Jun 25, 2023 
Chris Baschuk‘, MPO, CPO, LP, FAAOP(D) is an Upper Limb Prosthetics Specialist having lectured nationally and internationally extensively on the topic of upper limb prosthetic rehabilitation. He is the Director of Clinical Services for Point Designs, LLC. He currently serves as the Chair of the Upper Limb Prosthetics Society of the American Academy of Orthotists and Prosthetists. Chris is a graduate of the University of Utah with a BS in Biomedical Engineering and obtained his Masters of Prosthetics and Orthotics at UT Southwestern Medical Center. He lives in Centerville, UT with his wife and four children. Chris will be speaking at the upcoming 3D Printing for Prosthetics and Orthotics event.
When was the first encounter you had with 3D printing? What was that experience like? What were you thinking at that moment?
Chris: I remember around 2009 at the Orthopaedic Research Lab at the University of Utah where I was working at the time, we had a Stratasys machine. I don’t remember which model, but I do remember that it took 30-plus hours to print out models of bones that we had produced from CT scans of cadavers. I didn’t get any personal experience running the machine, but I recall being very fascinated by the possibilities that it could provide. I’m a very tactile person. I like to work with my hands and create things, so the ability to create something digitally and then to be able to print out that model and be able to have it in my hands was really exciting.
What inspired you to start your journey?
Chris: I clearly recall in 2014 there were several new articles that came out talking about kids who were receiving prostheses for their hands that were being produced by 3D printing enthusiasts in their garages. That is when I first remember hearing the comparison of a $13 3D printed hand to an $80K prosthesis. As a prosthetist who was starting my journey specializing in upper limb prosthetic rehabilitation, this caught my attention. I wanted to see what it was all about. I was living in northern Idaho at the time and it just so happened that in Coeur d’Alene, ID there was a guy named Chris, who was part of the Rep Rap community. He started working with the e-NABLE group and at the time was printing out the parts for the Talon Hand and then later the Raptor hand. He was then shipping the kits of parts to families to assemble and then use. I went and visited his workshop where he had a lot going on. Now that I look back I realized just how much he was doing that I had no concept of. He was making custom control boards for the Rep Rap machines. He was printing out parts for custom filament extruders. He even had a bitcoin mining setup. It was all very new and unfamiliar to me. But he was kind and printed me out a set of parts for a Talon hand that I took home and assembled. Around the same time I reached out to Greg Mark from MarkForged on LinkedIn. He, to my surprise, accepted my invitation and scheduled a phone call with me. We had a great chat about what I saw the potential to be for additive manufacturing in the construction of prostheses. At the end of the call, he offered to send me some of the parts with carbon fiber and Kevlar reinforcements in the filament. When I got those parts I was blown away by their strength and lightness.
I took that Talon hand and those sample parts from Markforged to the American Academy of Orthotists and Prosthetists Annual Scientific Meeting that year and presented it at the Upper Limb Prosthetics Society Meeting. I passed the Talon hand around the room and someone broke it almost immediately. That was a bit disappointing because it really raised my concerns about patient safety. The MarkForged parts on the other hand withstood the prosthetist’s attempts to break them. That gave me hope and helped me recognize that additive manufacturing had real potential in the creation of prostheses, the limitations at the time were the cost of machines and the build volume.
Who inspired you the most along this journey in 3D printing?
Chris: The first person that inspired me to take a deep dive into practically applying AM into upper limb prostheses was Matt Mikosz. I remember attending a trade show in Las Vegas, NV in 2017 where Matt presented his workflow to make finger sockets for partial hand prostheses using Meshmixer. I came home from that conference and immediately downloaded Meshmixer and started playing around with it. Most recently it has been Brent Wright. I’ve enjoyed seeing how he has pushed the envelope with the application of new processes and materials. In the fall of 2019, I flew out to North Carolina to see what he was doing at East Point in Kinston, NC. They had recently installed an HP MJF 4200 machine. Michael Gorski from Filament Innovations had brought one of his first high-flow machines down to show off as well. It was after that meeting that I took a deep dive into applying AM. The company that I worked for at the time, Handspring, invested in a 3D scanner and Geomagic Freeform Plus software. The very first project that came out of that investment was a prosthesis for a dog.
What motivates you the most for your work?
Chris: Currently I work for a manufacturer that designs and manufactures parts for individuals living with partial hand/finger loss and/or differences. This is a patient population that has historically been underserved. In large part due to a lack of functional options. Additive manufacturing has enabled the creation of prosthetic components for fingers and hands that weren’t possible with traditional manufacturing methods. Many people in this population have been told that they have minor amputations and that they can just live with them. Or, if they really want a prosthesis the only option is “rubber fingers.” I find those statements quite harmful. Even to this day the American Society for Surgery of the Hand still lists silicone fingers as the only option for this patient population. This is just not true. I want to improve access to functional prostheses for this patient population and increase awareness of the options that now exist. So in short, it is the people that I’m helping restore functionality to that motivates me.
What is/are the biggest obstacle(s) in your line of work? If you have conquered them, what were your solutions?
Chris: The greatest obstacle to providing solutions to the people who need them is reimbursement for prostheses. This is a whole area that I could easily get on a soapbox about and it is something that I’m actively working to pursue. In essence, the problem is a combination of how prosthetists are reimbursed for their clinical work and that these are new technologies that do not have established billing codes. Beyond the reimbursement challenge is the fact that most prosthetists are not very familiar with the nuances associated with taking care of this patient population. Prosthetists spend more than 90% of their time on average working with people who have lower extremity differences. The clinical skills and principles for caring for individuals with lower extremity differences do not necessarily translate over to caring for individuals with upper extremity differences. So one of the things that makes up a large part of what I do is educating other prosthetists on the best practices and methods for caring for this patient population. I want to make sure that people are no longer making lower limb sockets that fit onto their hands. AM is a great way to avoid this pitfall.
What do you think is (are) the biggest challenge(s) in 3D Printing/bio-printing? What do you think the potential solution(s) is (are)?
Chris: There is a misconception by some that 3D printing is a panacea for prosthetic rehabilitation. There are still others for whom 3D printing is anathema to them. So the appropriate application of 3D printing is one of the biggest challenges. It makes no sense to design a prosthesis according to the same designs as we have historically done and then 3D print it. If you can make it with traditional fabrication methods effectively, why would you go through the trouble of 3D printing it? There is so much more that can be done and integrated into a prosthesis when applying the principles of dFAM than can be done with traditional manufacturing. So getting people to think differently and more creatively is a challenge. One of the best ways to get people to think differently is to keep sharing creative solutions that people are making in the hopes of inspiring others to attempt to push the envelope as well.
If you are granted three wishes by a higher being, what would they be?
Chris:
1 – Selfishly, I would like to be able to travel through space and time with my family and witness firsthand historical events.
2 – Establish a perpetual fund that would allow anyone with physical disabilities to receive anything necessary to meet their functional rehabilitation needs. (adaptive/mobility devices etc.)
3 – To magically finish the remodeling of my house and yard.
What advice would you give to a smart driven college student in the “real world”? What bad advice you heard should they ignore?
Chris:
Good Advice:
Do what is right, let the consequences follow. You will never regret it. There is never a right reason to do the wrong thing.
Bad Advice:
College is a requirement to be successful in life. As well as anything related to the necessity and normality of student loans. There are so many free/lower-cost learning opportunities and resources out there that can get you the skills to achieve your dream job that does not require you to take on a mountain of student loan debt.
Related Links:
Interview with Aadeel Akhtar: PSYONIC Bionic Limbs
3D Printing Custom-Fit Orthotics: Guide
Interview with Brent Wright: 3D Printed Orthotics and Prosthetics
3D Printing for O&P, Assistive Devices (On-Demand)
3D Printed Orthotics and Prosthetics (On-Demand)
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