To the topic in general,
If you were to ask for samples of milled orthoses from our lab, polyprop/nylon/acetal or any of the other polymers that we manufacture from, then you would receive a designed and manufactured device that is completely bespoke and to a standard that i rarely received as a practitioner.
The devices would be very consistent with a customers prescribing habits and requests. As i am sure others would claim.
If our practitioner is not happy with the device at time of issue, in terms of what is received, as opposed to expectation, then we will alter the design and re issue on a same day turnaround. With this fact in mind, i simply could not afford to have problems like this regularly. Hence our systems have to be able to deliver volumetric and so bespoke orthoses. We use Delcam, along with another free hand CAD package as of recently.
Having said the above i do not
believe that the process that we follow is replicated in all labs, there are undoubtedly labs chucking non bespoke (non volumetric) rubbish out of the door using insole based systems and yet claiming them to be custom orthoses as we have all come to expect.
We must also look at the practitioner, for accepting these devices and making some of these companies very successful. The issue is....Where does custom end and mass produced re sized insole models begin?
I guess it could be argued for a trading standards defense, that the devices are custom as they have individual prescriptions and size and arch height. But in my book that is not what any of my clients are ordering. Hence the reference to PFOLA's standards should be used in my view to avoid "confusion" down the line.
The above does not mean that i have a preference or bias to any method, clinically or as a Lab owner. Only within my company and professional life, i feel strongly that the product supplied should be as expected and ordered, without compromise or indeed areas of grey.
Irrespective of system used, there will always be companies willing to use the easy method. That is a fault of the user, not the Software used.
The fact of it is, Matt is correct in that the Delcam system takes time to design custom orthoses as volumetric devices. It is not a fast route to manufacture at all, unless non volumetric manufacture is sought.
I would also argue that there is a very steep learning curve associated with designing orthoses in the volumetric manner. I undertake all designs as a podiatrist. I really do not think that the results of a tech would be fit for purpose without a LOT of training.
Training anybody to use these systems to make insoles would take a few days to weeks. To design anatomically correct orthoses will take a lot longer and constant supervision is required.
Furthermore the system requires additional development in the anatomical design aspect. As there are issues on this front, in terms of stability and some of the basic functions and needs associated with volumetric plastic orthoses design.
The key is understanding as a user, what is appropriate, where and when.
a pair of devices correctly and properly takes around 30 minutes
on this system. That is extrinsic of scanning/blocking/batching/Toolpathing/milling/cutting out of block/grinding/adhesives/topcovers/finishing/checking/package and dispatch.
The machine that Matt, mentions is not sufficient to cut plastic all day, in my opinion. It may well be fine for 10 pairs a week but i don't know in honesty. Machining and selection is a whole other problem.
As for the cost effectiveness of setting up an entire center, it depends upon your pocket !!!
I don't know or understand why you would even consider it for personal use. But you may be wealthy!
The reality is it depends upon location as to true payback. But at 15 units a week personally, i would never have even given it a fleeting thought. And if i were busier personally in clinic, then there would be no reason due to time restraints, hassle and noise alone!! The busier the practitioner, the greater a monetary value upon his time. It would be better to streamline with scanning and order manager and use a lab that you can build a full relationship with and trust in the product and service.
These systems are often purchased by large organizations and hence the people offering opinions on them are lacking in real world views as to Value and cost vs expectation.
Our company, as many smaller labs in the UK, who offer a superb product and friendly professional service, have paid for these products with hard earned monies and a lot of sacrifice. We did so on the belief of delivering the best we can irrespective.
Apologies for the ramble
There is more. But hopefully that adds to the body of experiences in an open and honest manner.