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We trace how affordable, reliable material extrusion is changing prosthetics and orthotics—from student labs to jungle clinics—and why toolpaths, not just materials, will drive the next gains in comfort, strength and cost. Real patient stories show the economics and ethics of access at scale.

• season launch and mission to improve patient outcomes
• shift from tinkering to reliable, prosumer 3D printers
• material extrusion vs FDM and why terminology matters
• nonplanar layers, multimaterial potential, pellet economics
• toward truly digital extrusion with better sensing and AI
• application focus over generalization in O&P innovation
• case study on low-cost pediatric prosthesis with reuse of CAD data
• orthoses workflows moving toward “toaster-like” simplicity
• education pathways as students learn on clinic-grade printers
• materials outlook: TPU, TPE, silicone prospects, polycarbonate tradeoffs
• variable density, air pockets, and hybrid fill strategies for comfort
• polar kinematics and toolpath planning as the next frontier
• print farms, software orchestration, and scaling production

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Is this the lost episode? No, but there is some "old news".

We dig into how O&P is changing fast: major acquisitions, new L codes, and a fresh vision for education that blends clinical reality with digital tools. Adrienne Hill shares a grounded path for students and clinicians to build skills without burning out.

• Hanger’s acquisition of Point Designs and upper limb strategy
• Medicare L codes momentum for partial hand coverage
• Three education models and how to choose
• Why residencies still define clinical growth
• Embedding scanning, CAD, and 3D printing in coursework
• Practical literacy vs making the "sausage" in-house
• Shifts from plaster to digital and what’s realistic
• Workflows that prevent burnout and improve retention
• Ownership dreams, debt realities, and timing
• The modified seven-year rule for career moves
• How to pick residencies that fit your EQ and IQ
• Going rural or high volume to accelerate learning
• Broadening applicant pipelines and faculty needs

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We break down how L code pricing is set, why crosswalk and gap-fill can fail innovators, and how appeals drain time and cash. Two case studies—Point Designs’ digits and Ethnocare’s volume system—expose how “divide by five” logic and invoice anchoring distort value, while 3D printing and hybrid workflows offer a path forward.

• crosswalk vs gap-fill pricing methods and trade-offs
• pitfalls of 99 miscellaneous codes and ALJ appeals
• point designs digits priced against a mechanical hand
• Ethnocare’s volume management tied to sock costs
• framing comfort as adherence, safety and savings
• click medical as a data-backed reimbursement win
• Medicare recognizing 3D printing as manufacturing
• desktop tpu print farms and reliability advances
• hybrid workflows using load-bearing capture and automation
• fragmentation in O&P advocacy and need for alignment

Thank you for listening. We’re in 118 countries and nearing 35,000 listeners—keep learning with us and share the show.

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We explore how foaming TPU, belt printers, and clinician-led automation can bring custom foot orthoses in-house, cut costs, and reduce lead times from weeks to hours. Fredrik from CADmed shares what actually works, what doesn’t, and how remote design plus per-pair pricing changes the game.

• why automation increases clinician control rather than removes it
• carving versus printing tradeoffs on speed, finish, and cost
• foaming TPU benefits including smoother surfaces and less waste
• belt printers for continuous TPU production and better surface feel
• FDM advantages over powder bed fusion for insoles
• practical lattices and gradients without overengineering
• decentralizing production to clinics for faster delivery
• remote design, slicing, and printer control with per-pair pricing
• scaling systems for reliability, repeatability, and low friction

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We trade trade-show gloss for real-world tactics, then lay out a three-step plan to bring 3D printing into O&P without risking patient care or cash flow. From Bambu-level starters to automated check sockets, we show how to start lean, learn fast, and scale what works.

• Formnext’s shift from machines to applications
• Materialise Bricks for modular workflows and costing
• Multi-material metal, gradient parts, and smarter tooling
• Affordable LPBF and the desktop print farm surge
• Start with a low-cost printer and print clinic tools
• Outsource complex adjustable sockets to free capacity
• Automate transtibial check sockets for speed and margin
• Scanner choices from budget to pro with trade-offs
• A three-tier roadmap to adopt and scale digital O&P

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We record on the road to the mothership to fit a 3D-printed adjustable suction socket using AirFit casting and compare loaded scans to raw scans. David shares his crash-to-career journey, why adjustability matters for neuromas and daily volume, and what makes the Americus foot feel lighter and livelier than it looks.

• AirFit casting under load versus direct scanning 
• Four-scan workflow and remote 3D fabrication 
• Suction plus adjustability for volume and hotspots 
• Flexible inner swaps for quick tuning 
• David’s neuroma history and fit lessons 
• Merecus foot layup, split keel, and energy return 
• Social media as connector, career builder, and patient support 
• Choosing a prosthetist who listens and offers trials 
• Safety, waste, and smarter ovens in the lab 
• Why 3D printing speeds care and improves revenue cycle

Find David: YouTube The Adventurous Amputee • LinkedIn David Slider • Instagram Pirate Peg Leg and The Adventurous Amputee

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We sit down in the Guatemalan jungle with filmmaker Todd Biss to explore how craft, ethics, and faith shape stories that fund care and protect dignity. From ad-agency polish to nonprofit trust, we trace how small crews, better audio, and sharp editing turn hope into motion.

• origins in photography and ad-agency production
• defining success through beauty, trust and client outcomes
• on-location logistics, tech scouting and studio control
• nonprofit storytelling with trauma-aware practices
• lighter gear, better mics and sensor gains
• editing as a puzzle with multi-length deliverables
• hooks that respect attention without hype
• tripod versus handheld choices for tone
• audio upgrades that elevate any video
• clinic systems from forming to fitting
• Adonis’s first steps and renewed hope
• faith-driven work and why it matters
• pricing, discounts and sustainable impact
• where to find Todd Biss online

Find Todd at “Todd Biss Productions” on Google, LinkedIn, and Instagram

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Two sentences from PDAC can potentially change the course of manufacturing history for O & P: additive manufacturing is now explicitly acceptable for coding prosthetic devices that meet existing HCPCS descriptions. We unpack what that clarity means for clinicians, patients, vendors, and payers, and how to adopt 3D printing.

• Why PDAC’s language ends the gray area for 3D‑printed prosthetics
• What PDAC and DME MAC do and how they shape coding
• How to match additive devices to existing L code descriptions
• Documentation discipline to avoid denials and audits
• FDA’s proactive stance and signals to industry
• Medicare vs Medicare Advantage realities for reimbursement
• When new codes help vs when they stall at zero pay
• Scaling care amid workforce shortages using digital workflows
• Using additive to improve fit, speed, and repeatability
• Practical steps to start: scanning, CAD, materials, records

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We share a personal update and then dive into how injuries, curiosity, and tough feedback shaped a modular myoelectric hand that is lighter, repairable in minutes, and priced for wider access. Ryan Saavedra of Alt-Bionics walks through additive manufacturing choices, PDAC approval, and a roadmap linking prosthetics with humanoid robotics.

• user and clinician pain points shaping design choices 
• modular finger architecture for fast field repairs 
• nylon 12 and MJF for strength, weight, and cost 
• tolerancing to reduce lash and improve reliability 
• pricing philosophy, PDAC approval, and reimbursement nuance 
• EMG control foundations, firmware over AI for stability 
• balancing service bureaus vs in-house manufacturing 
• funding from bootstrap to mission-aligned investors 
• product roadmap focused on hands and higher DoF 
• cross-pollination between prosthetics and robotics

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What if everything we think we know about human walking is oversimplified?

In this episode, we sit down with Dr. Steven Gard a biomedical engineer and leading gait researcher.  We unpack the real biomechanics behind prosthetic design. From artificial heart labs to O&P innovation, Dr. Gard shares surprising insights on:

• Why shock absorption and “energy return” don’t always behave the way prosthetic marketing suggests
• How soft tissue acts as a natural spring, changing everything about how force is transmitted through a limb
• The ongoing debate between ischial containment, subischial, and elevated vacuum sockets — and why no design is one-size-fits-all
• Where microprocessor knees and 3D printing fit into the future of mobility
• The missing link between engineering theory and clinical practice

Whether you’re a clinician, researcher, or just prosthetics-curious — this episode reframes gait in a way you’ve never heard before.

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