Tuesday 4 August 2015

ReMotion: An $80 Prosthetic Knee

The Incumbent Market
There are an estimated 10-20 million amputees in the world with about 2 million in the U.S. alone. Nearly 190,000 amputations are performed in the U.S. per year, and over 90% of these, or about 170,000, deal with the lower limbs.

Lower extremity prosthetic limbs for Western markets range in price from $8,000 to $50,000 and will need to be replaced every 2-4 years, mostly due to degradation of the device. A good example of a high end incumbent leg prosthesis is Ottobock's C-Leg costing approximately $50,000 in the U.S.

The U.S. market alone for lower extremity prosthetic limbs could therefore include $3.5 billion per year in new amputee fittings, plus another $9 billion per year in replacement fittings assuming that 25% of the 1.8 million lower extremity amputees in the U.S. replace their prosthetic each year and that the average price of a lower limb prosthetic is $20,000. This is a total market size of approximately $12 billion per year!

The Disruptor
The additional 8 to 18 million amputees in the world, most living outside of wealthy countries, face wrenching financial, health, and social challenges due to limb loss. In India alone, there are an estimated 5.5 million people living with locomotor disabilities arising from polio, congenital
The ReMotion Knee
conditions or amputations largely due to agricultural and traffic accidents. Most of these people cannot afford Western prosthetics, so disruptive companies like the famous Jaipur Foot in northern India have risen to meet the challenge of providing suitable, safe, and affordable prosthetics for Indian patients and low income patients across the globe. In fact, Jaipur Foot is the world's largest fitter of prosthetic limbs by volume, having provided prosthetics to over 1.4 million patients since their founding in 1975.

Jaipur's original prosthetic knee joint for above knee amputees, the Polycentric Jaipur Knee, although low cost and reliable caused problems of undesirable clicking sound, rotational instability and alignment. Over 7000 of these Knees have been fitted since the product's introduction in 2008. The Jaipur Knee was named as one of the world's best inventions by Time Magazine in 2009

D-Rev has helped design Jaipur Foot's next generation above the knee prosthetic leg, the ReMotion Knee, which still retails for less than $80 and operates as a poly-centric knee with world-class performance. More than 79% of patients fitted with the knee are still wearing it, and D-Rev's rules to create world-class products, be user-obsessed, and market driven have resulted in several design improvements that help dampen sound, improve the prosthetic aesthetics, and still maintain low-cost, scalable production potential.

Could The Re-Motion Knee Succeed In the U.S.?
Jaipur and D-Rev are rightly celebrated for providing affordable high-quality prosthetics to the developing world and the need for them to do so is urgent and large. But is there also a market for the ReMotion Knee in the U.S.? Which patients, payers, and providers might welcome the opportunity to fit a $100 above the knee prosthetic that performs 'well enough' to justify the cost savings? Are there enough of them to comprise a viable market and justify the additional cost of seeking FDA approval for ReMotion? How much cost would operating in the U.S. add to the device?

There are indications of demand for more disruptive prosthetics in the U.S. and North America generally. A recent crowd-funding campaign to fund the other half of a Carleton University student's new prosthetic leg came about because, after insurance coverage, he was still left with an out-of-pocket charge of over $10,000. He is not the only one who would find it difficult to pay that bill every 2-4 years.

One non-profit organization called e-NABLE seeks to donate 3-D printed prosthetic limbs to those in need and most of their activity has been within Western markets so far. They have over 5,500 members and have received a Google award of $600,000 for their work.

How many of the approximately 170,000 lower-limb amputees in the U.S. per year would be interested in fitting themselves with a ReMotion Knee?


Addendum from Dr. Pooja Mukul, Technical Director of Paul Hamlyn International Center of Prosthetics & Orthotics at BMVSS, Jaipur:
In 2007 when Mr. D R Mehta, Founder & Chief Patron of BMVSS, was visiting San Francisco he was introduced to some of the faculty at Stanford University by Dr. Armand Neukermans. Mr. Mehta gave a presentation about the work we do at BMVSS which was greatly appreciated at Stanford. Following his visit Dr. Neukermans informed Mr.Mehta that the Stanford University was interested in collaborating with BMVSS and this led to the signing of a formal MOU between BMVSS & Stanford University. 
The first research project that was jointly undertaken was designing a Prosthetic Knee Joint. The team of Stanford students visited BMVSS and after several brainstorming sessions it was decided to base the Knee joint on the Polycentric concept. Therefore from the very outset the design was Polycentric and not monocentric as you had noted in the draft for your blog. 
The first prototype of the Polycentric Jaipur Knee was ready in August 2008. After successfully going through the laboratory tests,clinical trials were commenced.
The initial user feedback in respect to stability in stance, ease of initiation of swing, toe clearance, acceptability, compliance and durability was very positive.
As you may have seen,the Jaipur Knee featured in the Time Magazine's November 2009 issue as one of the 50 best inventions of the world for that year. 
However, on long term follow up, we did have a few mechanical failures and patients voiced some concerns. The patients disliked the clicking sound that the joint made at terminal stance, after prolonged use the threaded portions became loose resulting in sudden rotation of the prosthesis, patients living in hilly or desert terrain suggested that an optional lock would enhance their confidence while negotiating challenging terrain and they also felt that the aesthetics needed to be improved. The joint was designed to interface with the existing prosthetic componentry at BMVSS but after observing the success of the design it was felt that to permit a more widespread use of the design it should be compatible with conventional prosthetic componentry commonly used in centers around the world. The user feedback was shared with the Stanford team that made several trips to BMVSS during the project. Many design modifications were made between 2008 - 2011. 
In 2011 the students graduated and the design was passed on to D-Rev a non profit organization for further development. A formal agreement was then drawn up between BMVSS and D-Rev and we have been working together since. D-Rev rechristened the Jaipur Knee as "ReMotion Knee" after incorporating changes that addressed the problems raised by the users at BMVSS. 
In 2013 we received the Indo-US Science & Technology Forum (IUSSTF) grant to carry out design and cost optimization for mass manufacturability and India Pilot Trials for the ReMotion Knee (which was technically the Version 3 of the Jaipur Knee).
We carried out trials of 41 ReMotion Knees as part of the IUSSTF project. The feedback was passed on to D-Rev, some design modifications were carried out and a Version 4 is now in the process of being manufactured. 
We continue to use the Jaipur Knee (Version 1) and have so far fitted 7350 patients of which 1900 were in 14 countries outside India. 
We are currently working on another project with the Stanford University , in which we are developing a Terminal device for upper extremity amputees. This has all been made possible by Dr. Armand Neukermans who is an ardent supporter of BMVSS.


  1. This comment has been removed by the author.

  2. Teacher Education should include how English language metaphors influence learning. If you use metaphors often to describe information and concepts, it is likely your choice of metaphors impacts your students perception and learning. By recognizing some limitations in our use of metaphors, teachers can see how using positive metaphors effectively can help create positive classroom environments and a positive learning experiences for students.http://www.thesisexample.info/

  3. This is a good idea to invest in re motion knee, although it is expensive but it will be very helpful for paitents who are suffering with such kind of illness.

  4. It's such a miracle that in Surfing Life you are ensured in some things. For example, traumas are no longer a big deal, cause medicine is developing fast these days.

  5. The visibility of such information should be at the highest level.

  6. That is really nice to hear. thank you for the update and good luck. Healthcare Marketing

  7. Awesome Blog!! Visit us www.expressclinics.in

    Express Clinics is India’s fastest growing “Multispeciality Clinic & Diagnostic Chain” having 24 clinics operational across Bengaluru, Delhi, Faridabad, Ghaziabad, Gurgaon, Noida, Navi Mumbai and Pune along with centralized Lab in each location.
    In addition, we also have a network of 3200 affiliate Diagnostic Clinics as our Network Partners, providing coverage in 500+ cities on a pan India basis. An ISO 9001:2015 Certified Enterprise with an NABL Accredited Lab*, Express Clinics currently serves 700+ corporate clients across various industries like Manufacturing, IT & ITES, Hospitality, Pharmaceutical, Banking and Insurance to name a few and has served over 10 Lakhs + retail customers since its inception in March 2011.
    Express Clinics is India’s family healthcare expert building a standardized network of clinics across India providing superior quality healthcare services to meet the needs and demands of each of its customers. Our Integrated model offers General & Specialist Doctor Consultation, Preventive Health Checks, Pathology, Diagnostics, Pharmacy all under one roof. Express Clinics also specializes in providing value added services like Disease Management, Loyalty Cards, Healthcare Apps etc to provide customers a holistic experience.
    Express Clinics engages over 350 doctors across its clinics and these include General Practitioners, Specialists and Super Specialists like ENT, Pediatricians, Gynaecologists, Radiologists, Cardiologists, Dentists, Physiotherapists, Ophthalmologists, Dietitians, etc to serve needs of the Family and Customers from other spheres.

  8. Bitcoin Support Number is the right place where you will get all kind of bitcoin support starting from transaction issues, blockchain issues etc. Bitcoin support service customer helpline number will help you in every possible manner to fix all of the bitcoin wallet problems and glitches.

    bitcoin Customer support number

  9. I found that site very usefull and this survey is very cirious, I ' ve never seen a blog that demand a survey for this actions, very curious... medical records storage

  10. Informative blog, thanks for sharing about Prosthetic Knee. For more orthopedic knee surgery visit orthopedic surgeon in Mulund

  11. Confronting general Mycelium technical glitches while using Mycelium account? then you can contact the Mycelium professionals for various issues, like Mycelium account blocked, security error, forgot password concern. Therefore to get the best support for different problems, you can contact mycelium support phone number providing company.

  12. If you want to get a tech support for forget yobit account password issue, changing the password or resetting Yobit password? then you don’t need to go everywhere. In order to get the right method for these concern, you require to simply depend on a tech support providing company. The firm aims in offer customer support for Yobit related concern to its customers. Dial Yobit support number for fix any issues.

  13. Some medical experts would argue that braces are merely a temporary solution to a long-term problem, and often just delay the possibility of surgical knee replacements. knee support

  14. When I originally left a comment I appear to have clicked on the -Notify me when new comments are added- checkbox and from now on each time a comment is added I get four emails with the same comment. Is there a means you are able to remove me from that service? Thanks a lot!

    KBC Jio Lottery Winner 2020 Check
    KBC Lottery Winner 2020 25 Lakh List
    kbc Lottery Winner List 2020
    Jio Kbc Head Office Number

  15. Informative blog, thanks for sharing about Knee painn and surgery. For more orthopedic knee surgery visit orthopedic surgeon in chennai laparoscopic at mogappair
    emergency hospital in mogappair


  16. Great to read article about berry update which i like reading about it.You have made an excellent effort in making this website which is appreciable. appvalley vip Sydney Brooke Simpson cotomovies streaming app

  17. Wonderful article, Which you have shared about the knee surgery. Your article is very important and I was really interested to read it. If anyone looking for emergency hospital in mogappair

    Critical Care Hospital in Chennai

  18. Coursework can be completed from home and will prepare you for entrance into the workplace. You can begin studies by choosing a career training path to follow and enrolling in an accredited school or college. 2 week cna classes online

  19. Such a website boasted of services such as check-ups when you are well, treatment when sick, total care when pregnant, check-ups and immunizations for children, dental care and prescription drugs and even mental health and substance abuse therapy. diabetic breakfast on the run


  20. Wow, this is fascinating reading. I am glad I found this and got to read it. Great job on this content.I liked it a lot. Thanks for the great and unique info.

    My web page::: 풀싸롱

  21. Where there's a will there's a way! Your are providing such a quality content that am looking for. Keep sharing quality content with us like GBWhatsapp Thank you keep it updated.

  22. People can access the services by subscribing to FuboTv with fubotv/connect code. You can acquire several facilities from fubotv/connect that you expect from any TV service providers. there is always an update error, which gets resolved after you’ve successfully updated it. Try fubotv/connect or log in with your credentials to launch the app. fubotv/connect

  23. Bagi para penggemar yang ingin bermain Slot Online Deposit Pulsa Tanpa Potongan yang tentunya bisa dimainkan dengan sangat mudah dan dimanapun kapanpun kalian inginkan hanya dengan smartphone yang sudah didukung dengan android & IOS bisa langsung mengunjungi situs IDN89 yang sudah terpercaya melalui Slot Online Deposit Pulsa

  24. As you are switching to a newer TV service, you might don’t know much about FuboTV. So, we are here to help you with that. The first question you might have is-how does FuboTV work? FuboTV is an alternative to cable or satellite services where instead of having any of these, you can work with your internet connection. fubo.tv/Connect

  25. Thanks for the detailed article on this topic. I would like to see more such awesome articles from you.

  26. For example, if you would like to earn your Associate or Master of Science degree in nutrition or herbal sciences, there are some healing arts schools and colleges that offer course-intensive studies that allow aspiring natural health practitioners to earn valuable credentials. plant based diet for diabetes

  27. It’s remarkable to visit this web site and reading the views of all mates concerning this paragraph i much like this.

  28. Casinos near Casino Yr Las Vegas, NV - MapYRO
    Casinos 남양주 출장마사지 Near Casino Yr Las Vegas, NV · 1. Red Rock Casino Resort · 2. Hard Rock 충주 출장안마 Hotel & Casino Las 당진 출장샵 Vegas 진주 출장안마 · 3. Treasure Island Hotel & Casino · 4. Wynn 충청북도 출장마사지

  29. Is it not a hassle to wear that one? But, it's really helpful! https://www.aaafencedeck.com