The rise of open-source prosthetics

Waking up from a nine-year coma, “Snake” realises that the hospital he is recovering in is under attack and, worse still, that his left arm has been replaced with a hook. After escaping, Snake is fitted with an advanced red prosthesis, which he learns to use to his advantage in his fight against the mysterious Cipher organisation.

Snake’s plight in the latest incarnation of the iconic game Metal Gear Solid motivated British designer Sophie de Oliviera Barata and Konami, the Japanese company behind the game, to team up in producing a bionic arm. “Why not be inspired by the world of fiction and create a prosthetic limb that makes people think ‘wow’ instead of looking away?” asks Konami’s Su Yina Farmer.

Known as the Phantom Limb Project, the partnership will give the first prosthetic it manufactures to avid gamer James Young, who lost an arm and leg in a train accident. “We want people to look at James’ prosthetic arm and say, ‘That is cool!’”

The bionic hand technology comes from a British start-up, Bristol-based Open Bionics. Led by design engineer Joel Gibbard, Open Bionics won the prestigious James Dyson Award in 2015 and gained a place on the Disney Accelerator programme, from which – collaborating with the entertainment giant’s creative teams – the company recently unveiled their own Iron Man, Star Wars and Frozen inspired bionic hands.

Changing perceptions

Making bionic limbs cool by linking them to trendy games and entertainment is a creative way of changing people’s perceptions while also bringing fun into the lives of children who have had to face serious challenges. But for the tens of thousands of people missing limbs in war-torn or chronically poor regions of the world, a prosthesis that can cost anything from €4,000 to €85,000 and take weeks or months to be delivered has been little more than a pipedream until now.

3D printing technology like that of Open Bionics is on the cusp of offering an alternative. In under a week and for a cost of around €2,750, the company will make and fit custom bionic hands capable of performing the same tasks as expensive, advanced prostheses.

The trailblazers

Open Bionics has received support through crowdfunding and grants from companies like Intel. It does not yet have a product on the market, but has made prototype designs and instructions available to anyone with a 3D printer. The company embraces open source to ensure fair access and speed the development of their prostheses. And they are not alone in seeking to democratise their technology.

Japanese company Exiii has developed the Hackberry, an attractive 3D printed prosthetic hand for which they will make the blueprints and source code freely available. And in France Nicolas Huchet – an arm amputee himself – is working on Bionicohand. “I want to test all open-source solutions in upper-limb prosthetics and make links to current research,” he says. “The goal is to create a cheap, robust, affordable, easy to make, easy to fix and open-source bionic arm.”

Nicolas Huchet, French engineer. 

“I want to test all open-source solutions in upper-limb prosthetics and make links to current research.”

Helping hands

The greatest advantage of open-source 3D printing is its power to reach anyone anywhere. “There are 3D printers within 10 miles of more than 1 billion people,” says Andreas Bastian, 3D printing research scientist at Autodesk, an engineering software company.

Bastian is part of e-NABLE, a decentralised global network of 7,000-plus people that designs and distributes 3D-printable upper-limb assistive devices wherever there is a need – almost exclusively in volunteers’ spare time and for free. “Much of the work within the community is still accomplished independently of any funding,” explains Ivan Owen, entrepreneur in residence at the University of Washington and e-NABLE volunteer.

After developing six devices without funding, the community has begun to solicit donations to scale up its impact. “The non-profit Enable Community Foundation supports our mission with funding and operations assistance,” explains Bastian. And with a $600,000 grant and many other donations, a project that started as a way to help one child has grown to a global endeavour offering prosthetic hands to people in 37 countries.

An open and closed case

The early success of start-ups like Open Bionics and initiatives like e-NABLE could make one believe that cheap, 3D-printed, open-source technology is the future for biomedical device production.

But even proponents agree that an industry based only on philanthropy, grants, crowdsourcing and volunteerism will not suffice in the long term. “For open source to really work, proper business models and incentivisation strategies need to be developed,” says Bastian. Valentino Megale of the Open BioMedical Initiative agrees: “Open source means easy information access, but to assure this information is valid and safe you need major investment.”

This last point is echoed by advanced prosthesis expert Hubert Egger of the University for Applied Sciences of Linz, Austria: “Prosthetics go through quality checks and corresponding regulatory affairs that are highly complex and expensive, and may need the support of public or private organisations.”

And even if these hurdles were surmounted, do we really want to put an end to traditional closed innovation? “There will always be a place for closed innovation in the medical sector,” argues Owen, “particularly for problems that involve far higher levels of risk and complexity.”