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Rich Dubin, CEO of LER Expo, shares his journey creating digital educational platforms that foster cross-disciplinary learning for healthcare professionals in the lower extremity market. We discuss how bringing together specialists from different fields—from podiatry to orthotics and prosthetics—leads to better patient outcomes and more innovative approaches to care.

• Founded LER Expo in 2019, perfectly timed before COVID shut down in-person educational events
• Created an engaging digital conference platform that recreates the in-person experience with lobbies, exhibit halls, and networking spaces
• Uses innovative approaches like tournament-style presentations to keep audience engagement high
• Emphasizes the importance of cross-disciplinary education across healthcare specialties
• Discusses concerns about the rising cost of O&P education with master's programs approaching $200,000 in total costs
• Highlights the critical value of mentorship and hands-on experience versus academic credentials alone
• Shares practical advice for clinicians wanting to present at virtual conferences
• Believes collaborative care across disciplines leads to better outcomes for patients
• Encourages professionals to look beyond their specialty silos to find new connections and innovations

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We explore the exciting intersection of engineering, biomechanics, and 3D printing in prosthetics with our guest Ashton Stoop, who shares his journey from mechanical engineering student to designing 3D-printed prosthetic limbs in Mexico.

• Ashton's background in mechanical engineering and his path to O&P through biomechanics research
• The importance of both functionality and emotional integration in prosthetic design
• How custom prosthetic covers serve as tools for patient acceptance and identity
• Using Rhino and Grasshopper software to create automated workflows for socket design
• The balance between maintaining clinical control and leveraging AI automation
• The potential for 3D printing to democratize the prosthetics industry
• How small clinics can compete with larger corporations through innovative technology
• The critical importance of clinical evaluation and fitting despite technological advances
• Challenges in biomechanical understanding of complex structures like feet and ankles
• Community initiatives like the Digital Limb Collective that share knowledge and best practices

The field of prosthetics needs professionals from all backgrounds – you don't have to be a clinician to make a difference in people's lives. If you have design skills and a passion to help others, there is room for you to contribute to this meaningful work.

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Dhruv Agrawal, founder of Aether Biomedical, shares how a birthday gift 3D printer led him from medical school to developing the Zeus hand, the strongest bionic prosthetic hand on the market with revolutionary cloud-based tracking capabilities.

• Journey from medical student to prosthetics innovator began with a 3D printer birthday gift
• Uses additive manufacturing not just for prototyping but for actual production components
• Zeus hand features industry-leading grip strength and 30-minute repair capability
• Cloud-based platform tracks usage data, showing super users complete 700-800 grip cycles daily
• Data collected helps optimize device settings and provides evidence for insurance authorization
• Most users rely on 4-6 standard grips plus 2-3 customized grips for specific activities
• Currently working on multiple versions of the Zeus hand at different price points
• Long-term vision is to become "the operating system for assistive devices" across prosthetics, orthotics, and exoskeletons
• Company of 60 people with half dedicated to research and development
• Future developments include VR training tools for phantom limb pain management

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Jochen Weigel from Stuttgart, Germany joins us to discuss his innovative contributions to prosthetics, including post-processing for Niagara feet and the development of the AirFit casting system.

• Jochen's journey from clinical specialist to R&D manager to starting his own business 13 years ago
• The AirFit system uses air pressure instead of water to create comfortable prosthetic sockets
• Air pressure uniquely compresses only soft tissue while preserving bony structures
• Testing in Kenya combined the AirFit system with low-temperature thermoplastic sockets for immediate fitting
• The Niagara foot provides exceptional durability compared to SACH feet commonly used in developing regions
• Made with special DuPont material (Hydrel) through a complex molding process few can replicate
• The foot works across weight ranges from 70-190 pounds when properly tuned
• High initial cost compared to $20 Chinese alternatives creates adoption challenges despite long-term savings
• Ways to help include volunteering with NGOs, making targeted donations, or collaborating with small companies

If you have ideas for prosthetic products that could help in developing regions, reach out to smaller companies who are more likely to be interested in humanitarian solutions.

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The mobile prosthetic clinic model is gaining traction as Hanger acquires Colorado-based Agile Orthopedics, potentially changing how prosthetic care is delivered nationwide. Raise3D's new RMS-220 SLS printer enters the market with open material capabilities, challenging the economics of small-scale prosthetic production.

• Mobile clinics solve transportation challenges for patients with mobility limitations
• Bringing care directly to patients is especially valuable in rural areas with weather challenges
• Centralized fabrication pairs perfectly with mobile clinical services
• Hanger could dramatically expand market reach by adding mobile clinics to existing locations
• Open-material 3D printers may help control costs when material prices increase but reimbursement doesn't
• Entry-level SLS systems face challenges with powder handling and economic viability
• Lattice structures should be used thoughtfully based on function, not just aesthetics
• Using others' designs without permission demonstrates disrespect for intellectual property

Join us next time as we continue exploring innovations in prosthetics and orthotics. Remember to subscribe to the podcast and share with colleagues who might benefit from these discussions.

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David Pierick, a retired Applications Engineer, shares the journey of bringing powder bed fusion technology to prosthetics and orthotics, revolutionizing patient comfort and outcomes through advanced materials.

• The initial challenge: proving 3D printed prosthetic components were as good or better than traditional methods
• Testing showed printed sockets were remarkably strong—in one test bending the aluminum testing rod before deforming the socket
• Patient feedback consistently reported greater comfort with PA-12 sockets, especially when paired with flexible interliners
• PA-11 offers superior fatigue properties and better strength-to-stiffness ratio than PA-12, though at higher cost
• PK5000 combines nylon stiffness with TPU softness, enabling thinner socket designs with excellent impact resistance
• Proper design principles are critical: avoid sharp edges, ensure proper radii on all features, and properly transition corrugations
• Future innovation requires thinking beyond traditional manufacturing constraints and adopting true 3D design approaches
• Collaborative teams of polymer experts, design specialists, and clinicians are essential for solving complex challenges
• New applications could include integrated functionality with shock absorption zones and varying flexibility in a single component

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Dr. Nate Crider joins us to discuss his approach to prosthetic care through telemedicine, where he bridges the gap between prosthetists, patients, and insurance requirements. As a PM&R specialist, he has expanded to 14 states in just three years, improving outcomes by bringing medical expertise directly to prosthetic clinics.

• Telemedicine solves mobility challenges for amputees while improving communication between medical and prosthetic providers
• Insurance documentation requires specific medical necessity language that many primary care providers don't understand
• Collaborative appointments with patients and prosthetists ensure accurate assessment of functional needs and appropriate technology selection
• Technology advancements including osseointegration, pattern recognition for upper extremities, and K2 microprocessor knees are changing patient options
• Proper socket fit, liner replacement, and supply management significantly impact patient comfort and functional outcomes
• Interdisciplinary approaches with surgeons, PM&R specialists, and prosthetists lead to better amputee care from surgery through rehabilitation
• Small and large prosthetic practices benefit from specialized medical documentation support that reduces denial risks

For more information about Dr. Crider’s telemedicine services, connect with him on LinkedIn or contact Madrina company, which operates in 46 states.

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Bill Wright shares his global healthcare and engineering journey spanning 36 countries over 50 years. His uniques experiences reveal how important it is to create lasting impact through sustainable solutions with good engineering.

•On one of his jourey's Bill was introduced to prosthetics  in Bangladesh where he encountered the Jaipur foot made from sandals and rubber tire parts
• The design uniquely suited patients who walked barefoot and needed to squat for daily activities
• Working across 36 countries required addressing universal needs: water, wastewater management, electricity, and material supply chains
• Haiti stands among the most challenging locations due to extreme poverty and lack of infrastructure
• Solar power has revolutionized healthcare delivery, from small charging panels to systems powering entire hospitals
• 3D printing offers potential for on-site manufacturing but requires finding and retaining technically skilled personnel
• Success can be measured in individual lives changed – like Jose Manuel who now drives and studies law despite missing all four limbs
• Sustainable development requires training locals rather than relying on expatriate presence
• The most effective organizations focus on teaching

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Bryan Costello shares his incredible journey from nuclear power plant worker to prosthetic innovator after losing his leg an accident. Drawing on his mechanical expertise, he developed heating and cooling systems for prosthetic sockets that address temperature regulation problems that have plagued amputees for decades.

• Developing heating elements that integrate between carbon fiber laminations in prosthetic sockets
• Creating cooling systems with circulating water that prevent overheating and excessive sweating
• Designing moisture-wicking distal end pads that absorb sweat and protect sensitive residual limb tissue
• Working with Special Forces members who successfully climbed Mount Everest using his heated sockets
• Expanding his technology to orthotics and medical emergency cooling boards for trauma patients
• Pursuing L-codes to make his innovations more accessible through insurance coverage
• Finding success through direct marketing on LinkedIn and social media

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Matt Doering shares how Cypress Adaptive came to fruition.

• Entering the prosthetic industry through an unexpected path from Coast Guard service to selling cars
• Building Cypress Adaptive with a focus on superior valve technology using spring and diaphragm systems that work even with debris present
• Designing components with replaceable parts that prioritize patient convenience over planned obsolescence
• Introducing the Symphony Aqua system that captures limb shape under weight-bearing conditions
• Creating a repeatable "recipe" for successful socket fabrication that bridges the experience gap between senior and junior practitioners
• Addressing industry challenges of consistency and knowledge transfer as new master's-level practitioners enter the field
• Enabling practice owners to maintain quality standards across all clinicians through systematized approaches
• Fostering collaboration between traditional fabrication methods and new technologies like 3D printing
• Emphasizing patient-centric care while maintaining business sustainability

To learn more about Cypress Adaptive's products and the Symphony Aqua system, visit cypressadaptive.com or reach out directly through their website.

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