets and I think that there's a lot there.

Brent:

In the US side of things, there are what we call preparatory sockets. So it's right, when somebody has had an amputation, you know about six weeks later you get them up and walking. It's quick, it's fast. But because of the history of prosthetics and orthotics and these very beautifully handmade devices like the carbon fiber and the t-shirts with the unicorns or the your favorite team and all that stuff, this is not that. This is big lines and it's a different look. Now, I like the look, but it's not historically the accepted look.

Brent:

So I think you're for a long-term, definitive socket. I think you're going to be up against just what looks right from a patient perspective, especially when you go up against something like the powder bed fusion stuff. So any of the SLS stuff that's vapor polished or the color multi-jet fusion that's just absolutely gorgeous. You're going to have this perception of is this truly a socket that's going to be used long-term? Even though you can prove it, it just does not look like the powder bed or the historical stuff. So I don't know whether that matters or not.

Brent:

And sometimes, like you know, when we broke down the annual report for OSER, which is now EMBLA right, and it showed that most of the demand for prosthetic care is actually outside of the US and it is the least population or the least served population. You know this may be a great opportunity as far as a low cost definitive socket that you're not dealing with insurance or picky patients or whatever that actually reaches the whole world and for that I you know, I would say that's a pretty exciting and a large market reach yeah, exactly like you could easily put like a thousand printers in indonesia or whatever, and then, yeah, you'd be full.

Joris:

And then the funny thing is that for the country like that, people aren't doing it. You know those are huge countries and people aren't really investing in it. So I hope they do do that, because I think it could be good business. I think it could be really good ethics as well.

Brent:

Yeah. So I think you know overall, you know what a heads-up move by Protear to see that. Cool and good for Mike. For you know, I haven't talked to him since the acquisition and so, but he seems to be super excited and what a great team. There's a lot of good things that are happening out of Proteor and even on the software side of things, they are doing some really neat things around modification on iPads. So they are building this kind of infrastructure.

Brent:

But, as we know, building this infrastructure is wicked expensive. Software's not cheap. Hardware is hard and not cheap. But it seems like they've got a good team together. So I'm excited to see what's next.

Brent:

And you know, and Mike isn't one of those types of people that would put his company in a position where they didn't believe in what he was doing, like like he isn't the type of person that would just take a golden parachute and be like I'm out of here, yeah, so yeah, and you know any of these companies are going to require time for the founder to be after it most of the time, because you are the face of the company and so I don't know, I have no idea what that looks like for him, but you know you don't want to put yourself in a position that's just absolutely terrible, where you hate going to work every day because you got a you know, a big payday. So I think it's you know, knowing Mike and the history that you know we had, I think that he sees that they're onto something big and they're kind of hitching the wagon both ways.

Joris:

All right, there's one more thing I would like to talk about. That's something I thought was interesting, because we always talk about this market, right, we've got these big consolidating companies Mansion, hanger, oster and stuff We've got the independent vendors. Are there alternative ways for it? And I was thinking of one. It's really funny because, like in the begin days, like the commercial kind of consumer additive stuff let's say 2000-ish, beginning, 2000-h uh, people started thinking about this files and n is one, and then products for everyone, all this stuff, right, I remember, like the shapeways, when we started shapeways, for example, the idea was to sell files, essentially be a file distribution platform, and we thought that either everyone would print it out at home or everybody would find their own uh, print shops or whatever. That would be cheaper than we could ever do and that was already the assumption. But that was for a long time, hasn't actually been. A lot of people started companies and then it didn't actually happen, but one. But now we're seeing in mro so some maintenance, repair and digital warehousing stuff for oil and gas stuff that it is kind of working. That's interesting. And then there's another company that started a couple years ago and I thought that would be. That's interesting. And then there's another company that started a couple of years ago and I thought that would be a really interesting model for OMP. So the company is called AMCraft. So what AMCraft does is it has its own production capacity and it's a Latvian-based company and they did something really interesting and I think it's really cool actually. It's really cool actually.

Joris:

So what they do is they're able to design an EASA or EASA Form 1 parts producer and they have relevant design authority and relevant design ability on aircraft and everyone on the aircraft is going for metal brackets and metal components and aircraft engines and stuff. They focus on the polymer parts for the interior and they use Stratasys I think F900, so big FDM, really expensive FDM machine, accurate, reliable, repeatable. It prints Ultem mainly for these and Ultem is a material that has flame self-extinguishing properties great for aircraft obviously low smoke, low toxicity, high combustion and heat deflection temperatures and it's quite strong. It's allergic to rocket fuel or aviation fuel, which is a bit of a problem, but apart from that everything's okay. So they print that material which has already been used for aerospace stuff for a long time, and what they basically said is they're going to create a platform where they design, qualify and do acceptance testing on polymer aircraft components?

Joris:

So stuff like screens of the entertainment system, those little you know those fans, stuff like this. If you go to their website, amcraft, you have an overhead bin divider panel you know Business economy seat components, right, or what else else seat arm cap, right, it's like the stuff that in regular aviation will go broken all the time, right. For example, I was on my way back from from new york, the guy in front of me, his tv was broken, the little army thing didn't come out, so he didn't have a tv, didn't complain. Stuff like that, right, it's not going to keep the airplane aloft but it's going, you know, rinse on those day or be really expensive. So what they do is they print it out in Latvia. But they also have a unit they bought in Singapore that prints it out as well. Singapore is a major aviation hub and then they also have partners, I think, in Dubai and a couple other places that will print it out for them.

Joris:

There's one in Germany as well, and I love this model because I hey, look, think about it Like we're always talking about certified medical liability, all that problems. Right. Now, you know, whatever these guys are doing, it's a lot harder, right, and a lot scarier if they mess it up, right, and so I just think it's a beautiful model. I think it might be a beautiful model for OMP. You design something, right, you certify it or put it up there, and there's like this you know, network, this production network that can produce it, but they operate in a really constrained way, right? You would literally tell them, like, only this machine, only these settings, you have to do this, you know. So what do you think? Do you think it's cool for Empirical?

Brent:

So I 100% agree, and you almost captured what I'm going to speak about at the Academy meeting next week. What? No, no, seriously, I give you know. So for those that listed, this is going to be a foreshadowing, okay, so I give three different.

Joris:

Well, don't do them too much.

Brent:

No, I give three different ways that you can get involved in 3D printing. One is decentralized design centralized production. Two is centralized design centralized production. And three is decentralized design decentralized production. And so I give three examples and so, like, after this talk, there is literally no reason for anybody to be able to start, and because you have all three options, if you don't know how to design but you have a printer, guess what you can find somebody to help you.

Brent:

If you don't know how to design, don't want to know how to design and don't want to have a printer, guess what they can do it. And then, if you want to learn how to design, you maybe use an automation tool and you have a printer, you can do everything in-house. And so those are the things that I think is important, and so that's what I love about this is they already have some of the, or they have the certifications that dialed in the machines, all that stuff, and so it's a machine material, file-specific thing that is certified, that they're doing, and I love that, and I think that is a lot of the way that things are going to go.

Joris:

Cool. Yeah, that's good. I've known about them for a long time. So I was just thinking like, oh wow, for the OMP model. This is really really good, this is really time. So I was just thinking like, oh wow, for the O&P model. This is really really good, this is really interesting. So I'm glad you're thinking along the same ways as well. So exciting news, roundup, stuff happening, good stuff happening, I think. What do you think? Yeah, absolutely.

Brent:

I love that. We'll probably have some more news at the Academy. A lot of times there will be either another acquisition or two that happens right at that where they announce it or what have you. I actually haven't, like usually I hear of a couple things beforehand, but you know, maybe I'm not as cool anymore, I don't know. But yeah, I haven't heard of any like rumor mill type of things. But you know, it's a very interesting time, especially with the change of leadership here in the US. Whether you love it or hate it, I mean, we just got to deal with it either way. And then the people that are going to win are the people that can see the opportunities, and that's just life in general. And so it's going to be interesting to see really what this next few years holds for not only additive manufacturing, but additive manufacturing in P. Awesome, completely agree.

Joris:

Well, thank you very much for sponsoring this episode of Structure and thank you for being here, brent, and thank you for listening to another episode of the Prosthetics and Orthotics Podcast.

Brent:

Have a great day. And that's a wrap for the Prosthetics and Orthotics Podcast. A special thanks to Structure for sponsoring this episode. If you want to check out the Structure Sensor 3, please go to structureio and also follow them on all the social media channels and give Ravi a follow as well on LinkedIn. If you enjoyed this discussion around AMS, the acquisition of filament innovations by Proteor and where we think some of the digital manufacturing is going to go in orthotics and prosthetics, please leave us a comment, a review, connect with us on LinkedIn. We always enjoy the interaction from our listeners. So until next time in the next episode. Have a great day.

People on this episode

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Brent Wright

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Contributor

Joris Peels

Co-host