You’re starting to hear more and more about 3-D printing, a computer driven fabricating method for foot orthotics and more. But, are they the best available? Although 3-D printing is fascinating on what it can do, until many issues are resolved, in my opinion, they are not the best available.
Why? Well, it starts with the operator or the person position the foot to obtain a cast or scan of the foot. This is a critical step and relies on an experienced, educated individual to obtain the ideal position of all areas of the foot, not just an inside arch (medial arch). For example, the orthotic should not be straight across on the front edge of the orthotic by the metatarsal heads (ball of foot).
Next, prepping the computerized model of the foot. This is performed on a 2D screen. It is impossible to make accurate 3D corrections on a 2D screen. For example, enhancing the metatarsal (transverse) arch of the foot. There are many “Cast Corrections” that can and sometimes need to be made.
Then, we have material selection. This needs to be appropriate, not only for the orthotic to bear the pressure on it without collapsing, but also to allow enough cushion as well. In the pictures shown, one can see the medial (inside) arch easily collapsed on this patient, resulting in very little support and function.
Also, the design of the orthotic should be tailored to that individual. The shape of the orthotics, as well as any enhancements, additions or corrections that should be made, should depend on the individual. For example, how high the heel cup, walls, length, strength, etc. These designs are driven by the operator and the ability of the computer program to do such.
Finally, there are corrections or adjustments that sometimes need to be made after the patient has broken into the orthotics. This allows for further accommodation, function and comfort. Everyone is different and will respond differently so these changes sometimes need to be made. If one tries some of these changes to the 3-D printed orthotic, it will destroy the framing integrity of the device. Overall, there are many ways to adjust an orthotic and the 3-D printed orthotic will not withstand or be able to change.
So many variables! Yes, 3-D printing is here and will improve but with so many variables still in place, I would not advise one to run out and buy a pair just because it is the newest thing.
David J. Sables, D.P.M., C. Ped. ArchMasters