Member Spotlight

Digital Design

Company offers 3D printing and traditional fabrication to support O&P professionals

PROTOSTHETICS BEGAN AS a student project at North Dakota State University. Founded as a university engineering project, the company aimed to make myoelectric arms that incorporated 3D printing, but soon moved to leveraging the technology to create more traditional O&P devices. Darren Jacoby, who is now CEO and company owner, began offering full-service central fabrication services to clinics, with an emphasis on 3D printing and digital design.

Recently, Protosthetics launched a new program in response to feedback from O&P clinicians. “Our customers liked working with us on 3D-printed projects, but they wanted to have the technology in house,” explains Jacoby. “What they didn’t want was to have to learn digital design and become experts in 3D printing, taking time away from their ability to provide patient care.” The result was the Galileo program, an end-to-end offering that places 3D printers in clinics while Protosthetics does all the digital design work as requested by clinicians.

Using a proprietary app, clinicians scan the patient and transmit the information to Protosthetics, where product engineers design the device and send digital instructions to the printer, which creates the product on site. This entire process happens seamlessly for the clinician, essentially providing a central fabrication clinician experience, but delivering the efficiency and cost savings of on-site 3D printing, says Jacoby.

This system reduces turnaround time on devices to 12 hours or less, according to Jacoby. “And we include printer replacement every few years, so they always have the latest technology.” The contract has different pricing tiers based on clinic volume, unlimited customer support, and a full warranty and repair program. Protosthetics also offers short-term contracts that enable clinics to try 3D printing with very little risk, and the program can be cancelled without penalty, according to Jacoby.

At this point, Galileo can produce check sockets, flexible inners, and copolymer definitive sockets that accommodate a range of suspension and attachment methods. When a patient needs a new socket, the stored digital data makes it easy to recall patient information without going through the entire design process again.

“Our team of engineers is always figuring out new devices to offer to customers, so our product list will continue to grow,” says Jacoby. “Instead of every clinic having to reinvent the wheel on new devices, we can hire amazing biomedical

The Protosthetics team

COMPANY: Protosthetics OWNER: Darren Jacoby LOCATION: Fargo, North Dakota HISTORY: Seven years

Jacob Kinsella, head of fabrication, works on a socket.

Anthony Zaragoza, a product technician engineers and 3D printing experts to figure out new materials, designs, and products that can be done with 3D printing. These are then made available to Galileo members at no additional charge.”

Protosthetics continues to offer central fabrication services using traditional methods, 3D printing, or a combination of the two. Additional products include its flagship fully custom 3D-printed pectus carinatum and rib flare braces, the Amphibian Water Leg, and functional, diabetic, and accommodative orthotic inserts. The company also makes ankle-foot orthoses and definitive sockets and offers 3D-printed check sockets.

As technology evolves, the company hopes to be front and center, driving a trend toward more on-site fabrication while leveraging external support for clinicians so they can be as efficient as possible while maintaining control of the patient experience.

Protosthetics occupies a facility of about 10,000 square feet in Fargo. Its 20 employees include biomedical engineers, kinesiologists, and certified fitters, and its equipment ranges from traditional tools to automated CNC mills and a fleet of 3D printers.

The company works with a local nonprofit, Hope Inc., that offers children and adults with mobility challenges opportunities to participate in sports and recreational activities. Protosthetics employees volunteer at many of these events, including an upcoming golf tournament.

As the company evolves, Protosthetics will continue to do what it can to help practitioners provide optimal O&P care. “Practitioners have a lot on their plates,” Jacoby says. “We want to make it as easy as possible for them.”

Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.

Modifying and Motivating

Small facility seeks to continuously improve patient care

PETER BUFFINGTON, CPO, doesn’t dream of expanding his practice into a vast network of patient-care facilities. He likes the level of control he has in a small office where he is, for now, the sole practitioner. “We have a lot of control over how things get made and how people are treated,” he explains. “That level of control leads to better outcomes for our patients.”

In 2008, Buffington bought out his partner, who ran an O&P facility in New York while Buffington headed the New Jersey office. He changed the name of the practice to Achilles Prosthetics and Orthotics. Buffington, along with an office manager, an assistant, and a technician, has been serving patients ever since.

The facility sees a mix of orthotic and prosthetic patients of all ages, about of third of whom are pediatric. The office includes a large patient-care room and a fabrication lab where he and his technician build all devices. “I’m a little old school,” admits Buffington. “I still modify molds myself, doing all the hands-on work. I like it because there’s no intermediary—it’s a seamless and direct experience.” He does, however, welcome some hightech advances, such as the High Fidelity and Symphonie Aqua socket systems. “We try very hard not to stand still,” he says.

Achilles offers continuing education courses on upper- and lower-extremity prosthetics and orthotics to local therapists. Buffington also works with the New Jersey branch of Healing the Children, a nonprofit that provides medical care to children in the United States and internationally.

“I’ve treated children flown in from Pakistan and the Caribbean, and Central and South America,” he says. “I also went to Ecuador with an orthopedic team in 2019.” Recently, he helped the organization raise money to fly in a young man with bilateral lower-limb loss, and fit him with high-quality prostheses: “He was walking and literally dancing in them before he went back home,” Buffington recalls.

Achilles’ commitment to improving patient care includes surveys given to each patient. “Depending on how they respond, we can track our successes or things we need to improve.” Buffington says most of the feedback is positive, although some comments led him to modify his communication with patients. “It helped me clarify the way I talk to patients, especially when giving directions,” he says.

One of Buffington’s favorite success stories is Elizabeth Shea, a bilateral above-knee patient

Peter Buffington, CPO (right), with Carlos from Healing the Children FACILITY: Achilles Prosthetics & Orthotics OWNER: Peter Buffington, CPO LOCATION: Ramsey, New Jersey HISTORY: 14 years Elizabeth Shea, a bilateral above-knee patient who has been in microprocessor knees for almost a year who lost her legs in an accident in the 1980s. Shea had moderate success with prostheses after the accident, he says, but on Sept. 11, 2001, she was trapped in lower Manhattan after the attack on the World Trade Center. “The experience so traumatized her that she took off her prostheses and said, ‘Never again,’” Buffington recounts.

“But then, 20 years later, she decided to get moving again. She found us through the Amputee Coalition, and she started with ‘stubbies’ [foreshortened prostheses]. They got her up and moving, gaining strength, and she worked so hard. She’s been in microprocessor knees for almost a year and is now walking in the community. Elizabeth has been so committed to her rehabilitation and success—it has been an absolute joy to be along on the ride for this. She has achieved a level of success I never dreamed of!”

Achilles relies mainly on word of mouth to attract new patients and referral sources, although the facility has a presence on Facebook and Instagram. Eventually, Buffington would like to expand, adding more practitioners—but not so many that he loses control of the quality and service given to patients.

“I’ve been doing this for 30 years, and I like being the one who has to figure it out,” he says. “I love this profession. It’s a challenging blend of art and science that gives you the ability to have an impact on someone’s life.”

Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.