No limbits! The feasibility of providing low-cost 3D printed below elbow and below knee limb replacements in a resource limited setting


  • Matt Te Water Naude
  • Mark A. Roussot University of Cape Town
  • Ruqaya Gabier
  • Kelly Sweatman



Background: South Africa faces the challenge of producing large numbers of prostheses each year. Three-dimensional (3D) printing was investigated as a potential method of efficiently providing prostheses.

Objective: To evaluate the need for below-knee (BK) and below-elbow (BE) limb replacements at Groote Schuur Hospital; and to determine the feasibility of providing low-cost 3D printed limb replacements at Groote Schuur Hospital (GSH).

Methods: We performed a literature review and conducted interviews with staff at the Amputation clinic. Information regarding the need for BE and BK prostheses, qualifying criteria, durability and cost of traditional prostheses, and manufacture times was collected. Communication with e-NABLE and a senior biomechanical engineer provided further information. We investigated the feasibility of producing a 3D printed prosthesis by printing and assembling a prosthetic hand.

Results: 3D printing reduces the cost of a BE prosthesis by approximately 26.6% and shortens the manufacturing time; however, 3D printing technology is currently unable to provide adequate weight bearing BK prostheses and is not as cost efficient as traditional manufacturing techniques.

Conclusion: It is feasible to provide 3D printed BE prostheses in a resource-limited setting; however, BK prostheses face design challenges and are more costly than those traditionally made. 


Download data is not yet available.


D Printing Systems. 2015. Up mini 3D Printer. Available: [2015, 25 July].

DUniverse. 2015. Cyborg Hand Handware Kit. Available: [2015, 20 July].

Anonymous. Physiotherapist. (Personal Communication, 27 July 2015).

Colombo G, Filippi S, Rizzi C, Rotini F. 2010. A new design paradigm for the development of custom-fit soft sockets for lower limb prostheses. Computers in Industry. 61(6):513-523. DOI:10.1016/j.compind.2010.03.008.

e-NABLE. Cyborg Beast Instruction Manual. Available: [2015, 21 July].

e-NABLE. Frequently Asked Questions. Available: [2015, 16 July].

e-NABLE. 2015. RIT Arm Assembly Guide. Available: [2015, 21 July].

Francis EH, Tay MA, Manna LX, Liu. 2002. A CASD/CASM method for prosthetic socket fabrication using the FDM technology. Rapid Prototyping Journal. 8(4):258-262. DOI:10.1108/13552540210441175.

FrederiksI JP, VisagieII S. 2013. The rehabilitation programme and functional outcomes of persons with lower limb amputations at a primary level rehabilitation centre. South African Journal of Occupational Therapy. 43(3):18-27.

Gretsch KF, Lather HD, Peddada KV, Deeken CR, Wall LB, Goldfarb CA. 2015. Development of novel 3D-printed robotic prosthetic for transradial amputees. Prosthetics and Orthotics International. 1-4. DOI:10.1177/0309364615579317.

Herbert N, Simpson D, Spence W, Ion W. 2005. A preliminary investigation into the development of 3-D printing of prosthetic sockets. Journal of Rehabilitation Research & Development [serial on the Internet]. 42(2):141-146.

Protolink3d. Printers for Sale. Available: [2015, 24 July].

Rahmati S, Farahmand F, Abbaszadeh F. 2011. Application of rapid prototyping for development of custom-made orthopedics prostheses: an investigative study. International Journal of Advanced Design and Manufacturing Technology. 3(2):11-16.

Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, Giesel FL. 2010. 3D printing based on imaging data: review of medical applications. International Journal of Computer Assisted Radiology and Surgery. 5:335-341. DOI 10.1007/s11548-010-0476-x.

Robohand. 2015. Introducing Roboleg. [Blog, 22 May] Available: [2015, 17 July].

Rogers B, Bosker GW, Crawford RH, Faustini MC, Neptune RR, Walden G, Gitter AJ. 2007. Advanced trans-tibial socket fabrication using selective laser sintering. Prosthetics and Orthotics International. 31(1):88-100. DOI:10.1080/03093640600983923.

Smith DG, Burgess EM. 2001. The use of CAD/CAM technology in prosthetics and orthotics-current clinical models and a view to the future. Journal of Rehabilitation Research & Development. 38(3):327-334.

Zuniga J, Katsavelis D, Peck J, Stollberg J, Petrykowski M, Carson A, Fernandez C. 2015. Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences. BMC Research Notes. 8(10):1-8. DOI:10.1186/s13104-015-0971-9.