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The Prosthetics and Orthotics Podcast
The Prosthetics and Orthotics Podcast is a deep dive into what 3D printing and Additive Manufacturing mean for prosthetics and orthotics. We’re Brent and Joris both passionate about 3D printing and Additive Manufacturing. We’re on a journey together to explore the digitization of prostheses and orthoses together. Join us! Have a question, suggestion or guest for us? Reach out. Or have a listen to the podcast here. The Prosthetic and Orthotic field is experiencing a revolution where manufacturing is being digitized. 3D scanning, CAD software, machine learning, automation software, apps, the internet, new materials and Additive Manufacturing are all impactful in and of themselves. These developments are now, in concert, collectively reshaping orthotics and prosthetics right now. We want to be on the cutting edge of these developments and understand them as they happen. We’ve decided to do a podcast to learn, understand and explore the revolution in prosthetics and orthotics.
The Prosthetics and Orthotics Podcast
CPO/Inventor Beyond Borders with Jochen Weigel
Jochen Weigel from Stuttgart, Germany joins us to discuss his innovative contributions to prosthetics, including post-processing for Niagara feet and the development of the AirFit casting system.
• Jochen's journey from clinical specialist to R&D manager to starting his own business 13 years ago
• The AirFit system uses air pressure instead of water to create comfortable prosthetic sockets
• Air pressure uniquely compresses only soft tissue while preserving bony structures
• Testing in Kenya combined the AirFit system with low-temperature thermoplastic sockets for immediate fitting
• The Niagara foot provides exceptional durability compared to SACH feet commonly used in developing regions
• Made with special DuPont material (Hydrel) through a complex molding process few can replicate
• The foot works across weight ranges from 70-190 pounds when properly tuned
• High initial cost compared to $20 Chinese alternatives creates adoption challenges despite long-term savings
• Ways to help include volunteering with NGOs, making targeted donations, or collaborating with small companies
If you have ideas for prosthetic products that could help in developing regions, reach out to smaller companies who are more likely to be interested in humanitarian solutions.
Special thanks to Advanced 3D for sponsoring this episode.
Welcome to Season 11 of the Prosthetics and Orthotics Podcast. This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen. Our goal is to share stories, tips and insights that ultimately help our patients get the best possible outcomes. Tune in and join the conversation. We are thrilled you're here and hope it is the highlight of your day.
Speaker 2:Hi everyone. My name is Joris Bieles and this is another edition of the Prosthetics and Orthotics Podcast with Brent Wright.
Speaker 1:How are you doing, brent? Hey, joris, I'm doing well. You know it was interesting. One of the last podcasts that well, I guess you were at Rapid I did with Dr Kreider really did very well and it was interesting to kind of get the feedback from people as far as they liked the fact that a doctor who is doing the prescription of these devices is so into orthotics and prosthetics and can help you and can help you. So the way that it works in the US is the doctor has to write a prescription and provide the documentation for a prosthesis, so you get paid by the insurance company and many doctors just don't want to be bothered or they don't. It's just a lot of extra work. Well, with Dr Kreider and then his colleagues that are in some other states as well, that's what they do. They're physiatrists that do this kind of documentation and evaluation via telemedicine and it was just a really great interview with him to just know that that's a service to our industry and it really helps us get reimbursed for the things that our patients deserve.
Speaker 2:That's super cool. I think it's also a testament to how good it is for us to talk to people around it. You know we've talked to, now, the therapists, we've talked to surgeons, and I think it's great to keep talking about people around the industry as well, to get different perspectives from around the OMP, not just the only practitioners to know about. I'd love to have an insurance person on, for example. I don't know if that's ever going to happen, but I think, apart from that one, I think they're doing a great job of trying to tackle all the people around the industry, to be able to give people more of a 360-degree perspective, let's say.
Speaker 1:Well, I'd say, let's hop right in man. I am super excited to introduce our next guest and I had to practice a little bit, so hopefully I get it close here. So we have Jochen Weigel with us from Stuttgart, germany, and I know I just butchered the Stuttgart but he is not only a clinician, an inventor and a manufacturer as well, and he does a bunch of things, and one of the things I think yours we'll get into a little bit well, two things really is he does a lot of the post-processing for the Niagara feet and he's a distributor of them, and those are the feet that I use in Guatemala and we use in Ivory Coast as well, and it is a great foot for the developing world. It looks like a simple foot but is highly, highly engineered and the materials from DuPont and its injection molded in a very specific way, and so there's just a lot of thought in it, so very near and dear to my heart.
Speaker 1:And then the second thing that is very neat is he has created a system that is, I would say, fairly portable, but it allows you to take a cast using this mechanism that uses a paddleboard pump that allows patients to be standing and bear weight through their leg while you're taking the cast. And I used this for the first time it's probably been about a week and a half ago and it was very, very neat. So I have not fit my patient yet with that, but one of the great indications that a patient appreciates something that feels good or a good fit is that they can bear weight through the cast and they feel like their weight is being distributed all over the prosthesis and they have no pain. And so for this particular patient, it has a very short limb, very bony limb, and so technically a tough fit. But this air fit casting method is going to be very interesting.
Speaker 1:So I don't have the final results of that as far as a dynamic walking with the patient, but the patient was very pleased with the way it initially felt, and she is actually a very experienced patient. She's been an amputee for a very long time and so she's done this a lot, and so she was very excited about how it feels too. So we've got a lot to dive in. I mean, those are just two of the things that he does. He does many more things and a clinician on top of that. He just got back from kenya as well, so a very genuine person, a person that's looking to do good in the world.
Speaker 2:So I think we're going to have a lot to talk about awesome, so welcome to the show thank you for introducing welcome so, jochen, first off, uh, how did you get involved with the orthotics, orthotics and prosthetics?
Speaker 3:yeah, I'm a cpo and, uh, I worked a long time as clinical specialist for traumatic amputees and, um, then the industry took me over. So I was eight years manager, r&d of a small but very old company here in in stuttgart. Now they are the biggest supplier of willow wood parts here in germany. Um, yeah, then, uh, I came back to, uh, the workshop, or or to the clinic, and I was manager of the biggest workshop here in Stuttgart. We had 40 employees.
Speaker 3:But 12 years ago I started, besides my own business, because I want to be my own boss and do what I think If you have the higher age, that is possible. Do what I think If you have the higher age that is possible. And I'm in the business since 1988, so a long time. And yeah, now I'm running my business 13 years. And, yeah, I'm how brand said, I'm looking for prototypes, I'm looking for prototypes, I'm looking for serial production, doing ideas. And that's pretty interesting for me because I said the last 10 years in my business life, I want to give back a little bit of that, what I got.
Speaker 2:Super cool that what I got, okay, that's super cool and then, and so, um, if we're looking at the, the, the, the prosthetics, it seems like it could be. It was for you. It's a very rewarding kind of thing, you know, place to be as a very rewarding industry to work in. And why is that for you? Is it just like you know, watching patients walk? Is it that guy? Is that the payoff for you? Or or why is it such it has been such a good place to you?
Speaker 3:Because I need the helping situation. That means it's enormous if you see someone coming in in the wheelchair and you help them, that they can walk out of the clinic, and that is what I always love and I loved it, uh, for for with with every patient. So that's, that's the reason.
Speaker 2:And do you think like, uh, you know, when you now kind of more, uh, you know, you invent things right. So do you think that you, because you got started in trauma, is that why you got? Because it it was so, all the solutions were so complex and new that you got into the idea of inventing things.
Speaker 3:No, it became because I started my business at the company Greisinger and Greisinger after the Second World War. He invented the Greisinger foot and the Greisinger knee. So it was very normal for me to speak with the industry about cereal production since I started my business. And then I switched to industry and saw the same. And yeah, when I started my own business, old contacts always asked me can you help me? I have this idea, you help me, I have this idea. And so I did it and I did, how Brent said the Niagara foot, the old Irani, now the AirFit system. So that's always looking for better solutions for the patients.
Speaker 2:Okay, talk to us a little bit about this AirFit system, which Brent is well in the early days of trying out. How did you come up with it and why did you come up with it?
Speaker 3:It was a project with the Fraunhofer Institute here in Germany. We have different places from them and the one in Stuttgart has the orthopedic part too. So we had the project to find out which material is best for prosthetic sockets. So we came over to 3D printing and we developed, together with a plastic company, a 99% bioplastic in filaments which is now really good working. We think we can launch it this year working. We think we can launch it this year. But in this project.
Speaker 3:The second question was how is the best impression to make for a socket? And so we compared hand casts, vacuum supported casts, we made the overpressure cast with a very old system. We made a scan, we made on the beginning, an MRD later. It was ultrasonic and what we saw is that for every patient with these different kinds of casting we have different sockets. But we can compare all the sockets from the pressure cast system and they have always the same shape. When I did it five times, we had have always the same shape, for for when I did it five times, we have we had five times the same fit and it was a good fit from beginning.
Speaker 3:So that was the the background in this project. And then then I thought I have to take that idea and look if I can make a system that is usable far away. If you're out of energy just to have it in your car, and if you're driving to the fields, you can make a cast as well. So I created the Airbus, more or less for, for embarking, not embarking. How is it called? The, the, the, the, the, the, the countries who are who are coming, emerging, emerging, yes, emerging, yes, emerging companies, countries.
Speaker 3:And and yeah, that's that's why I, why I thought it's pretty good if you have a nurse or a doctor there, they can fit a socket as well, because in these countries often you don't have the education for prosthetics.
Speaker 3:And that was the beginning. And then I saw, oh, that works in industrial countries as well, because we have customers who have central fab and a lot of satellites of workshops, and if they bring in from from every cpo his his own hand sign, let's say, um, then the, the central fab, has the problem to know how it should be made. One makes more reductions and the other makes less. So that's the the question for them. And the answer is making it with air fit, because the air fit system it's doing on its own and the cpo has more time for his patient because he don't have to modify the molds, he don't have to think about reduction press percentages and and the, the guy who is making the socket, he knows I use this mold and it fits okay, that's cool, and well, there's one thing we're designing something for an emerging economy or for austere conditions, but have you actually tested it out?
Speaker 2:Have you gone to places like that and had it work? Because that's, of course, a very different thing, right?
Speaker 3:There I tried out a pretty new idea. It's a low temperature thermoplast socket. You know it may be from Amparo. There is a second company who is called Olivio and they make the same kind of sockets and the idea was can we combine the socket and the air fit system? So I was in kenya to fit three patients um with this combination and it worked very well. So I think we should not bring it out for the, for the whole world, because reimbursement system don't want to know how fast we have been and how good it fits. And in Germany all the CPOs tell me don't tell it to the reimbursement system because we want to earn money. Yeah, but in third world and so on. I think it's the perfect way because after one hour they worked and it's a definitive socket, it's not just a check socket.
Speaker 2:Yeah, that's a really amazing thing, I think. The idea of being able to leapfrog some other functionality, maybe even get a better kind of customer experience, and then some people could get in like the richer part of the world, that could be really exciting. And were there other things that surprised you? For example, working in Kenya, for example, that there's, you know, bigger problems with temperature. There's bigger problems maybe transporting things. Were there things that you realized that there were even more difficult or easier maybe.
Speaker 3:I don't think that Kenya is really so behind. Think that kenya is really so, uh, behind um. I am member of an ngo from cameroon, so when I compare this to african countries, there is a big technical difference. In in kenya, you find um, you can find cpo workshops, um. They have oven, they have a sander machine, they have a sauce and so on. So the, the tools are there and and so it's not a problem to do that, the the climatic situation is no problem because it's not so hot there, um.
Speaker 3:So with this, with this um sockets, it was no problem and and in the, in the, in the manufacturing of the sockets, you have to overheat them and then let it a little bit cool down, that it's possible to use it over a silicone liner on the stump, that it does not burn the skin. So it's not a really low temperature thermoplast that we know from orthotics or something like that, who is just used in hot water. We really need temperature and it's then a really stable construction. I I built a iso test machine, a easy system, and I have the socket now, one of the sockets in the test machine, and we saw no problem now and we have one million cycles, yet it's still running, so I think this can be a good solution for this country.
Speaker 2:That's also, but then you know. So you're saying in Kenya it's pretty advanced, actually maybe more advanced than most people think is less problematic. But if you go to a place like Cameroon, are there local CPOs, are there workshops or is that kind of like would it be very impossible to find or would patients have to travel very long distances? Is that an example of a country that's going to be much more difficult to implement prosthetics generally?
Speaker 3:Yeah, that's right, cameroon.
Speaker 3:I looked deeper in it and I just found one prosthetics company and when I saw the pictures I was not amazed about the socket design and I think that, yeah, in Cameroon, it's really the basic what we have to do there, and in the moment we are building a clinic and education center and in autumn we want to have ready the first floor and so we will start with prosthetics in the in the end of the year there.
Speaker 3:And we had the, the minister of of work work parts. He visited us here our our NGO, and he said if, if you will bring prosthetics to cameroon, the government will help you. So I hope that that he uh, remembers what he promised when we start and, um, even if, if, if people have to come there, maybe that could be a help, that they sponsor buses or something like that, because long distance, bad roads, takes a long time to come, and that's why I like the system so much. It's reheatable. That means if the patient is coming again because the stump shrank, it's no problem to reheat it and go again into air fit and make the socket smaller.
Speaker 2:So it's usable several times and that's perfect for these regions. Okay, that's cool. And do you think that you know, would you say? Because I like the approach of like we've noticed this a couple times in this podcast when we have people that have actually worked in the field, like Brent and like other people in different parts of the world, they actually come up with, like you know, much more kind of customized solutions for a country in a situation where other people who are trying to kind of like say kind of like you know, western technology solves all problems, these kind of more utopia vision. People try to kind of have the idea you can invent something in San Francisco and it'll just be used by everyone all over the world, kind of you know. And I think there's more nuances is kind of is probably needed. And do you think you know, would you? You know, somebody gave you like a lot of money to solve prosthetics in Kenya and then to solve prosthetics in Cameroon. How different would your approaches be in both of those countries?
Speaker 3:I'm not thinking about the money in the moment because I think we have to look about the real possibilities in the beginning. I'm a member of this NGO so I think we can collect money here in western industrial countries, like we did it for the water systems there made. How is it called?
Speaker 3:I have to look in my dictionary, sorry pumps augers, water filters, fountains water fountains we did 62 now in Cam, cameroon, um, and they are all financed from, from german people or or companies. So we, we asked them to donate and we write down their name on the side of the fountain, uh wall and they get pictures back that they can really see that every cent is going there to help. And we will do the same with the prosthetics, but in cooperation with the common prosthetics company. We don't want to to take him out or or make him make him work less because we donate everything. Um, so we went, we, we want to try to cooperate with him because it's good to have something there, someone there, but what we want to do as well is to take someone here to germ Germany that we educate them in prosthetics, that he can educate later more people.
Speaker 1:So that's the idea behind so I want you to dig into a little bit more and put on your clinician hat, scientist hat or what have you. And you talked a little bit earlier, especially on the AirFit system. Why air, why not water? Why not some of the other stuff like uh, the uh, you know the old-timey pressure pump that had two bladders and all that stuff. It sounds like you. You really did think about this quite a bit. You tried a bunch of different things and I'd love just for, uh, you know you to share. Hey, what was the journey?
Speaker 3:yeah, how I told you, um, it was out of the project. So, um, in the first beginning, um, I did not think about that, I just did it for the project. And when I saw it then I Then I looked deeper in it. Why is it in this way? And then I saw that air bladders and everybody's remembering when we played with the air pump for bicycle tires when we were children you can push it together and if you have the finger on the valve you can throw away or press it back because air is compressible. And that is the reason why the AirFit works, different like the others.
Speaker 3:Water pressure is the system everywhere and the air system is compressible. That means the air pressure presses just soft tissue away, the bony parts, and that is the important thing. Air pressure presses just soft tissue away. The bony parts and that is the important thing will not be pressed so much If we have fat or muscles, they are weak and air pressure presses it together and compresses it. And that's the the background of the system. And, um, we don't need electricity for that, we don't need, uh, water for that, we just have a pump up. Then we stand up, pump and up puddle, pump, and with this pump you can inflate and you can deflate the bladder inside. So that's pretty good too, because if I want to go inside the air bladder in the system I need room, I need space. So that's good that I can pump out the air between the tube and the bladder and make a big area where I can go in. And if I'm inside I change the side of the pump and I give air pressure inside. And how?
Speaker 3:Brand said the patient gives his body weight, it's enough if you give 50%, but if you want it's no problem to give all the body weight into the stump side. And that makes that the cast is really natural. It's not just a hydrostatic socket, it's really a formed part and I'm happy that Brent is looking deeper in that because he wants I think the picture he had in LinkedIn was comparing two different casts and I'm really happy that he is looking for that because in the moment I can just explain it but I cannot really prove what I told. I have no analyzes, I have no scientific points. Really, uh, brings it on the point. But I know it from the several amputees I fitted in that and they say all the same and that's the big difference to the other systems. It does not ache when I'm standing there.
Speaker 1:That sounds like a fantastic result yeah well, no, I love that and you know, the thing that's so important is you have to kind of put aside the ego of the clinician, like when you tell somebody actually I've got a recipe for you, right, and it works. Almost all the time that's a difficult thing for a clinician to go up against, but at some point and you've done this is the patient's input, or their feedback, is the most important part. So if they say it's the most comfortable thing they've ever been in and it shows that with their walking and there's a whole bunch of ways that you can see that they're comfortable, you have to, as a clinician, you have to evaluate that system, because if you're truly a clinician that wants the best outcome for your patients and patients are saying this then you need to evaluate it. You're right.
Speaker 3:You're right and I'm, I'm thinking more about that and um, um two hours again. I, I, I spoke with Tim Bryant and uh, I should uh say hello from him.
Speaker 1:And uh Tim.
Speaker 3:Bryant and I should say hello from him and maybe his students are interested in finding out what really in the system brings this success. And yeah, I have to evaluate it to your right and the CPOs can evaluate it with their patients and then I'd like to talk a little bit about another thing.
Speaker 2:This is this foot. You developed the Niagara foot, so first of all, tell us about you know why did you develop this? And then tell us a little bit how you developed this thing.
Speaker 3:I did not develop it. It was a Canadian CPO. I think I don't know him because it's so long um brent. I think you know him. Yeah, rob, yep, rob gailey uh, uh, it's his name.
Speaker 1:Last name is hard, it's like gaboni, gaboni or something like that yep and um.
Speaker 3:His idea was to invent a prosthetic foot that has a long life, because if we look in developing countries, they all use the Satch foot, and Satch foot I've seen it in Kenya he begins after six months to break under the forefoot and I always thought the heel is the problem. But I saw have anything else in this price region, because you can buy now Chinese Sedge feed for $20. And that was, for Rob, the reason to think and look for a better solution, not just half a year and and using a half year. And what he, what he created, was, um, two things it was a design and it was a material. And the, the design, like brand, said it's. It's really interesting because it's not just a spring like a carbon foot. When you roll over, you load it and if you go away, it deloads. No, in the, a moving point, um, and and it's yeah, the, the, the foot, is adjustable. That's unique too. You can yeah, you can grind down and sand down it, um, to make it more flexible, and you can cut it for the length. You can modify it for left and right.
Speaker 3:So what Rob invented is really amazing and it was just possible because DuPont, the plastics manufacturer helped, because normally this material it's called hydrel is not moldable in this thickness and that's what we have here in in my workshop. I I make the the post processes after molding. We have to fight against because if you really measure every foot, every molded foot has a little little difference and that's not common for cnc milling. Because you have to clamp it, you have to bring your zero point on the right position. So that's what is our daily work to fight against these little differences. But this material is really the longest standing material I've ever seen in prosthetics. It makes no problem to go in salt water. It makes no problem to walk in sand. What is always damaging the fiber feet, the Niagara foot stays, stays, stays. It's really a dream how long the people can walk with it.
Speaker 2:Yeah, I think that's really exciting. We don't really often see a prosthetics and orthotics innovation coming from the material sector, but we know that, for example, in the liners, but also in these, carbon use of carbon fiber is when people apply new materials and new processes to prosthetics and orthotics. You know the industry makes these great leaps forward of this material being developed that really does different things in a different way than other. It's like elastomeric material but it's super durable. It's post-processable in a way that really benefits the workflow. It's kind of a rubber, but then it can be molded, also 3D printed, by the way, although it's not really done a lot as a thermoplastic does.
Speaker 2:So I think it's a really exciting material. I think it's really exciting kind of points to a lot of companies that maybe could get a nice little business on the side, because, of course, the volume is never going to be huge for them. You know, in developing or adapting materials that are, you know, really going to be doing something completely different. And do you have like a lot of? You know how many of these feet are out there? Is it really growing this foot, or is it, and should it grow a lot more, according to you?
Speaker 3:You mean the amount? Who is sold?
Speaker 2:Yeah, something like that. I don't know how successful these respective kind of more emerging feet designs are. I have no idea.
Speaker 3:All over. We have numbers, I think around about 5,000 feet, who are yet produced. But yeah, we have the price. Fight against the Chinese Sedge feed. That means even ICRC, who is one of the biggest NGOs, can't buy it at the moment because it's molding, it's the post-process, it's the adaption, it's the cover. So altogether we are a little bit higher price than a Chinese Satch food and we hope that we can explain it in the way that it stays longer, because if you have to buy every year a new Satch food, on the end it's more expensive. I, yeah, we, we, we show it in in the ispo congress in sweden. Now again, um, that everybody knows that it's. It's always the same if, if there is something cheaper, they mainly take the cheaper one, don't thinking what is in a year, maybe because they don't have so much money and just can buy it now with 20 dollars. So it it's a pity.
Speaker 1:I think that's one thing that's always difficult is, you know, everything comes down to price, right, it's like, well, I know this could be better, but it costs about $4 more and they just don't take into consideration you know the longstanding I mean I have. I think I even still have some Model 1s still out in Guatemala. I think I even still have some Model 1s still out in Guatemala. Definitely, the Model 2s are going strong and have done very well, and I've done everything from a size 26 down to a size 21,.
Speaker 1:Very petite female short weighs 70 pounds, and I've even put some on some kids too, where we've tuned them 70 pounds, and I've even put some on some kids too, where we've we've tuned them. And so that's the beauty, is this one foot literally can span the you know nearly, let's say, 190 pounds down to, you know, 70 pounds. So it's, as long as you tune it correctly, I think it's a it's a really neat innovation. I think one of the difficult things, though and I know we've talked about this is the idea of foot shells, foot covers for these feet. A lot of people wear sandals of some sort or a shoe, and you want a lot of times to fill out that shoe. It doesn't necessarily have to look like a foot, but these are the little innovations along the way, right, that make a difference.
Speaker 3:Yeah you're totally right. I have a good friend in Mexico who uncollors Maybe he is hearing us later. He is really a creative prosthetist and he made his own cover on the Niagara foot. He just used a semi-rigid foam to cover it and sanded it in a foot form car wheel um profile, uh, under under the foot, um, that the persons can walk without you and uh, so it's really really long standing and and looks fine and yeah, if, if someone is a little bit creative, it's possible to make something like that or or I think it was yeah, it was you, brent, what you told me. It's a kind of bathing shoe who is possible to rub over it, to use it, and I think if, yeah, we have to collect the ideas and have to write it down in our catalog that not just buying a cover is a solution. Maybe it's a better solution to think about it. What is better for your patient?
Speaker 2:Yeah, I think the cool thing about this Niagara foot thing, because I didn't sorry. I know it is a Canadian gentleman who developed it, but it does explain the name a little better.
Speaker 1:Straight out of Stuttgart.
Speaker 2:Yeah, now I'm like okay, now I understand, maybe when in his honeymoon, I don't know, um, anyway, and but if I look, I remember I looked at this video online of him, like on, I can find very little information. As a nygrapher, by the way, right, because I looked into it once because to me it was like kind of the crocs of this thing, because it just seems such a deceptively simple thing that does work and it's kind of like if you want to mass produce something or if you want to make it uh and a lot of large scale, you probably come up with this. I remember I saw this is youtube video about it on a testing bench, like you explained before, during all these cycles of testing, and it's just super ingenious and it's really a beautifully elegant thing, right.
Speaker 3:Yeah, it's ISO tested. It's now up to 125 kilos tested and yeah, it's really nice because it's a jointless joint foot and it really rolls perfectly. It's from his sole shape, it's a circle like from the hip, so it's not so much energy, what, uh, what a user needs to to walk over it? Um, and it's, yeah, if, if you it, the best visible um point is if the patient is is walking up um a hill and the forefoot play is is visible in horns between of the top. So that's really the area where it moves a lot, and then it's understandable that it is not just a piece of plastic.
Speaker 1:Yeah, the other thing that's really wild is that satch feet are notoriously difficult to align and such specifically for transfemoral or above-the-knee amputees. This has such a beautiful heel where it still gives you a stable knee, with an inexpensive knee, and it's stable with that softer heel. It really is amazing, and these people walk unbelievable with this foot. So, yeah, there's a lot going on, a lot of thought, even though it does look simple. And the other thing that's very interesting is that you see that DuPont was involved in all this, but, like Johan said, it's super difficult to mold, and so there's literally only a couple places in the whole world, and one of them, I forget, is somewhere in the US. I think that makes these molds and they're familiar enough with the material, but you can't just take that mold and take it anywhere and inject it. There is a deep tribal knowledge that goes into how this is done, and I think that's pretty neat you're totally right, brand.
Speaker 3:That's why we let the mold in stay in canada. Um, I have, I work together with a pretty good, good molder in serbia. Serbia is a a country here in in europe who are not yet in the eu and that means they have pretty good prices for molds. And that's what the first thought. But then, when I spoke with with tim bryant and and heinz tribine and all the team behind the Niagara foot, we said no, we will let it stay in Canada.
Speaker 3:This company who knows to mold. It is better than we try out somewhere else and fail you, because there are so much heating and cooling zones inside, so much heating and cooling zones inside. Um, that's the, the, the, yeah, the. We don't need the patent because nobody else can build this, this mold again and no molder will, will, will be possible, because it's so incredible, unnormal. So that's why it was only possible, with the help of Tepo, to make it, because they always came down to the molding company and said, no, here it's too hot, no, here it's too cool. And we changed it all the way and the mold is now pretty good and we will never touch it. That's right.
Speaker 1:I just think it's amazing, though you think that, well, mold is a mold is a mold, it's so much more than that, and that's one of the interesting things about all this is, while simple things look simple, there's so much that goes in there. So go ahead, joris, sorry.
Speaker 2:No, I was about to sing the praise of conformal cooling channels and molds.
Speaker 2:Oh yeah well, that would be amazing. But no, don't worry about that, this is really boring. But there's another question for Jochen. Then I mean, I think if you have somebody who's listening who also wants to help out and I know there's a lot of people that want to help out and then just don't end up doing it because it's too complicated or they don't know where to help out or what to do what would you advise they do? Do you have any specific advice for those kind of people?
Speaker 3:Sorry, that was too much American and too fast.
Speaker 2:So imagine there's people listening that want to help out just like you've been helping out with the developers' fee for the developing world and co-develop them and help them get out there and you know how would you advise them on helping, just generally helping people obtain easier or low-cost prosthetics and orthotics.
Speaker 3:Yeah, there are different ways. One way could be to help out, and that means any NGO is happy. If someone wants to help and work in developing countries, let's say for three or four weeks in summer holidays for free, that's a pretty good help. The other help possibility is really to donate, to pay some money and, how I said, we personalize the donation to that that everyone who gives the money can really see where it, where it is used for and, um, if, if, yeah, if, if CPOs really wants to help, um, maybe they have a good idea for a product. So speak with NGOs, speak with manufacturers. It can be me, but it must not. So the bigger the companies are, the less they are interested in third world and helping. So ask the small companies. That could be a big help.
Speaker 2:Okay, that sounds really, I think, very direct and actionable news, I think. And how about when you're back in Germany doing work here, we're doing work in Germany are you now a bit bored with that kind of regular stuff, or do you still find it very challenging to do the regular kind of CPO kind of work you do normally?
Speaker 3:No, I'm really not boring, because I always have new projects. Um, what I'm looking for, um, yesterday was a young lady here with a knee disarticulation, and that is the next point I want to to try out with the air fit system, because I I really think that it should work. The knee disarticulation has the real shape of the femur distal and that is the point. Who has to be molded very good, and I think that's how I said it's possible with the system. So, no, boring is not my thing. That's awesome. So, jochen, thank you so much for your time today with us and thank you so much for coming with the system. So, no, boring is not my thing that's awesome.
Speaker 2:So, jochen, thank you so much for your time today with us and thank you so much for coming on the show.
Speaker 3:Thank you both for speaking with you and inviting me.
Speaker 2:And yeah, brian, thanks for you all, as always.
Speaker 1:Oh, this was great and to hear all the things that we got going and there's so many more discussions to have, so I'm sure we'll be following up with him soon again. So that's a fun thing, because, man, we WhatsApp at all hours of the day. So it's a fun thing, that's right.
Speaker 2:All right, and thank you very much for listening to another episode of the Prosthetics and Orthotics Podcast. Have a great day. Okay, much for listening to another episode of the prosthetics and orthotics podcast. Have a great day.
