A review of history of CAD/CAM system application in the production of transtibial prosthetic socket in developing countries (from 1980 to 2019)

Abstract

The development of the CAD/CAM (Computer-aided design and computer-aided manufacturing) system has globally changed the fabrication and delivery of prosthetics and orthotics. Furthermore, since the introduction of CAD/CAM in the 1980s, many successful CAD/CAM system are available in the market today. However, less than 20% of amputees have access to digital fabrication technology and large portion of the amputees are from the developing countries. This review designed to examine selected studies from 1980 to 2019 on CAD/CAM systems in the production of transtibial prosthetic sockets. A review was conducted based on articles gathered from Web of Science, Pubmed and Science Direct. From the findings, 92 articles found related to CAD/CAM-derived transtibial prosthetic socket (TPS). After a further screening of the articles, 20 studies were chosen and only one study was done in a developing country. The results showed an increase interest in CAD/CAM application in Transtibial prosthetic socket (TPS) production for both developed and developing countries, yet the technology has not fully utilised in the developing countries. Factors such as resources, accessibility, knowledge-gap and lack of experienced prosthetists remain the major causes of the lack of CAD/CAM system studies. Large-scale trials are required to employ digital fabrication in the developing regions, consequently advancing the production of high-quality CAD-CAM-derived TPS where most prosthetic and orthotics are needed.

A qualitative study on stakeholder perceptions of digital prosthetic socket fabrication for transtibial amputations

“…CAD and 3D printing can be problematic for end users as there is a steep learning curve and particularly so for novice users. 1,7 This corresponds to findings by Rogers et al 22 that prosthetic socket fabrication with its complex pressure redistribution and intricate fit needs requires experienced CAD software designers and technical support for end users. Even with software glitches being experienced, prosthetists appreciated the ability of saving digital models of the residual limb with the 3D scanning and computer-assisted manufacturing software.…”

“…4 With advances in technology, CAD is now being combined with 3D scanning and 3D printing technology to fabricate sockets in a complete digital workflow, eliminating the need for CNC carvers. 3,7 There are a variety of 3D printing methods, one being rapid prototyping with fused deposition modeling (FDM), which involves heating, excreting, and fusing material one layer at a time to build the object. 8 FDM is a technique that has been found useful for low cost and quick prosthetic socket fabrication.…”

Effect of restoration material on marginal bone resorption around modified anatomic zirconia dental implants: A randomised controlled trial

“…CAD/CAM systems have been applied clinically in many fields [ [17] , [18] , [19] ]. Zirconia dental implants are one of these applications that have been recently introduced [ 12 ].…”

Limb Prostheses: Industry 1.0 to 4.0: Perspectives on Technological Advances in Prosthetic Care

“…Early champions identified multiple benefits coming from the adoption of this technology in prosthetics ( 20 ). Seminal work was done to create sector specific software and hardware and included CANFIT (Vorum), Seattle ShapeMaker and CAPOD systems, with Vorum becoming an industry mainstay internationally ( 21 ).…”