The Clinical Perspective of Computer Aided Design and Manufacture in the Orthotics

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´│░an> Orthotic Biomechanical Solutions 2010


Orthoses produced by Computer aided design and manufacture (CAD CAM) were produced as early as the mid 1970s in America. However Utilization of the systems in the UK has been slow to follow the model in some parts of America. However there are now a number of practitioners who are able to utilise CAD CAM to produce orthotic devices. There are also an increasing number of systems available in the UK.

The progress of CAD CAM in Orthotics has been slow for a number of reasons. Many of the barriers to usage are common with that of prosthetics. However there are a number of further problems in applying the process to Orthotics. Devices applying three point pressures are difficult to produce without resorting to casting. Digitisation over more than one joint can be difficult for the patient who has to keep very still for the process to work accurately. Other devices, which pass over fewer joints such as foot orthoses are effectively produced from a digitisation of the patient’s foot. Another significant problem is the geographic spread of clinics, from which orthoses are supplied. Many systems would need to be purchased to ensure complete usage of CAD in orthotic clinics throughout the UK.

Being able to rectify and modify orthotic shapes on the computer provide the practitioner with the ability to have more control over the finished item. Overlaying of plantar pressure measurements can provide more information to better design foot orthoses Patients have also commented that digitalisation is less messy and they often feel more involved as the model can be rectified within the clinic. Another distinct advantage for the patient and the practitioner is the ability to repeat an orthoses, which is often difficult to achieve by conventional methods. This tends to reduce clinic appointments. and provide more time for the practitioner to spend with his or her patient.

We are beginning to see a revolution in the use of CAD CAM to produce orthoses in the UK. This is being driven by a determination to do better for our patients and to reduce the costs to our over stretched orthotic budgets As more systems are used, costs may further reduce and this can only be of benefit to the end user (the patient)

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