Our CPO & Clinical Specialist in the USA, Richard Miltenberger, met up with Joe Johnson, CEO & Clinician at Quorum Prosthetics, to talk about the changes in the digital landscape of O&P in the last couple years. Specifically, how Joe moved the needle with his innovative, individual 3D-printed Quatro Socket. Let's talk about it in this episode of #MecurisMeets.
Joe Johnson, CEO and Clinician at Quorum Prosthetics made full use of digital technologies when creating his individual 3D printed socket that patients can adjust during the day: the Quatro Socket. It's an innovative solution that could only be accomplished by implementing 3D Technology on every level of development and manufacturing. Our colleague Richard talked with Joe about the long way he and his team have come in digital O&P and what the Quatro means to their patients.
Excerpts from the interview. Content adapted for better readability and understanding - you can find the entire video-interview recording below. For all US CPO: get free CEUs
Richard: Tell us about the Quatro Socket? What makes it special and what got you to designing this unique socket?
Joe: The Quatro in its design is more specifically a strategy. It allows the patient to adjust the tightness of the fit throughout the day. That will enable them to accomodate to fluctuations in volume of the residual limb. Behind it is a very complex design that was possible to realize thanks to additive manufacturing.
How did I get there? I´m a practitioner. Always chasing the perfect socket. Working with patients, I saw the need for an adjustable socket to increase comfort throughout the day. What felt like 1000 iterations later, we were ready to produce the Quatro Socket.
Richard: You were personally driven, being an amputee yourself. Take us back to those first days and what got you started.
Joe: I lost my leg in 1984 from a motocross accident right below the knee, which is not ideal. It's a very short amputation. Originally the Quatro was designed for transfemoral amputations. But because of the MJF printing technology (note: MJF = multi jet fusion) and the precision of engineering that goes into these sockets we were able to manufacture trans-tibial sockets as well. So now we can use it for such difficult amputations as I have myself.
Richard: When you first tried it, I assume it was not with 3D technology?
Joe: Oh no. At first, it was a wet lamination. That would take a technician 8-12 hours just to manufacture. It was quite a dirty process. Inaccurate on top, because everything was pretty much left wide open to interpretation in the communication process between me as a practitioner and the technician, actually working on it. In that stage we never made the perfect socket.
Richard: Did that drive you towards a digital solution? How many years ago did you start using digital technology to improve your workflows and processes to begin with?
Joe: Actually it's only just been about 3 years. We won a grant and they pointed us towards MJF in 3D printing. That was the first time I've heard of that technology. I didn't even know what MJF stood for. Before, I only just knew of FDM printers. That was what I had in my mind in terms of 3D printing. And that technology I didn't see fit and mature enough for our industry. And boy was I wrong!
Richard: 3 years is not a long time! Have you always been a tinkerer and visionary in that way? To make use of new ideas in such a way?
Joe: Yeah. But I think that every practitioner - prosthetist and orthotist alike - we are all inventors in our own right. To have good practice you need to be creative.
Richard: I agree and I think you have been inspiring to a lot of people. You created a well known, industry changing product. You are a role model in that way. Do you think it was 3D printing that gave you the ability to do that?
Joe: It's a combination of so many factors. A great engineering team, creative ideas, software and MJF as a printing solution. The combination of hardware and the software just propelled it forward. There are so many different technology parts in the system and the digital workflow behind it. It has given us amazing opportunities. I think that HP even describes it as the “4th industrial revolution” with MJF. That fits for me.
Richard: It definitely seems to have exploded and finally found its way into prosthetics. It seems that materials are now catching up to the ideas they need to serve.
Joe: Yeah. I think it's every practitioner's wish or even dream to optimize their devices. Their patients' sockets for example. For me and my team, we really take a lot of pride in our end product. It functions incredibly well - I'm living proof of that. My prosthesis for example has close to 4 million steps on it. Just to give you an answer on it´s strength, the question of longevity for a 3D printed socket. We will even have some study information on the difference of our 3D printed socket vs. carbon fiber in the near future.
Richard: Quorum Prosthetics has been around for about 24 years and you have a few locations in Colorado. Does your technology come out to all of your patients?
Joe: Yes. We´re always chasing that perfect fit. For now, the Quatro is going on about half of our patients. We are trying to get in on everybody. But it's still a process and sometimes it's quicker to do a wet lamination for patients we need to hurry along. But I´d say in about a year from now we will have it on everybody. We are working out all of those little “kinks” in the manufacturing process as we speak. That will lead to a lot faster results.
Plus, we have the possibility to do iterations on each and every patient easily. Once we have their respective sockets in our digital model, we can easily do adjustments. Before that, you had to grind it out or see what you could do with the material used. Maybe you stretched your carbon fiber already to the limit. You just tried to do the very best with what you have.
Now, digitally we tweak it how we need it and reprint it. It's not as expensive, obviously, to reprint it because it's just the printing costs this time and not the engineering. So we get a better result more easily.
Richard: So, how far do you think you guys have moved the needle from 3 years ago to now in terms of providing digital solutions, in selling it and getting good results out of it. Did it change, like: 80%?
Joe: We´ve taken a lot of risks. We invested in software, manpower, printers - trying to put it all together. There's so many choices out there in printer technology alone. That's why it was so important to have great advice from engineers. We moved the needle big time! We´ve been able to partner with companies such as yourself, Lubrizol, Hewlett-Packard. Testing with the University of Boulder. All those parts fit together now and give us an edge.
Richard: One of the things people wonder about is: how much better is digital design? And: why should I switch, if that's what I'm doing works? What is your take on that?
Joe: Even I ask myself that sometimes. In the end it comes down to the precision that you can obtain with the digital process. When I look at all the old diagnostics sockets that I keep for various reasons and I ask myself: Can I remember 6 month from now, or 1 year from now what modifications I did last to that mold? Could I confidently recreate that socket, if the patient needed some change? Digitally I pull it up and see exactly what happened. We can even see precisely in percentage how much volume a patient lost and therefore reprint an inner liner perfectly.
Richard: That's a huge benefit. Please, tell us some more about that inner liner.
... You want to hear the answer to that question, and the rest of the interview? Sign up for the recording and learn more on:
The buildup of the 3D printed Quatro socket and how it works with different lock systems and alignments
Material: Experiences to printing powder PA 12 vs. PA 11 and TPU (Lubrizol)
3D print: MJF printing by HP and the feel of it to an amputee
Joint workforces: how we modeled Joe´s latest socket with the Mecuris3D Modeling tool on the Mecuris Solution Platform that then led to a 3D printed Quatro Socket by Quorum Prosthetics.
Extra DeepDive (20 minutes): learn more in detail how to apply the new tools for modeling a residual limb on the Mecuris Solution Platform
PLUS: For all US CPO: Get Free CEU 2.00 free scientific CEU’s
Thanks to Joe for the great interview and also to Jack Fleischmann for chipping in with his valuable knowledge!
Our tipp for all US based practitioners: At the end of the video we will provide you with the form that will enable you to get 2.00 free scientific CEU’s by ABC.
You want a personal demo of the tools on the Mecuris Solution Platform? You can see availabilities for a personal call right here.