The role of additive manufacturing and antimicrobial polymers in the COVID-19 pandemic. Expert Review of Medical Devices. Accepted 14 April 2020.

The purpose of the current investigation was two-fold: (i) to describe the development of 3D printed prostheses using antibacterial filaments and (ii) to verify the antibacterial properties of the 3D printed prostheses. Three-dimensional printed finger prostheses were manufactured using PLACTIVE^TM antibacterial 3D printing filaments. Two adults with left index finger amputations at the proximal phalanx were fitted with a customized 3D printed finger prosthesis manufactured with an antibacterial filament. The manual gross dexterity was assessed during the Box and Block Test. Patient satisfaction was assessed using the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0). Bacterial analysis of the 3D printed prostheses was performed by two independent laboratories against Staphylococcus aureus and Escherichia coli (ISO 22196). Two customized 3D printed partial finger prostheses were manufactured using a 3D printed antibacterial filament. The bacterial analysis showed that PLACTIVE^TM with 1% antibacterial nanoparticles additives was up to 99.99% effective against Staphylococcus aureus and Escherichia coli. The manual gross dexterity assessed was improved after using the 3D printed partial finger prosthesis. The research subjects indicated that they were “quite satisfied” to “very satisfied” with the 3D printed partial finger prosthesis. The present investigation showed that the antibacterial 3D printed filament can be used for the development of functional and effective antibacterial finger prostheses.

An insufficiency of accessible allograft tissue for corneal transplantation leaves many impaired by untreated corneal disease. There is promise in the field of regenerative medicine for the development of autologous corneal tissue grafts or collagen-based scaffolds. Another approach is to create a suitable corneal implant that meets the refractive needs of the cornea and is integrated into the surrounding tissue but does not attempt to perfectly mimic the native cornea on a cellular level. Materials that have been investigated for use in the latter concept include natural polymers such as gelatin, semisynthetic polymers like gelatin methacrylate, and synthetic polymers. There are advantages and disadvantages inherent in natural and synthetic polymers: natural polymers are generally more biodegradable and biocompatible, while synthetic polymers typically provide greater control over the characteristics or property adjustment of the materials. Additive manufacturing could aid in the precision production of keratoprostheses and the personalization of implants.

Traditional prosthetic fabrication relies heavily on plaster casting and 3D models for the accurate production of prosthetics to allow patients to begin rehabilitation and participate in daily activities. Recent technological advancements allow for the use of 2D photographs to fabricate individualized prosthetics based on patient anthropometrics. Additive manufacturing (i.e. 3D printing) enhances the capability of prosthesis manufacturing by significantly increasing production speed and decreasing production cost. Existing literature has extensively described the validity of using computer-aided design and 3D printing for fabrication of upper limb prostheses. The present investigation provides a detailed description of the development of a patient specific body-powered 3D printed partial finger prosthesis and compares its qualitative and functional characteristics to a commercially available finger prosthesis. A 72-year old white male with a partial finger amputation at the proximal interphalangeal joint of the left hand performed a simple gross motor task with two partial finger prostheses and completed two self-reported surveys (QUEST & OPUS). Remote fitting of the 3D printed partial finger began after receipt of 2D photographs of the patient’s affected and non-affected limbs. Prosthetic fitting when using 3D printable materials permitted the use of thermoforming around the patient’s residual limb, allowing for a comfortable but tight-fitting socket. Results of the investigation show improved performance in the Box and Block Test when using both prostheses (22 blocks per minute) as compared to when not using a prosthesis (18 blocks per minute). Both body-powered prostheses demonstrated slightly lower task-efficiency when compared to the non-affected limb (30 blocks per minute) for the gross motor task. Results of the QUEST and OPUS describe specific aspects of both prostheses that are highly relevant to quality of life and functional performance when using partial finger prostheses. The use of 3D printing exhibits great potential for the fabrication of functional partial finger prostheses that improve function in amputees. In addition, 3D printing provides an alternative means for patients located in underdeveloped or low-income areas to procure a functional finger prosthesis.

Background: The objective of the current investigation was twofold: i) describe a remote fitting procedure for upper limb 3D printed prostheses and ii) assess patient satisfaction and comfort with 3D printed prostheses fitted remotely. Methods: A qualitative study using content and score analysis to describe patient satisfaction after remote prosthetic fitting. Research participants reported QUEST and OPUS scores that allow for perceived rating of general aspects and functionality of upper limb prostheses. Results: Six children (three girls & boys, 6–16 years of age) and 2 adult males (25 and 59 years of age) with congenital (n = 7) and acquired (n = 1) upper limb loss participated in this study. Highest device satisfaction items of the QUEST include weight (4.50 ± 0.76), safety (4.38 ± 0.52), and ease of use (4.13 ± 0.64). Functional tasks of the OPUS observe that prosthesis donning and doffing (1.5 ± 0.84) and drinking from a paper cup (1.75 ± 0.89) were the easiest functional tasks. Conclusion: The presented methodology for remote fitting of 3D printed upper-limb prostheses exhibits significant potential for rapid fabrication of functional prostheses to developing countries due to increased availability of digital devices in rural areas.

Background: The delay between amputation and prosthesis fitting contributes to the high rate of prosthetic abandonment despite advances in technology. Three-dimensional (3D) printing has allowed for the rapid fabrication of prostheses. Allowing individuals with amputations to interact with a prosthesis shortly after their procedure may reduce rejection chances. The purpose of the current investigation is to compare functional outcomes and patient satisfaction between a standard transradial prosthesis fitted in a clinic with a 3D-printed prosthesis fitted remotely. The standard prosthesis featured a hook terminal device, while the 3D printed prosthesis’ terminal device was a functional hand. Results: The main finding of this case study was that the use of a 3D printed arm prosthesis fitted remotely resulted in better functional performance, but lower overall patient satisfaction than the standard arm prosthesis. Use of the 3D printed arm resulted in improved gross manual dexterity as measured by the Box and Block test. The 3D printed prosthesis also allowed improved performance in bimanual coordination. However, the standard-hook device scored higher in patient satisfaction survey results. The patient's concerns with the 3D printed prosthesis were the durability and effectiveness of the device. Conclusion: While durability and complex grip patterns remain a concern, the positive attributes of 3D printed prostheses include visual appeal, ease of donning, and customization of parameters to improve upper-limb symmetry offers a promising option to familiarize new amputee patients with the use of a prosthesis. Rapid manufacturing and remote fitting allows 3D printed devices to serve as postoperative transitional devices and may function as definitive devices with minimal loss of functionality if standard clinic-based prostheses are not available. Methods: The patient was a 59-year-old male with a traumatic transradial amputation of the dominant arm. A 3D printed transradial prosthesis was remotely fitted and manufactured using photogrammetry. Assessments were performed initially with the standard-hook prosthesis and then with the 3D printed device after a 5-week familiarization period. Functional outcomes were evaluated using the Box and Block Test and Bimanual Coordination Tray Test. Patient satisfaction was evaluated using two self-reported questionnaires (the QUEST 2.0 and the modified OPUS).