When Microsoft and Toyota aired Super Bowl ads featuring prosthetics users — Braylon O'Neill, 6, born without leg bones; and Paralympic snowboarder Amy Purdy, a double amputee at 19 — they showcased the tremendous technology behind the devices.
Emerging prosthetics technology, from advanced robotics to the blade-runner Flex-Foot Cheetah design made famous by Oscar Pistorius, is driving revenue at a handful of small businesses in the city.
While many patients can't afford the most cutting-edge technology, demand for prosthetics is growing — and promising techniques from the 3-D printing industry may make them more affordable. The niche is just beginning to attract the interest of New York-based 3-D printer specialists who hope to one day offer custom products at lower costs.
Home to some of the world's top orthopedists and orthopedic hospitals, New York has long been a base for firms that manufacture or fit artificial limbs, with about 40 such brick-and-mortar businesses in Manhattan, the Bronx and Brooklyn.
"Prosthetics have become essential to patient care because the need for them has never been greater,"said Chris Kort, president of Prosthetics in Motion. "There has been a rise in diabetes-related amputations."
Those amputations make up 82 percent of cases nationally, while trauma-related amputations constitute 16 percent. An additional 2 percent of amputations are congenital- and cancer-related, according to the American Academy of Orthotists & Prosthetists. War-related trauma is encountered less often by New York prosthetics companies, although some do contract with the Department of Veterans Affairs to provide prosthetic services.
The Manhattan firm Kort founded in 2009 averages annual growth of 10 percent to 20 percent. Prosthetics in Motion recently doubled its Manhattan space to 5,000 square feet.
East Coast Orthotic & Prosthetic Corp. is the largest such manufacturer in the New York area. Founded in a small office space in 1997, the company today has a 60,000-square-foot warehouse in Deer Park, N.Y., where it develops and tests products in its labs. It also has a dozen local offices where patients are fitted. It employs about 150 workers. The company recently purchased a 13-foot-tall robot for production work requiring accuracy and precision.
"The demand for prosthetics has always been growing; to keep up, we have invested in technology and the most up-to-date inventory of products," said Vincent Benenati, chief executive of East Coast.
The high cost of prosthetics is one reason why local businesses believe 3-D printing will play a bigger role — and perhaps compete with New York's traditional prosthetists — as the technology behind 3-D printing evolves.
Sam Cervantes, chief executive of 3-D printing company Solidoodle in Brooklyn, said the advantage of 3-D printers over traditional methods is the ability to produce small quantities at a lower cost, and to produce highly customizable products with relative ease. "We're seeing the early stages of what will be a widespread phenomenon, especially since it will essentially be one-100th of the cost of prosthetics while having 90 percent to 95 percent of the functionality of them," he asserted.
The average cost of a prosthetic is $50,000 and up. Medicare beneficiaries are required to pay 20 percent of the Medicare-approved amounts for their new devices, according to the Medicare Rights Center in Manhattan. That co-pay is still costly, which is why the industry is pondering whether 3-D printers can address affordability.
The answer? Not yet.
"The media buzz around 3-D printed prosthetics that cost $20 to make for a hand doesn't show the full story," Benenati insisted. "Behind the scenes, there was a prosthetist who designed and modified the hand. This takes time and money, and it's not so easy as pushing a button and boom, a hand comes out."
The hidden costs
Mr. Benanati said he hopes that 3-D printed prosthetics will be a part of the services his company offers. For now, products from the printer are in the experimental stage and far from fully functional.
"It's easy to lose sight of the hidden costs of these plastic prosthetics because there's always a cost beyond just the raw materials it took to make them," added Benenati.
Prosthetics in Motion's Kort pointed out that patients want high-tech prosthetics such as the $115,000 microprocessor waterproof knee — equipment that mirrors the natural gait of a user — and the $65,000 Michelangelo hand that grasps like the real thing.
"Three-D printing is definitely exciting, but it's really the advances in prosthetic technology that has astounded us so far," he said.
At this stage in the development of 3-D prosthetics, there is more promise than product.
"As of today, it still takes about 10 hours or longer to print a prosthetic," Kort said. "In that same 10 hours, I can make eight to nine prosthetics. It's not the most time-efficient way of handling the high demand."
But where 3-D printing has ignited the imaginations of prosthetic makers is in the nascent industry's body-scanning functions, which are a prelude to intricate plastic designs.
"When you hear of the success stories of a kid who got a cool new hand or fingers, there's always a lot of digital design that went behind the manufacturing," explained Jonathan Schwartz, a product director for Manhattan-based Body Labs, which makes digital models for the human body. "It's the design that makes [the 3-D] printed prosthetics look and feel better."