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
Takeaways and Awards From The AOPA 2026 and Breakdown of Hanger<>NuMotion Merger with Joris and Brent
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
AOPA always shows you what’s next, but the real story is what people are trying to fix right now. We walk through our on-the-ground takeaways from the exhibit hall and the education tracks, starting with the shift from “look what we can print” to “how do we remove the worst friction in prosthetics and orthotics.” AI is popping up as a serious workflow tool for documentation, admin, and turnaround time, but we also talk about the non-negotiables: HIPAA, patient health information, and why bolt-on tools can create double work if systems don’t talk to each other.
From there, we get practical. We shout out traditional manufacturing strength in areas like custom liners, break down why “cheap materials” aren’t the whole cost story, and highlight hardware that matters, including compact suction valve design that could make both traditional fabrication and 3D printed sockets cleaner. We also talk 3D printing in O&P with an honest lens: belt printers for foot orthoses, low-cost model printing, material limitations, and why controlled thermals in smaller build volumes can produce better parts.
Finally, we zoom out to the business side with the Hanger and Numotion announcement and what it could mean for complex rehab technology, wheelchairs, seating, and the broader platform direction of patient care. We explore potential synergies, the clinician shortage, “care extender” models, and the uncomfortable reality of consolidation and private equity incentives. If you’re building, buying, or simply trying to deliver better patient outcomes in orthotics and prosthetics, this one is full of signals worth tracking.
For the awards you will just have to listen!
Special Thanks to Advanced 3D for sponsoring this episode.
Welcome And Vegas Recovery
SPEAKER_04Hello everyone. This is Yoris Peels with another episode of the Prostetics and Orthonics podcast with Brent Wright. How you doing, Brent?
SPEAKER_00Hey Yoris, doing well. I'm recovering from Vegas. Not that I do anything in Vegas, but uh it's just three hours behind, and you know it because you're probably recovering from your marathon podcast with us, man. You were you weren't a marathon it wasn't a marathon.
SPEAKER_04The thing is, I had started working that day at six in the morning. So we started at nine my time in the evening. So I was a bit, you know, I was a bit fried to be perfectly honest. So it was only I was only there for a couple hours that it, but I thought that was a lot of fun.
SPEAKER_00Did you how about you? It was it was a lot of fun, and uh you know what was interesting is let's uh I'm trying to think. I I think I did a total of ten interviews, actually it might have been more than that, uh, but 30-minute slots, so that's that's five hours of content, you know, over the course of two days.
SPEAKER_04And I was only there for like three or something.
SPEAKER_00And uh yeah, so it was it was great, and it was all people that had not been on the orthotic and prosthetic podcast before. Wow, and so I thought that was pretty neat. Yeah, yeah.
SPEAKER_04Yeah. I can't wait to just see that in podcast form as well. I really enjoyed doing it. I think you enjoyed doing it.
SPEAKER_02Yeah.
SPEAKER_04Are you getting better at this kind of expeditionary recording thing? Uh are you getting better at knowing what to take and what to how to do it and everything?
SPEAKER_00Well, I I was pretty good until you had an echo and uh you know that that kind of tick that you had after hearing yourself, but I did figure out what button I did not push. So I think I think we'll have that figured out for the next time, actually. Don't
Field Recording Wins And Mistakes
SPEAKER_00drop me up the wall.
SPEAKER_04So for those with like a 10-second delay while you're speaking.
SPEAKER_00For those that don't know, so this was the first time I actually took a soundboard, so it's a Rodcaster 2 Pro. And so it connects to my computer, but so Yoris is able to dial in. We can hear on the headphones, we can hear each other on the headphones. The problem is, is Yoris was hearing himself twice, and that was uh that was a big problem. So but it's a it's a setting deep in the menu where uh because you so what was happening is you were getting the whole mix of the broadcast, and what I needed to do is take you out of the mix that went back to you.
unknownOkay.
SPEAKER_00So anyway, now I know but yeah, so but it was it was good and it and it actually sounded pretty good for a very loud haul. And the other thing that was really neat, I thought, was not only were we able to hear you, but then we were also able to hear each other. And what was what was crazy about that was people saw that our mouths were moving, but because of the board and and all that stuff, we were able to get the noise out, and so it was just having a normal conversation, so it's not like you're yelling at the microphone.
SPEAKER_04I was I was actually amazed at the sound quality and also the lack of the background and stuff like that. I thought I was actually quite amazed at that. I thought that was really, really very good. Just for me as a participant, I think uh listening to it, I think we'll see we'll find out that it's actually quite good. So I'm really happy with that, dude. Okay, first off, what was
AOPA Show Energy And Scale
SPEAKER_04the show like? First off, the overall kind of impressions, things like that. Is it growing, getting bigger, smaller? Well what kind of audience is there, and and then and what was your feel of it generally?
SPEAKER_00Yeah, so I would say the energy was high. The thing that's interesting uh, and there was the most vendors and registrants in the trailing five years. So that's pretty good since since COVID, so uh you know, that's going on six years. So we because there was, I think it was cancelled or I forget what it was that year. It just didn't happen. But I think that like it felt great. But the thing is in Vegas is every every room is big and all that stuff. So stuff was spread out and so it might not have felt as big as what it actually was.
SPEAKER_04Yeah, okay, because these hotels are are huge and they dwarf anything really, yeah. Because they do session and stuff like this, right?
SPEAKER_00Yeah. Okay, okay. Yeah, so but it was it was nice, and it was nice to have the space. And uh the cre it was at the Mandalay Bay, and um, you know, it takes me it was almost a mile walk to go from my room into the same hotel, right? Yeah to my booth in the same hotel. Yeah.
SPEAKER_04That's insane, dude.
SPEAKER_00Yeah.
SPEAKER_04That's completely insane.
SPEAKER_00So but I would I the energy was really high. Uh a lot of kind of buzz, I would say, like just around in the the exhibit hall and such. I think the sh the the classes were well attended as well. The exhibit hall did kind of empty out during those times, but there was still quite a bit of motion going on there. And uh you know, it's interesting, there's always like an unofficial theme of the
AI Targets Workflow Paperwork Bottlenecks
SPEAKER_00show. So the last few years it's been what can you do with 3D printing essentially. You see more and more companies have 3D printing things in their booth. But this one was more around AI. And and it wasn't necessarily AI to help with the design and 3D printing, it was AI to help with the bottlenecks of the workflow aspect, all the paperwork and all that stuff. And so that was that was really interesting to to see and hear different people kind of approach that in different in different ways with the technology, and then how they felt that that was beneficial.
SPEAKER_04But do you feel it was like is it a real thing, or was it everybody doing a quick AI demo to be cool? Or was it like they were literally looking for value for the for the customer on the site?
SPEAKER_00Yeah. So I would say they're looking for the value for the customer and doing some things that some of the current electronic medical record companies are not doing. It's not that they don't have it on the roadmap, they just don't have it yet. The the big thing about, and I think you and I touched on this, the big thing about using AI is you have to make sure that all your I's are are dotted and your T's are crossed for patient health information. Like that that is a you know, that is a paramount, paramount thing. And that's why I think some of these electronic medical records companies are just making sure that everything's buttoned up, all the business associate agreements are in place, you're, you know, you're it's not going to the web, there's no way that it's going to the web, all that stuff. Whereas some of these smaller, I would say in the startup realm companies, they they are able to be fairly nimble in those areas. And uh they can kind of probably get there faster than some of these bigger, you know, ginormous electronic medical record companies. The pr the problem with that though is that it ends up being like a like a bolt-on sort of thing. So so sometimes you may be doing work twice, and then you're like, did I put it in here or did I put it in here? And because the things don't necessarily talk to each other. And so I think that's probably the next frontier is how do you remove some of the friction with some of these tools that do save time and get things right? Not only is it right for the patients, but you get paid faster, your documentation is correct, you don't miss anything. There's a human aspect to that that I think is I think it's important to have as part of your your workflow. It's just a matter of of making it so easy that why would you do it? Why wouldn't you do it another way? Or why would you do it another way? Yeah.
SPEAKER_04I think that that could be that could be very interesting. And you're right to point out that if they keep the data safe and if they don't do all sorts of things incorrectly or something like that, then if somebody just figure out how to do that, I think it'd be really valuable, shape for people all the time. Uh so that could be really cool. Other trends or things that you notice or things that you really would like.
SPEAKER_00Yeah, uh a couple I I would say a couple shout-outs. So there's a company called So we just for our listeners, we will do a best of show and best startup. Um, but I'm I'm gonna give a couple shout-outs as well. There's a company called High Tech that I've got to know the and I don't know, I've uh uh his last name is escaping me. His name's Sean that owns it. They not only have clinics, but they also do some contract manufacturing. But on the traditional side, they do have a 580 and a vapor polisher, but they do some cool things f with making liners, so those gel
Contract Manufacturing And Custom Liners
SPEAKER_00liners, so they have not only their own silicone they use, but they have a method to attach fabric to it and all that. So that's a lot of time and energy, and I think there's a lot of uh benefits, not only cost-saving benefits, but especially if you go to custom liners. So we've talked about some of the rapid liquid print stuff before. This is still in the traditional sense. Now he does have one of the original rapid liquid print. Uh I forget what the name of it was. The machine, but it's it's it was it was before they really launched their commercial product.
SPEAKER_04Okay, okay, okay.
SPEAKER_00And but the the the issue is is trying to make financial sense with with some of that. So for instance, like the silicone material cost, you're probably talking eighty to a hundred dollars, like on a rapid liquid print, something, something to that effect. At a at a you know, not a major scale. Where if you pour it in a traditional sense, you might be into it for say twenty-twenty-five dollars. Now, there's a lot of labor and there's a lot of things that go in, you've got to degas the stuff, and and there's just it's so much. So when people think, oh my goodness, $20, $25, why is it so expensive? Well, there's a lot of labor, there's a lot of lot of stuff that goes on the back end of this to make a final product. But I think high tech's doing a really nice job, and they do a lot of things in the orthotic space as well. So they make uh KAFOs, which is knee-ankle foot orthoses, they make a lot of components. And I I think that's what I was really impressed with is their abilities are so vast as a traditional contract manufacturer that I just didn't realize the the scale at which they were. And so I I really liked them and uh and he was really free with information too. So
Smaller Components With Big Impact
SPEAKER_00I think that is really neat.
SPEAKER_04That's super cool, though. That's super cool. Uh what about uh more on the component side or the device side or anything like that? You tickled your fans for the time?
SPEAKER_00Yeah, well, one of the things that is always difficult on the prosthetic side of things is there's a there's a method to keep somebody's leg on them called suction. And so what it is is their leg goes into the socket and then it seals off with a sleeve that goes on the outside. So I I don't even know how to you know, so like if you broke your leg and you put the little uh like baggie over top of your cast and then you pump pump it down to get all the air out, that's the kind of suction that we're talking about that keeps the prosthesis on somebody's leg. The problem is is some of these devices or some of these valves that allow the air to come out are fairly large, and so with 3D printing, it is kind of hard to hide some of these things, and even with traditional fabrication, it's hard to hide them. But there's a there's an independent company called Bulldog Tools, a really neat company, and they have created this little valve, it's a three-quarter inch hole, and then there's a hexagon that's still under one inch, so so for those that are in millimeters, 25 25 millimeters, and then roughly say call it 19.5 millimeters for the thread. But overall build heights only about eight millimeters or or less. And so compact huh very compact, and so I think that is gonna be a little bit of a game changer for 3D printing. And uh I'm really interested.
SPEAKER_04What are they selling, like the the invention or the the the actual actual thing device physical thing?
SPEAKER_01Yeah, yeah. Okay, yep. Yeah.
SPEAKER_04That sounds really cool, dude. And I think it's a really interesting approach of just applying engineering to something that a lot of people may need, and a lot of people aren't focusing a lot of effort on. That's really nice.
SPEAKER_00Yeah. So and and and that's one of the neat things that Bulldog does. It's it's not it's not necessarily super sexy to make these components, but it's super important to make them, and they do a nice job doing that.
SPEAKER_04Yeah, I think well, that kind of thing, if you could just make the form factor less, make the weight less, that has a huge improvement for everyone, you know? Yeah, yeah. So that's cool. Okay, that's really exciting. And what else? What else?
SPEAKER_00Let's see. Mosaic was there. They were showcasing their belt printer for foot orthosis.
SPEAKER_04So, you know, I think we just only showed me the the the FDM, the Cartesian things, but but did you what do you think of it?
SPEAKER_00Yeah, uh, you know, I think the price point is gonna be tough, but for a high volume company uh that no, an industrial 3D printer uh that's on a belt makes a lot of sense. Uh and they, you know, having it all dialed in for you, there's a lot of value there. Their price point is like sub 10,000, I believe, so which means what, $9,999? But yeah, so very very well built. But the other thing that was interesting is they do have some people building models on them. So let's say if they need to make an ankle brace, instead of pouring plaster, they might use an inexpensive higher temperature PLA. And so you can print that on the the belt printer really nice without supports, and then you can pull it traditionally. So it's pretty inexpensive. You know, full models run about thirty to forty dollars per. And so to be able to print that with a very inexpensive plastic and then pull over top, it is a money-saving uh deal. But it would take a you know yeah. So I think that the there's some stuff. There is a trend for some recyclability. So how do we say sustainable and you know the the pieces and parts that we use, how do we reuse them in another way? Whether we can recycle the plastic or or other other things. So I think that's a very nice thing as well.
SPEAKER_04Okay, yeah. And yeah, it's also buy to fly, right? It's also kind of if you make efficient gains there or reuse material, you're also you're saving money, right? It's not only cute, let's say. Right. Okay, and how about one thing I want I'm curious about is stands-wise. Was there a stand that you thought was like really amazing that people get a really good job of explaining like something or showcasing something or demoing something or something like that?
SPEAKER_00Yes. And I I think I may want to the person the people that won the best of show would also be the one with the best stand.
SPEAKER_04Okay, okay.
SPEAKER_00Well, so so yeah.
SPEAKER_04How about the presentations or the learning bit? Was there anything that you thought? Of course, there's a lot of interesting stuff,
Adjustable Sockets Get Stronger Evidence
SPEAKER_04right? And you and given the fact that you're spending so much time doing the podcast, you couldn't attend a ton of stuff. Uh, but was there any stuff maybe you or Katie went to that you thought from the learning of the presentation stuff was like really valuable or really cool?
SPEAKER_00Yeah, so there's a there's a couple things that is uh very interesting, and it revolves around socket design and adjustability. So we I know we've talked about the click medical stuff, and you really like that kind of adjustability there. I think that that is definitely a trend. So Hangar uh recently, with probably within the last month or so, they released a study that was almost a 500-person study with adjustable sockets, and it showed that these patients did in fact benefit from having adjustability. And so that that is one of the largest studies ever done in orthotics and prosthetics. And so, with that, I think that there's going to be a springboard into a focus of how do we incorporate more adjustability because the data now shows that it's better for the patient. And so I think that's a really exciting uh thing. So any of the adjustable stuff that touched on that, Katie and I really liked to hear. And there's a variety of people that that are trying their you know spin on it, and we don't necessarily agree with all of it, but I think that you pick and choose some of those pieces and you're on to something for sure.
SPEAKER_04That's cool. And then and how about like a 3D printing wise or 3D printing materials or machines, anything really cool there?
3D Printing Hardware And Material Tradeoffs
SPEAKER_00So Stratasys was there, which was a surprise to me. So I thought that was very cool to have them there or at least see that they are interested in the O and P space on the medical side. HP was there, Dimension was there, Form Labs was not there, which is I mean, I was kind of bummed about that, to be honest with you, but that is kind of their brand. They they have decided that they are going to be machine salespeople and not necessarily hey, in this niche aspect. So if it happens that O and P is one of those markets, that's fantastic. It's a great use of their machine, but it's not why they build machines. So I I I can I guess respect that aspect, but uh the 1200, uh HP twelve hundred was there. They weren't running it if it was there. You know, I think it's a I think it's a great machine. It's it's it's gonna be a great gateway drug, I guess, for going into the larger machines. You're gonna have a quick turn. I think they're doing a lot of work on the material side of things. I'm not a fan of PA twelve so they're gonna have to go into the PA11 or TPU for for for me to really consider something like that. But at the price point, it's kind of hard to pass up, you know?
SPEAKER_04And then are you looking at one for for for for yourself?
SPEAKER_00Probably not. Just because just because it doesn't run peak.
unknownOkay.
SPEAKER_04So and then it's but if it would run more materials, if it the the do you see this? Because I I've wrote this entire article about this, like parson about this, about this idea of saying, hey, we can use these things to run like niche materials if they do end up offering it, right? So this I I see like a bigger service or a service using bigger machines could be like, you know what, we have you know only so much need for this one material, we can put a smaller machine on it.
SPEAKER_00Yeah, yeah. No, I I think that that's a true thing. And for like small things like body clips and you know, other tooling and that sort of thing, I think it makes a lot of sense. Uh so it seems like a well-built, well uh thought-out machine. And I like that smaller bill volume. You know, we run a bunch of the 580s, and the the quality of the parts, the way that it fuses, even though it's the same technology to the the bigger commercial ones, there's something about printing in a smaller space where the thermals are better controlled that give you a really nice consistent product. And and you also see that in the form labs, like the form labs one plus, or is it called form labs? Whatever it's called. Fuse one. Yeah, yeah. Plus, um, those smaller build volumes, it's it's definitely easier to control the thermals in there, and you end up getting really great parts. So I think that is a uh a really great thing. And I mean, if your parts are the right size, I'd definitely rather have a small fleet of those than a rather than uh and and have some redundancy than one of the big machines.
SPEAKER_04Okay, that's cool. Good. Because that's what I thought as well. Okay. Was there SAF as well by uh Astratis or not?
SPEAKER_00Or just uh other I believe that was a SAF machine. When I walked by, there wasn't anybody there, but uh I know that they were very active, like walking the show and that sort of thing. I did see, you know, Aopa does have a you know, don't sell out of a suitcase kind of policy. So but there there there were some vendors that are very well known that uh were selling out of their suitcase. So I didn't I didn't I didn't particularly appreciate that side of things, like especially, you know, when you're you know, multi-gazillion dollar company, you know, get yourself a booth. Not a big deal. Show off your technology.
SPEAKER_04Yeah, it also and it actually literally undermines the show, right? If you get a lot away with that, then less people get booze, more people will do that. And then uh yeah, and then it kind of like you know, then the you know, the show thing, it's expensive. We all know that, but but it does pay for everyone getting there, you know what I mean, it's getting getting together there, you know. So That's right.
SPEAKER_00That's
Scanners And Software That Reduce Friction
SPEAKER_00right. So yeah, and then uh I did go over the PO creation. uh booth and that was they were showcasing some of their printers and they had a pellet extruder doing TPU that was very cool and then the Shining 3D was there which was very cool and I got to meet uh she's probably kill me I I've uh I think her name was Jenny but they have the Medix scanner which is specifically for medical and body scanning so they've kind of tailored it to that it's all it's all wireless. I miss that entirely yeah so very cool all wireless it's interesting you know it's it's uh very portable very handheld I think the thing that's difficult on it I like it a lot uh don't get me wrong but if I had a knock on it is that because they tried to make it so like compact and small and everything happens on the machine itself the the processing of the scan data takes a long time okay you know what I'm saying so electric also scanners that's why it's so annoying that's okay that's right and and that's what we say scanning is hard so for for a a a smaller company that's you know not doing a ton of volume this sort of thing would be perfect and I think the price point's right it's five thousand or sub five thousand dollars very very cool and how does it compare them with the other the existing shining models which you'd like for that kind of thing anyway right yeah so I believe it's on par with like the shining H2 H2. Yeah and so I like that I the it'll be interesting. I want to get my hands on one of the Medixas and just see what it's like you know that's one of the reasons why I love the Arttech Eva so much is they just do a really nice job of taking the geometry and the actual photogrammetry I guess and and they put it together somehow on the back side and you're able to get like the inside of molds and that sort of thing.
SPEAKER_04And so I think the Arctic Eva is the only scanner I actually like I I can't I can't actually enjoy using that thing actually as as a but you know it was actually fun. It was kind of like a game kind of you know and and and it worked and it worked when you get interrupted it worked when things would change or things would be the angles would be awkward you have to break off a scan or something. It's the only scanner that to me actually works and everything else is like you it's a skill set you know you have to learn yeah and I'm just I'm just not suited for that dude remember there's a lot of precision and patience that I do not do not have and and yeah this thing is that's and I just want more and more machines to be just like that thing but then a little bit you know not like two two other cameras or whatever. Yeah yeah whatever that thing calls. Yeah okay that's good it's good that they're they're they're coming out with new things though I like that that's nice and then what else um how about software stuff is there the new software stuff or do was it all that AI stuff you talked about before was there any newer software in in different types of ways or not so much?
SPEAKER_00Not so much I mean we did um you and I we interviewed Amit Banti from Hike Medical and they have a a way that they're doing their insults and the paperwork and putting it all together to reduce friction to get to some of these most painful things to deliver like small margin high volume stuff that can totally clog up an office. They are trying to come they are I I and I think they're doing a a good job with it. So I think in that sense like a end-to-end workflow including the paperwork I think that's interesting. So you know it's I would say it's more of a just a wait and see game of how all that gets wrapped used day to day whatever that comes yeah use day to day the uptake on who's doing it but I I think I think that there's some really great use cases for what they're what they're making.
SPEAKER_04I thought it was exciting because we've been talking about this idea of a vending machine for a thousand kind of you know either for in office use or at a customer site or something like that. Like imagine you go to UPS go to their office and scan everyone you know and then just print them out there and just like that economics that would just make it a lot you can go to a supermarket and say hey look we'll make all you guys more comfortable you know so so this kind of thing I think would be really exciting if you just took that that that friction like you mentioned before that you should just took that friction away and made it like a vending machine. So I think I think they're actually working like other people have said this but then if you look at the software and the fitting and all the stuff it isn't actually like that. And they seem to at least have the vision you know let's see if they can get come up with a solution but but at least the idea seems to be like possible you know yeah which I think is interesting. Um okay so how about your best in show so we have two things we have two things the best in show and the best like what's the other one? Startup category.
SPEAKER_00Startup which one do you want to do first and it's up to you so let's do the best startup because it kind of ties into the hardware side
Best Startup And Best Of Show
SPEAKER_00of things. And we touched on it on the looking forward to aOPA show and that was the the Nora scanner and that was a yeah so that was the little scanner that went down inside the the cast and scans the inside of the cast or socket and and then you're able to make the prosthesis from that. Now the one thing that I didn't know that was going to be happening is they have been doing kind of a for lack of a better term like a hackathon because one of the biggest things that is needed is to scan the s inside of a leg cast. So if you if you can imagine a leg cast looks like an L so it comes down your calf and then it turns to go on the bottom of your foot. And you can't necessarily get a scanner around that corner. What they've done is they put the probe down and then they have some sort of camera laser thing that will shoot all the way to the end of the cast and capture the top of the cast to get the the whole foot section. And I I actually think that's gonna be a pretty significant game changer.
SPEAKER_04But why okay because I can get the whole foot in just a really quick way or something what what's what's the real advantage saves me time.
SPEAKER_00Well so currently the only way to really do that either you split the cast and you have to scan the cast three times. So you have to scan the outside and then scan the left and right halves and put it together and then you have to clean up to get that inside surface so it's kind of a pain. Or you actually have to pour it down with plaster Paris.
SPEAKER_04Okay.
SPEAKER_00And then and then you can either scan that or go from there or you scan the outside the cast which isn't really probably the best option. Yeah. So I think for for innovation and what they're doing I think it's a very very cool thing that they're doing and I think it's going to be well needed. So you know I really hope they make it.
SPEAKER_04But how often does this happen? How often are you doing this?
SPEAKER_00Well for instance there's a there's a large company on the west coast that only does pediatric orthotic bracing and they probably send out three to four hundred pairs of orthoses a day. Literally a dude every single time like scanning a thing three times well they I think they scan the outside of the cast and they use some calipers but that's not really a great way to do it.
SPEAKER_04No that's not amazing when I do that at all that doesn't work like that.
SPEAKER_00So to be able to so essentially like if you imagine like having four or five of these in a row and you have one person they load a scan press the button load another one press a button and by the time you finish that one that one's done and then you just keep the cycle going and I I really think that it could be a a a game changer for some of these companies. You know the the hard thing about hardware though is that you've got to figure out some way to have recurring revenue and if if you don't have the recurring revenue just selling the hardware one time that's gonna be a hard hard road to hoe interesting to me if they can really do this there's a lot of there's also lots of industrial stuff right that could make sense here involve oil and gas all these other things they need a similar thing right sometimes they don't they're going downhole in how a down downhole in oil and gas and they don't know what is down there or what's broken or what's not broken.
SPEAKER_04And to reconstruct it so they can rebuild it or or replace certain parts and stuff like that.
SPEAKER_00Same in some industrial sites and stuff like this it's actually maybe they're a broader application for this actually well and and um you know there's the first scanner for the inside was a a vase like they were trying to get the inside of what what does some of the artwork look like inside and I think that's pretty cool.
SPEAKER_04That's nice okay that sounds like a really good it's very niche I don't know if they can make a business out of it but it sounds really very very useful. It's really good. Okay and what's your best of show?
SPEAKER_00Best of show actually goes to the is it's twofold, right? It's the best booth and the best new product and they really kept this thing under wraps for a while but they showed up to this show and they had a two story booth. And this was the first time in the history that I know of of a Oprah or any show that there was a two story booth. Oh wow okay so you know if that wasn't eye opening then I don't know what is so a very beautiful booth beautifully done I you know kudos to them for pulling that off catering um you know I maybe I I wouldn't I I think they probably had some food at the booth or beer at the booth at some time at some point in time.
SPEAKER_04Apex additive there was like there was like the booths that had like you know that had like a coffee bar downstairs and another one upstairs. That's when we were like you know everybody's running over them falling over themselves to to to to make an impression it was crazy dude.
SPEAKER_00Anyway go on you go on well in I mean I remember was it Formnext or some of those companies that are no no longer with us blew a lot of money on some of that stuff. Oh my god that was crazy dude crazy and I'm like a journalist so they're just like overfeeding me all day I feel like a pet dog that got left alone in the bag of dog food dude it was like crazy anyway okay but go on uh and then so and then then then everybody's like wow what's that already right yep right right so and then they had a a product that they showcased and you know I I I was a big fan of like what the airfit does uh you know it's a standing cast that sort of thing and they've it's not the same concept but the the concept is how do we scientifically make a transtibule or below the knee socket using some technology. So you know when when I'm evaluating a patient I'm putting my fingers you know I'm feeling the tissue of the leg I'm kind of pushing in feeling the muscles feeling where the bones are seeing if they have any neuromas a neuroma is like uh if you hit your funny bone or your elbow you know and it kind of jumps and you're like it's very uncomfortable if you do that. So so what they did is they've created this kind of like spring loaded probe and what you do is you take the probe on the willow people. It's a willow yeah willow wood. Yep and you take this probe and you put it on the in 15 different areas and there are numbers that get spit out of the probe of how much you can push.
SPEAKER_01Okay.
SPEAKER_00And I love it.
SPEAKER_04And so then from there But the probe is like freehand or is it like on a robot arm?
SPEAKER_00It's a free hand. Yeah it's free hand. So the kind of so what they've done is they've marked those, they do that it's freehand. But then the the next level of this is how do you get the probe to actually talk to the software as you're doing it. Mm-hmm and uh I mean that's I they probably already have it but that uh it was just an amazing piece of uh technology and I love the way they do it and I love kind of the science like where does that take you? How hard can you actually push? How does this make your socket different and I think one of the things that they found is you can be a little bit more aggressive maybe a lot more aggressive than what we currently are uh doing traditionally in prosthetics. Now the other part of this that I think is interesting is this model feeds a traditional way to make a prosthesis. So one thing that I'm kind of curious on is okay so if you feed this information into a data set we then maybe we let the computer say hey this is the shape that I think it should be and then what that does is it brings other shapes to the forefront that we've had blinders on that we would have never tried to begin with. Some may work some may not we may be surprised but I think that is what is exciting about that and Matt Wernkey and uh Janine and we had her on the show what was her Finley. No not Finley. I forget her last name Janine I'm so sorry okay but you forget everyone's last name that's okay just call everybody Janine Janine. So Matt and Janine have been working on this um for a while and as as reach researchers and I really think that they've hit on something and I'm really excited to see where they go and how they combine that with technology and I don't think you know remember remember you asking about I think this was getting close to your delirious point uh when you asked my like I I've been working for like the for the better part of 22 hours. When yeah so what uh when uh she was explaining the history of willowwood you're like oh that makes sense and then we go through all this software so you and then you said well are you gonna make it out of willowwood?
SPEAKER_04I mean that's get get back to your ribs no no I think I had a completely legitimate business idea okay okay for the hipster community that is interested in authentic things right and natural materials right and things that last right you make wood prostheses right just that extra the extra kind of and you could sell them at a premium you know so that that was the idea I think it's a good suggestion. Okay and I but I do regret making fun of kind of fun of their name and stuff like that. And and and and but I do think that was a good idea at least and but but but this is really interesting this is really interesting because so first off it takes away a lot of guesswork right that's good that's always good. Yep yep but we could really envision if we're looking at an additive what it is we can really envision this could change the way you do additive sockets right you could really change or other things as well right you could really change how wait where you put density or where you put cushioning or where you put air pockets or you could really very very change a lot of aspects of designing a lot of like interfaces if you will with the the the the person and the and the processes right yeah yeah I think that's really good I think that's really really good.
SPEAKER_00So they they get the best of show for not only the booth and the product I think and I think you know people may give me a hard time about doing it for a bigger company obviously that I think they're I forget what they are either VE or PE or VC backed but here's here's the thing they've been around for a long long time carving you know sockets out of wood and now we're talking about how to use digital probes to to get better sockets and integrate that with software you talk about you know a full circle moment where you're you're you're literally changing uh the direction and and and staying staying with the times not only technology but to to help better patient outcomes and I think they're super deserving of that.
SPEAKER_04Okay that's good and I think yeah this is like a digitization because it's not only the probe itself but it's also also capturing the values and coming up with some kind of value system for this right some kind of way to rate this gives you like a new kind of vocabulary right that means that you can talk to a contract manufacturer in a certain way or the patient in a certain way you know and I think that that just gives you a new set of tools. So it's not only just you know a probe whatever you know what I mean it's it's more like a new kind of like set of of terms you could use to communicate with your manufacturer and your patient to to find out things. And I would love the fact that like what you said before like imagine they found out that what everyone needs is extra material or you know whatever kind of like innovation then you could really kind of have a basis for saying hey we need to change this particular thing. So I think it's it's a really really exciting thing to move forward.
SPEAKER_02Yeah. Yeah.
SPEAKER_00Well and we have one more thing
Hanger And Numotion Deal Explained
SPEAKER_00to talk about. Okay, okay okay yeah so I think it pretty much coincided with the show and that is hangar and new motion yeah it did it on September 10th 2026 they're come combining into a company called Hanger New Motion and it was an all cash the hungry hungry hangar caterpillar it was an all cash acquisition by Patience Square Capital and it was being sold by AEA investors and LLR partners it's supposed to close in Q4. So the the interesting thing about this you know we've talked about hangar we've we've uh evaluated I don't know that we've done their annual reports but we definitely you know they're one of the big let's call it four companies in the world the New Motion is a complex rehab technology company they call it a CRT company and they specialize in wheelchairs seating positioning adaptive equipment for like spinal cord injuries ALS cerebral palsy muscular dystrophy uh multiple sclerosis they're based out of Tennessee they have over 200 locations uh nationwide and it says they serve over 5000 people a year so you the the interesting thing is there's a there is an overlap of patients so wheelchair users a lot of times will use a prosthesis or they may wear braces and so this is an interesting opportunity to you know we we've talked to business owners that the best way to make money is have the money go through your hands multiple times so you know you have your seating and mobility stuff and maybe you're providing a prosthesis and it's all the same company real easy we already have your data we already know your doctor we've got your insurance company stuff the insurance company already knows us. It it makes sense right it's a frictionless thing but it does create a super power so to speak okay that that's really exciting and but okay so but these are like really difficult things.
SPEAKER_04So one is like kind of basically like wheelchair stuff like are we talking about custom wheelchairs or wheelchairs in general and also kind of like patient care stuff. Is there really as much synergy between those things?
SPEAKER_00Is it just like two different really kind of different medical companies that are very kind of adjacent it is it is two very different things but that's the way that it is done in the US but in Europe you actually see prostitutes and orthous pollinate into this seeding and mobility aspect so you have prostitutes providing this complex seeding technology providing things walkers and things at the home you know commodes that sort of thing. And so it's interesting I think it's an interesting mix but the other thing is you know when you're looking forward to this acquisition and why it matters is there is not enough clinicians to serve the U.S. population and we're just not getting enough out of school. And so you have this whole other pathway of physical therapists, occupational therapists and assistive technology professionals, ATPs, that are already part of the new motion and they potentially could be what we call care extenders. So think of it like a physician's assistant so they might not be the the one that does the evaluations and that sort of thing but if somebody needs an adjustment or a follow-up or something like that it is good care especially if like the wheelchair person's already going to be there oh can you take a look at my braces at the same time it's a pretty interesting and compelling thing to do. And you know I don't know if that's what they were thinking. I'm only speculating and that's that's what you and I both and I I think this probably is a good time to say hey we are just two guys shoot the breeze. Yeah not investment advisors your mileage may vary all that stuff we have no insider information we just use what's available to the public but I think that may make some some interesting ways using this idea of care extender and really allowing The clinicians to do clinical things that are meaningful revenue generating events like an evaluation and a delivery and allow the adjustments and in the in-betweens to potentially happen by these care extenders. So I think it's very interesting.
SPEAKER_04They're all doing like device plus activity plus lots of different things, primarily in LMP, right? And now they're they're all buying clinics. And we thought we'd see kind of uh you know warfare clinics and getting the biggest clinics, you know, that kind of thing, right? And basically like the most logical assumption would be for hangar to be kind of like Kingmaker in this in essence and go to whoever, you know, one of the most clinics. And now we're seeing that all of a sudden they've kind of positioned themselves in a much bigger game. No, no, it's about this. We could also add a bunch of, I don't know what else, spying clinics or whatever kind of other manual therapy, right? We could, you know what I mean? There's there's like a ton of different things you could add to this. So then it all of a sudden becomes like, rather than being quite a large player or one of the largest players in OMP, they're now like a middling payer in a really broader segment, you know. So it's interesting. I don't know.
SPEAKER_00Well, and I think the other thing that's interesting is when you're when you're both of these companies are very large companies, and so they have a seat at the table of the insurance companies, you know. So and that that that is a very good thing. So they negotiate their own rates, they might have preferential rates, uh they you know, there's a whole bunch of things that could happen when you have a seat at the table because you are taking the risk on for so many patients. And I think the total they said is like almost like a million and a half patients. It's when the when you get both of these companies combined. It's pretty incredible. So total they had 925 US clinics, and then New Motion has 200 roughly clinics, so that puts them well over the eleven hundred mark uh for for clinics. So that's a pretty significant reach. So you know, it's gonna be an interesting thing. Uh you and I have talked about this all the time. It's always good to have the gamut of companies as competition. So you have the big guys, and I think you mentioned McDonald's, right? And I and we're not saying that hanger is McDonald's, we're just saying in the scope of things.
SPEAKER_04And then you may have more model as well.
SPEAKER_00Yeah, more niche stuff. So let's if we're if we're sticking with like burger joints and that sort of thing, so you have like regional players, so like an in-and-out burger.
SPEAKER_04In and out burger, yeah. Very good choice.
SPEAKER_00Yeah. And then you have these independent guys. And so, and I'll say I just had the best burger of my life not too long ago at a uh there's a restaurant, it's there's only one in the whole United States called Angus Barn.
SPEAKER_04Okay, okay.
SPEAKER_00And so you so you run the gamut, you've got your your large players, you've got your regional players, and then you have your independent guys. And and I think everybody needs each other. And so I I yeah, so you know, the jury's still out, whether it's good, bad, or indifferent on the patient care side of things, but you know, on paper, it makes a lot of sense. Unfortunately, when you're at this scale, you know, it does become about the money. Uh, how are we gonna make money on this? Like
Consolidation And Patient Care Tension
SPEAKER_00these venture capitalists and the private equity guys, that they're not in there because it's a nice story. Yeah, uh, yeah, they don't they they don't actually I mean, they may care a little bit on how many people get walking on the prosthetic side of things, but the reality is it's it's it's about how are we going to get a return on our investment. And doing that in the patient care space is is is difficult. It's a two-edged sword because you can make really good money in the patient care space if taking good care of patients. But if that's the driving factor, it's a hard it's a hard thing to balance. And I and I don't envy any of those people in leadership positions.
SPEAKER_04So you don't want to get paid, yeah. Um but but yeah, but I think but I think one thing is that's really interesting is that in prosthetics you can have a really long, lifelong or decades-long relationship with a patient, right? Yeah, a lot many people stay a long time with their dentist and stuff like that, uh maybe a psychologist or something like that. But many other uh doctor thinks it's a kind of really much more transactional thing. You're looking for a heart surgery in your neighborhood. Maybe it's really important, right? But it's only for that that one area or one time of your life or that one one very critical disease. So that lifelong connection or that multiple decade connection could be a really valuable thing for such a company to have that recurring revenue and to have that long-term relationship, you know.
SPEAKER_00I agree.
SPEAKER_04Yep. Uh, and if you then see that many of these customers would then maybe at one point need a wheelchair or something like this, then it becomes kind of very much a kind of like we we we there's a synergy there. Yeah, right? Yep. Uh and then and then it then that long relationship makes a lot more sense because I think yeah, the European thing is different. Like you have like in Spain for those technical orthopedics, they call it, and you can get in, you can get like all these things you said. You can have a thing that you put in your bath so it's easier to get out of, or you can get a wheelchair and all these things, or you can rent a wheelchair, it's all the same place, right? Uh but these guys are very kind of captive of the system, so they don't make a ton of money. But they do offer all those, so you would literally like, oh, if you're if you you're you know, literally like if you break your leg or something, you need a kind of uh uh one of those walkie stick things, whatever, you would go to that place as well, right? It's all the same one stop shop, if you will.
SPEAKER_02Yeah.
unknownYeah.
SPEAKER_04But if you look at that, that differs so much from from having a really good relationship with a person that you really understand them, they understand you, and you can advise them. So I think that could be actually a really interesting thing for them to do this, uh, to really extend that relationship to a lot of things. And we still we talked about this before, like that through 3D printing and all the custom things you do, OMP people actually can make really custom devices, right? So you could really make like a really customized kind of thing for for wheelchairs or for other kind of like long-term care thing, right? A lot of these kind of paraphlegic type folks and all this stuff, that's very different. It's also very different what I want to do. Maybe I'm into uh gonna gaming, I want to use my PlayStation again, you know, or somebody else might really desperately want to work with a particular MacBook or whatever, you know? So these kind of things, I think you know, that custom solution thing actually could be quite interesting as as populations age and people get bigger and or smaller at the moment now, maybe, but uh uh and we get to see these longer term kind of this intersection of these different uh types of diseases and old age and stuff. So I think it could be interesting from that perspective, I think.
SPEAKER_00Yeah. Agreed. And I don't I don't want to like hammer on this this point of the public the private equity and the VC side of things. But here's the the the neat thing is hangar was public and they got taken private, which I think was a very good thing, which which I believe righted the ship a lot with the true focus of patients, patient outcomes, good patient outcomes. And I I have a lot of friends that work at Hangar, and it's been a it's a great place for them. And I can't say that historically it's always been that way. Um and so I think in that sense it's been very positive being out of the not no longer publicly traded, but really in this private sense. Because I do think that people are doing some of the right things for the for the patient. And if you're only about the bottom line, which is where the stock market is, you you're chasing that, and that's so hard to do with with uh patient care. So, you know, I would say uh, you know, also kudos for staying in that kind of private realm. I know that there's probably gonna be a IPO at some time again. That's the only way to kind of get out of out of the cycle, maybe. Yeah, I think maybe. But but being private has changed the way that hangar uh providing patient outcomes. And I think that they're doing some really great things with that. And so, yeah, I didn't want to hammer the money side so much. I I also wanted to have like a very positive thing. Like, I think it's very positive that they're private and not on the stock exchange right now.
SPEAKER_04The downside of this thing, uh, my point is if we look at these patient square capital guys, they have like $19 billion under management, right? Uh-huh. And and they they're a professional like healthcare, really focused on healthcare. So that's good, I guess. But if we do look at like that, a lot of this this PE investor kind of behavior is very rent-seeking. They're really trying to put themselves, you know, in a position to keep catching those rents as as uh as this thing happens. And they will kind of tend to raise prices and reduce um quality levels often. So there is a real worry there that that that this would just be like a par for the course kind of medium-term kind of offering where they're just like looking at, you know, how do we cost out things and how do we kind of you know make make things more expensive essentially and and reduce care. So there is like that that is a worry that that you know, we don't know the and I don't know anything about these guys, right? So maybe they're the nicest guys ever, or they're they want to be like really high quality or whatever. But but but you know, there is a worry there that they you have a serious player in your business that's all of a sudden gonna degrade its quality level, you know, because that's just what the parent wants, you know? Yeah, yeah.
SPEAKER_00Well, and I think that there is a sense too, when you're at that scale, there there are gonna be there's so much consolidation, and we're seeing it on the 3D printing side, but so much consolidation happening, and then when you have that consolidation and you have fewer suppliers that are independent or even the regional players, they it can allow there to be less competition to fix some of the problems that have been plaguing our industry for and the wheelchair industry for that matter for a long time. And so you know, like I said, I don't I don't envy any of the people in leadership where you're trying to balance this idea of hey, we've got to make money and hey, we've got to take good care of patients. I think it can be done together, they're not mutually exclusive, but it could be. It's just a real it's a real hard balance. And I don't envy those people at all.
SPEAKER_04Yeah. It's really simple if you're evil. If you're trying to do the right thing, which is your default assumption, which is really nice, then it's really really difficult. I understand. But uh yeah, exactly. It's it's like it's like if you look at care as a platform technology, then you kind of basically then you're basically putting more and more things into it, and you're basically kind of you know, then then you look at it much the same as kind of like a revenue generating opportunity rather than maybe an excellence opportunity or rather than a business with customers, you know. You really look at the platform, and then then you're gonna be thinking of yourself as like, you know, the insurance company on the one end, maybe the government on the other hand, and then uh you're gonna get a very different type of business than than if uh than if if you know if you're just having a business that just wants to make money off of making people prosthetics,
Final Thoughts And Thanks
SPEAKER_04you know? Okay, dude. This is really great. I think um I think you think you had fun, right? You had fun on AOPA, I think, right?
SPEAKER_00This this is a good one. It's a really good and and good job to the AOPA staff. You know, if there was if they're to to put this together for from Tuesday to Saturday in Vegas, pretty much wall-to-wall programming. I can't imagine the behind the scenes stuff. Well, I can because I am on some of those committees, but the actual nitty-gritty of organizing makes sure that uh unbelievable to try to keep that thing rolling. So, you know, maybe if there was a best of show, it's to the uh AOPA staff because they they pulled off an amazing show.
SPEAKER_04Awesome, dude. I'm so glad. I'm so glad. That makes me very happy. All right. So uh yeah. So thanks, Brent, for being here, and thank you for listening to another episode of the Procetics and Orthotics Podcast. Have a great day.