title: Designing for scale: development of the ReMotion Knee for global emerging markets.
abstract: Amputees living in developing countries have a profound need for affordable and reliable lower limb prosthetic devices. The World Health Organization estimates there are approximately 30 million amputees living in low-income countries, with up to 95% lacking access to prosthetic devices. Effective prosthetics can significantly affect the lives of these amputees by increasing opportunity for employment and providing improvements to long-term health and well-being. However, current solutions are inadequate: state-of-the-art solutions from the US and Europe are cost-prohibitive, while low-cost devices have been challenged by poor quality and/or unreliable performance, and have yet to achieve large scale impact. The introduction of new devices is hampered by the lack of a cohesive prosthetics industry in low-income areas; the current network of low-cost prosthetic clinics is informal and loosely organized with significant disparities in geography, patient volume and demographics, device procurement, clinical and logistical infrastructure, and funding. At D-Rev (Design Revolution) we are creating the ReMotion Knee, which is an affordable polycentric prosthetic knee joint that performs on par with devices in more industrialized regions, like the US and Europe. As of September 2012, over 4200 amputees have been fitted with the initial version of the ReMotion Knee through a partnership with the JaipurFoot Organization, with an 79% compliance rate after 2 years. We are currently scaling production of the ReMotion Knee using centralized manufacturing and distribution to serve the existing clinics in low-income countries and increase the availability of devices for amputees without access to appropriate care. At D-Rev, we develop products that target these customers through economically-sustainable models and provide a measurable impact in the lives of the world's amputees.
authors.affiliation: D-Rev: Design Revolution, 695 Minnesota Street, San Francisco, CA 94107, USA. shamner@d-rev.org
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Hamner
authors.forename: Vinesh G
authors.initials: VG
authors.lastname: Narayan
authors.forename: Krista M
authors.initials: KM
authors.lastname: Donaldson
mesh_terms: D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000191:economics* / Q000592:standards* / Q000600:supply & distribution* / Q000639:trends; D008297:Male; D011474:Prosthesis Design / Q000191:economics* / Q000639:trends; D014944:World Health Organization