Editing Prosthesis (section)

==Cost and source freedom==

===High-cost===
In the USA a typical prosthetic limb costs anywhere between $15,000 and $90,000, depending on the type of limb desired by the patient. With medical insurance, a patient will typically pay 10%–50% of the total cost of a prosthetic limb, while the insurance company will cover the rest of the cost. The percent that the patient pays varies on the type of insurance plan, as well as the limb requested by the patient.<ref name="Cost of a Prosthetic Limb">{{cite web|title=Cost of a Prosthetic Limb|url=http://health.costhelper.com/prosthetic-legs.html|website=Cost Helper Health|access-date= 13 April 2015}}</ref> In the United Kingdom, much of Europe, Australia and New Zealand the entire cost of prosthetic limbs is met by state funding or statutory insurance. For example, in Australia prostheses are fully funded by state schemes in the case of amputation due to disease, and by workers compensation or traffic injury insurance in the case of most traumatic amputations.<ref>{{cite web|title=Funding for your prosthesis.|url=http://www.limbs4life.org.au/funding/funding-for-your-prosthesis|website=Limbs4life|access-date=28 January 2018}}</ref> The [[National Disability Insurance Scheme]], which is being rolled out nationally between 2017 and 2020 also pays for prostheses.

Transradial (below the elbow amputation) and transtibial prostheses (below the knee amputation) typically cost between US [[United States dollar|$]]6,000 and $8,000, while transfemoral (above the knee amputation) and transhumeral prosthetics (above the elbow amputation) cost approximately twice as much with a range of $10,000 to $15,000 and can sometimes reach costs of $35,000. The cost of an artificial limb often recurs, while a limb typically needs to be replaced every 3–4 years due to [[wear and tear]] of everyday use. In addition, if the socket has fit issues, the socket must be replaced within several months from the onset of pain. If height is an issue, components such as pylons can be changed.<ref name="eight">[http://www.boston.com/business/globe/articles/2005/07/05/cost_of_prosthetics_stirs_debate/ "Cost of Prosthetics Stirs Debate"], ''[[Boston Globe]]'', 5 July 2005. Retrieved 11 February 2007.</ref>

Not only does the patient need to pay for their multiple prosthetic limbs, but they also need to pay for physical and occupational therapy that come along with adapting to living with an artificial limb. Unlike the reoccurring cost of the prosthetic limbs, the patient will typically only pay the $2000 to $5000 for therapy during the first year or two of living as an amputee. Once the patient is strong and comfortable with their new limb, they will not be required to go to therapy anymore. Throughout one's life, it is projected that a typical amputee will go through $1.4&nbsp;million worth of treatment, including surgeries, prosthetics, as well as therapies.<ref name="Cost of a Prosthetic Limb"/>

===Low-cost===
{{See also|3D printing}}
Low-cost above-knee prostheses often provide only basic structural support with limited function. This function is often achieved with crude, non-articulating, unstable, or manually locking knee joints. A limited number of organizations, such as the International Committee of the Red Cross (ICRC), create devices for developing countries. Their device which is manufactured by CR Equipments is a single-axis, manually operated locking polymer prosthetic knee joint.<ref>{{cite web|url=http://www.icrc.org/Web/eng/siteeng0.nsf/htmlall/p0868/$File/Eng-Transfemoral.pdf |title=ICRC: Trans-Femoral Prosthesis&nbsp;– Manufacturing Guidelines |access-date=2010-10-03}}</ref>

Table. List of knee joint technologies based on the literature review.<ref name="ReferenceB"/>
{| class="wikitable"
|-
! Name of technology (country of origin) !!  Brief description !! Highest level of
evidence
|-
| ICRC knee (Switzerland) || Single-axis with manual lock || Independent field
|-
| ATLAS knee (UK) || Weight-activated friction || Independent field
|-
| POF/OTRC knee (US) || Single-axis with ext. assist || Field
|-
| DAV/Seattle knee (US) || Compliant polycentric || Field
|-
| LIMBS International M1 knee (US) || Four-bar || Field
|-
| JaipurKnee (India) || Four-bar || Field
|-
| LCKnee (Canada) || Single-axis with automatic lock || Field
|-
| None provided (Nepal) || Single-axis || Field
|-
| None provided (New Zealand) || Roto-molded single-axis || Field
|-
| None provided (India) || Six-bar with squatting || Technical development
|-
| Friction knee (US) || Weight-activated friction || Technical development
|-
| Wedgelock knee (Australia) || Weight-activated friction || Technical development
|-
| SATHI friction knee (India) || Weight-activated friction || Limited data available
|}

[[File:Low cost prosthetic limbs.jpg|thumb|Low-cost above-knee prosthetic limbs: ICRC Knee (left) and LC Knee (right)]]

A plan for a low-cost artificial leg, designed by Sébastien Dubois, was featured at the 2007 International Design Exhibition and award show in Copenhagen, Denmark, where it won the [[Index: Award]]. It would be able to create an energy-return prosthetic leg for US [[United States dollar|$]]8.00, composed primarily of [[fiberglass]].<ref>[http://www.indexaward.dk/2007/default.asp?id=706&show=nomination&nominationid=163&playmovie=wmv INDEX:2007 INDEX: AWARD] {{webarchive |url=https://web.archive.org/web/20090202173652/http://www.indexaward.dk/2007/default.asp?id=706&show=nomination&nominationid=163&playmovie=wmv |date=February 2, 2009 }}</ref>

Prior to the 1980s, foot prostheses merely restored basic walking capabilities. These early devices can be characterized by a simple artificial attachment connecting one's residual limb to the ground.

The introduction of the Seattle Foot (Seattle Limb Systems) in 1981 revolutionized the field, bringing the concept of an Energy Storing Prosthetic Foot (ESPF) to the fore. Other companies soon followed suit, and before long, there were multiple models of energy storing prostheses on the market. Each model utilized some variation of a compressible heel. The heel is compressed during initial ground contact, storing energy which is then returned during the latter phase of ground contact to help propel the body forward.

Since then, the foot prosthetics industry has been dominated by steady, small improvements in performance, comfort, and marketability.

With [[3D printing|3D printers]], it is possible to manufacture a single product without having to have metal [[Molding (process)|molds]], so the costs can be drastically reduced.<ref>{{cite news|last=Nagata |first=Kazuaki |url=http://www.japantimes.co.jp/news/2015/05/10/national/science-health/robot-arm-startup-taps-3-d-printers-in-quest-to-make-prosthetics-affordable/ |title=Robot arm startup taps 3-D printers in quest to make prosthetics affordable |publisher=Japantimes.co.jp |date=2015-05-10 |access-date=2016-12-28|newspaper=The Japan Times Online }}</ref>

''[[Jaipur foot]]'', an artificial limb from [[Jaipur]], [[India]], costs about US$40.

===Open-source robotic prosthesis===
{{See also|Open-source hardware|Modular design|3D printing|Thingiverse}}
[[File:Star Wars Bionic hand.jpg|thumb|''Star Wars'' themed "Hero Arm" by Open Bionics]]
There is currently an [[Open-design movement|open-design]] Prosthetics forum known as the "[[Open Prosthetics Project]]". The group employs collaborators and volunteers to advance Prosthetics technology while attempting to lower the costs of these necessary devices.<ref>{{cite web |url=http://openprosthetics.org/ |title=Open Prosthetics Website |publisher=Openprosthetics.org |access-date=2016-12-28 |archive-date=2006-10-04 |archive-url=https://web.archive.org/web/20061004053611/http://openprosthetics.org/ |url-status=dead }}</ref> [[Open Bionics]] is a company that is developing open-source robotic prosthetic hands. They utilize 3D printing to manufacture the devices and low-cost 3D scanners to fit them onto the residual limb of a specific patient. Open Bionics' use of 3D printing allows for more personalized designs, such as the "Hero Arm" which incorporates the users favourite colours, textures, and even aesthetics to look like superheroes or characters from ''Star Wars'' with the aim of lowering the cost. A review study on a wide range of printed prosthetic hands found that 3D printing technology holds a promise for individualised prosthesis design, is cheaper than commercial prostheses available on the market, and is more expensive than mass production processes such as injection molding. The same study also found that evidence on the functionality, durability and user acceptance of 3D printed hand prostheses is still lacking.<ref name="Review 3D-printed hand prostheses">{{cite journal |last1=ten Kate |first1=Jelle |last2=Smit |first2=Gerwin |last3=Breedveld |first3=Paul |title=3D-printed upper limb prostheses: a review |journal=Disability and Rehabilitation: Assistive Technology |date=2 February 2017 |volume=12 |issue=3 |pages=300–314 |doi=10.1080/17483107.2016.1253117 |pmid=28152642 |s2cid=38036558 |doi-access=free }}</ref>