By 2040, more than a quarter of the U.S. population will have diagnosed arthritic conditions. Adults with arthritis and other rheumatic conditions earn less than average yet have medical care expenditures that are over 12% of average household income. Adaptive aids can help arthritis patients continue to maintain independence and quality of life; however, their high costs limit accessibility for older people and the poor. One method used for consumer price reduction is distributed manufacturing with 3-D printers. In order to assess if such a method would be financially beneficial, this study evaluates the techno-economic viability of distributed manufacturing of adaptive aids for arthritis patients. Twenty freely accessible designs for 3-D printable adaptive aids were successfully fabricated on low-cost desktop 3-D printers and performed their functions adequately. The financial savings averaged >94% compared to commercially-available products. Overall, twenty adaptive aids were printed for US$20 of plastic; while on average, each adaptive aid would save over US$20. As printing a tiny subset of the adaptive aids needed by a single patient would recover the full capital and operational costs of a low-cost 3-D printer, it can be concluded that there is considerable potential for distributed manufacturing to assist arthritis patients.

Background Open-source, self-replicating rapid prototypers (RepRaps) have radically reduced the costs of 3-D printing while expanding its access. 3-D printing's model of distributed manufacturing can produce medical technologies at significantly reduced costs. We investigate this potential by evaluating the viability of an open-source 3-D printable infant clubfoot brace. Methods Starting with a list of key features present in currently available clubfoot braces, a 3-D printed clubfoot brace was developed in free and open-source CAD software (FreeCAD) to enable future customization. Poly-lactic acid (PLA), a biodegradable and recyclable bioplastic was selected among the various commercial 3-D printable materials based on strength and cost. Results The results show that the open-source clubfoot brace matches or surpasses the physical features and mechanical degrees of freedom of all commercial-and non-profit-developed brace designs while substantially reducing the costs of the braces to hospitals and families. Conclusions The 3-D printed brace has the features of commercially available braces while significantly reducing the cost, making this clubfoot brace particularly appropriate for use in developing countries. In addition, the results indicated that this model of distributed manufacturing of medical technology is technically and economically appropriate through much of the Global South.

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Roughly a third of the surgical procedures the World Bank is prioritizing as essential and cost-effective are orthopedic procedures. Yet in much of the developing world, prohibitive costs are a substantial barrier to universal access. One area where this is clear is surgical fracture tables, which generally cost >US$200,000 new. With the advent of 3-D printing, a new way to reduce medical equipment costs is to use open source hardware licensed designs to fabricate digitally-distributed manufactured medical hardware. That approach is applied here to make surgical tables more accessible. This study describes the design and manufacture of an open source surgical fracture table that uses materials that are widely available worldwide with specialty components being 3-D printed. The bill of materials and assembly instructions are detailed and the fracture table is validated to perform mechanically to specifications. Using an open source desktop RepRap-class 3-D printer, the components can be printed in a little over a week of continuous printing. Including the 3-D printed parts, the open source fracture table can be constructed for under US$3,000 in material costs, representing a 98.5% savings for commercial systems, radically increasing accessibility. The open source table can be adjusted 90–116 cm in height, tilted from +/-15 degrees, the leg height ranges from 31 to 117 cm, the arm supports and foot holder both have a 180-degree range, the foot position has a 54 cm range, and the legs can be adjusted from 55 to 120 degrees. It is mechanically adjusted so does not require electricity, however, surgical staff need to be trained on how to perform needed adjustments during surgery. The open source surgical table has verified performance for mechanical loading over 130 kg, geometric flexibility to allow for wide array of common surgeries, is radiolucent in surgical zones, and is modular and upgradeable.