3D printed AFO: How digital technology is changing ankle-foot orthoses

Introduction

An ankle-foot orthosis can look straightforward. A shell around the lower leg. Support around the ankle. A foot section underneath.

But anyone who has designed or fitted an AFO knows that the real work is in the details.

Where should the device contact the limb? How much correction is appropriate? Where does it need to be stiff, and where can it give? How should the trimlines sit? What happens when the patient actually walks in it?

These decisions begin with understanding the patient.

For years, AFO fabrication has relied heavily on physical casting, manual modification and the experience of the orthotist. Those methods remain clinically valuable. But digital technology is changing what is possible between the initial assessment and the finished device.

With 3D scanning, clinical assessment, digital design tools and additive manufacturing, the patient's anatomy can move from a physical form into a connected digital workflow. Within BenX, the digital anatomy becomes the foundation for clinical design, allowing orthotists to translate clinical requirements into patient-specific geometry, modify contours, trimlines, reliefs and thickness, review the design and then move the approved, manufacturing-ready model into production.

The shift from casting to digital anatomy

The first step in any customized AFO is understanding the patient's anatomy.

Traditionally, this might involve taking a physical cast of the limb and modifying it before fabrication. Digital workflows approach the same task differently.

A 3D scanner can capture the surface geometry of the lower leg and foot and convert it into a digital model. That model can then become the starting point for the design process.

A systematic review comparing 3D scanning with traditional methods found that digital approaches can provide a practical alternative for capturing foot and ankle morphology, with the resulting data usable in CAD-based orthotic workflows. The review also highlighted an important point: the quality and reliability of the captured anatomy still matter. PubMed Central (PMC)

A 3D scan doesn't replace a clinical assessment.

It simply gives the clinician a different way of capturing and working with the patient's anatomy.

BenScan captures patient-specific anatomy digitally, while BenX connects that anatomy to clinical assessment, orthotic design, design review and manufacturing workflows.

The scan is only the beginning

There is a tendency to think that once a patient's limb has been scanned, the rest can simply be automated. Clinical reality is different.

The scan tells you what the limb looks like. It doesn't tell you why it looks that way or what the patient needs from the orthosis. A patient may have foot drop, spasticity, weakness, instability or a completely different functional requirement. Two people with similar anatomical measurements may therefore need very different AFO designs.

This is why the digital workflow needs to keep the clinician involved. The assessment still matters. So do pressure-sensitive areas, footwear, activity level and the way the patient is expected to use the device.

Digital technology captures information. Clinical expertise gives that information meaning. That distinction is at the heart of good digital orthotic design.

Digital CAD is where the real transformation happens

he value of a digital workflow is not simply that it produces a 3D model. The important step is what happens to that model next.

BenX is designed around the transition from digital anatomy to clinically controlled digital orthotic design. Patient-specific anatomy provides the starting geometry, while the clinician remains responsible for determining the functional requirements of the AFO. The digital design environment can then be used to translate those requirements into changes in contour, trimlines, thickness, relief and other design parameters.

This means the digital workflow is not simply Scan → Print. It is:

Scan → Clinical Assessment → Digital Design → Design Review → Manufacturing → Fitting → Outcome Assessment

The design stage is where clinical knowledge is converted into a manufacturable digital device.

Why 3D printing changes more than manufacturing?

This is probably the most important distinction to make.

3D printing is often presented simply as a faster way to manufacture an existing design. But in a digital orthotic workflow, its significance is much greater: it allows the physical AFO to be manufactured directly from the patient-specific digital design. This creates a continuous connection between what was designed digitally and what is ultimately manufactured physically. The manufacturing technology therefore becomes an extension of the digital design process rather than a separate fabrication step.

Because the device is manufactured directly from a digital model, the design itself can take advantage of geometries that may be more difficult or time-consuming to produce using conventional fabrication methods.

A 2019 systematic review found that 3D-printed AFOs had biomechanical and mechanical characteristics broadly comparable with traditionally manufactured AFOs, while also identifying potential advantages in design freedom, stiffness optimization, weight optimization and ease of use. PubMed Central (PMC)

More recent evidence is encouraging..

A 2025 systematic review included 28 studies on 3D-printed AFOs. It found that walking speed and step length were mostly improved in studies comparing 3D-printed AFOs with other AFOs or no AFO, while satisfaction was generally similar to or higher than traditional AFOs. . PubMed Central (PMC)

So the takeaway isn't: "3D printing is better than traditional fabrication." It is more nuanced: 3D printing creates another set of design and manufacturing possibilities that clinicians can use when they are appropriate for the patient.

Where HP MJF fits into the workflow

Once the digital AFO has been designed, it still needs to become a physical device.

This is where HP Multi Jet Fusion (MJF) comes into the picture. MJF is an additive manufacturing technology that can produce polymer components directly from digital designs. For O&P, this is particularly valuable because it allows the physical device to closely follow the geometry established during the digital design stage.

One of the key advantages of MJF is its ability to manufacture complex, patient-specific geometries with good dimensional consistency and durable materials such as PA12. Using materials such as PA12, MJF can produce durable components with controlled geometry while keeping the finished device relatively lightweight. This can be especially relevant for AFOs, where structural performance needs to be balanced with patient comfort and everyday wearability.

There is already clinical research demonstrating this type of workflow. In a study involving people after stroke, researchers captured ankle and foot anatomy using a 3D scanner, digitally modified the AFO design, and manufactured patient-specific AFOs from PA12 using Multi Jet Fusion. PubMed

That sequence is important: Scan → Assess → Design → Review → Manufacture. The physical device does not need to be recreated from scratch after the digital design has been finalized. Instead, the manufacturing process can remain directly connected to the digitally defined geometry.

For BenGait, HP MJF is therefore not simply a standalone manufacturing technology. It forms part of a broader digital pathway in which the patient's anatomy, clinically controlled design, and final physical device remain connected, enabling precision-engineered, lightweight, and digitally customized orthotic solutions.

Can a 3D printed AFO be lighter?

Potentially.. but this needs a little more nuance than the usual marketing claim.

Digital design gives clinicians and designers greater freedom to consider where material is actually needed and where geometry can potentially be optimized. That can create opportunities to reduce unnecessary bulk and make it lightweight by optimizing geometry, weight distribution, stiffness and structural performance through digital design techniques such as thickness control and lattice structures.

An AFO can be technically successful but still fail in everyday life if the patient finds it uncomfortable, cumbersome or difficult to wear with their footwear.

Research into 3D-printed AFOs has reported positive findings around comfort and satisfaction in some patient groups. For example, one study comparing different 3D-printed AFO materials in people with post-stroke ankle dorsiflexion problems specifically evaluated patient experience and feedback. PubMed

But lighter is not automatically better. An AFO still needs to provide the mechanical characteristics required for its intended function.

The goal should therefore be appropriate weight, not minimum weight. That is one of the advantages of having control over the digital geometry: weight, stiffness, strength and fit can be considered together.

The digital AFO journey, step by step..

1. 3D scanning

The patient's lower-limb anatomy is captured digitally using BenScan. The result is a digital representation that can be used throughout the design workflow.

2. Clinical assessment

The clinician evaluates the patient's condition, movement, functional goals, alignment, pressure considerations and expected use of the AFO. This step remains fundamental.

3. Clinical Digital Design

The scanned anatomy becomes the foundation for a customized design. Geometry, trimlines, reliefs, thickness, stiffness regions and other design elements can be adjusted according to clinical requirements.

4. HP MJF manufacturing

The finalized digital model moves into additive manufacturing, where the physical AFO is produced from the approved design.

5. Fitting and outcome assessment

This is where the digital model meets reality. The AFO needs to be fitted, assessed and reviewed with the patient. If modifications are needed, the design can be revised using the existing patient anatomy and design data, creating a continuous digital record across multiple iterations.

What digital technology should not do?

The biggest opportunity in digital orthotics also comes with a responsibility. Technology should not turn clinical design into a button-clicking exercise.

A preset may be useful as a starting point in some workflows. But it shouldn't dictate the final design when the patient's anatomy or clinical requirements call for something different. The clinician understands the patient, function and treatment goals. The software provides the digital tools to translate those decisions into geometry.

The best workflow brings those two together.

That means giving orthotists the ability to make deliberate modifications, understand what they are changing and retain control over the final design.

For us, that's a much more meaningful definition of digital customization than simply taking a scan and automatically producing a brace.

The real advantage is the connected workflow

When people talk about digital AFOs, conversations often focus on the scanner or the printer.

But neither one tells the whole story. The scanner captures anatomy. CAD provides the design environment. Manufacturing creates the physical device. Clinical assessment connects all three. That is why the real shift is from a collection of individual technologies to a connected workflow:

Patient → Digital Anatomy (BenScan) → Clinical Assessment → Digital Design (BenX) → Design Review → Manufacturing (HP MJF or other methods) → Fitting → Outcome Assessment → Design Iteration

The important point is that these are not isolated steps. The patient's digital anatomy provides the foundation for design; clinical findings influence the design decisions; the approved digital design drives manufacturing; and fitting and outcome assessment can provide information for subsequent clinical decisions and design iterations

Each stage informs the next. And because the process is digital, the design can remain connected to the patient's anatomical data rather than being separated into disconnected physical stages. This is where customized AFO design starts to become genuinely different.

3D printing is a design opportunity, not just a printer

The future of orthotics isn't necessarily about choosing between traditional fabrication and 3D printing.

There will always be cases where different materials, fabrication techniques and clinical approaches make sense.

The more interesting question is:

What can clinicians do differently when anatomy, design and manufacturing are connected digitally?

That question goes beyond printing. It opens up possibilities for more patient-specific geometry, controlled thickness variation, digital documentation, easier design iteration and a more direct connection between clinical intent and the manufactured device.

And that is how we see the role of 3D printing at BenGait Labs.

Bringing the digital journey together with BenScan

At BenGait Labs, the goal is to make this digital journey more connected through BenX—bringing patient-specific digital anatomy, clinical information and orthotic design into a unified workflow

BenScan provides patient-specific digital anatomy, while BenX connects assessment, clinical design, design review and manufacturing into a single digital workflow. The workflow can move from patient-specific 3D anatomy and clinical assessment into customized AFO design and, ultimately, digitally driven manufacturing.

From capturing anatomy to refining the digital geometry and moving toward advanced manufacturing, the focus remains on maintaining a clear connection between what the clinician observes and what ultimately gets designed.

That is the real opportunity of digital orthotics: not simply to scan faster or print differently, but to change how customized orthoses are designed, reviewed, manufactured and ultimately delivered to the patient.

Learn how BenScan brings 3D scanning, clinical assessment and digital AFO design into one workflow.

See how a connected approach can take an AFO from patient anatomy → clinical assessment → digital design → HP MJF manufacturing → fitting and outcome assessment.

Frequently Asked Questions (FAQs)

A 3D printed AFO is an ankle-foot orthosis manufactured using additive manufacturing from a digital design. The design can be customized using patient-specific anatomical information captured through 3D scanning and modified using CAD.

What is a 3D printed AFO?

How does 3D scanning help with AFO fabrication?

3D scanning captures the patient's lower-limb anatomy digitally. That information can then be imported into a CAD workflow, where the clinician or designer can modify the geometry before manufacturing. Research suggests digital scanning can be a useful alternative to traditional methods of capturing foot and ankle morphology, although scan quality and reliability remain important. PubMed Central (PMC)

Can 3D printed AFOs be customized for individual patients?

Yes. One of the main advantages of a digital workflow is the ability to create patient-specific geometry based on anatomical data and clinical requirements.

Why is CAD important in digital AFO design?

CAD allows the digital geometry of the AFO to be modified before manufacturing. This can provide greater control over parameters such as contour, trimlines and thickness and allows the design to be reviewed before the physical device is produced.

What is HP MJF?

HP Multi Jet Fusion is an additive manufacturing technology used to produce polymer components directly from digital models. Research has demonstrated its use in manufacturing patient-specific PA12 AFOs following digital scanning and CAD modification. PubMed

Does 3D printing replace the need for an orthotist?

No. 3D printing does not replace clinical expertise. Orthotists remain responsible for patient assessment, prescription, design decisions, fitting and outcome evaluation. Digital tools support clinical decision-making and design but do not replace the clinician.

From anatomy to a patient-specific AFO design

Once the anatomy has been captured and clinically assessed, digital design becomes the central stage of the workflow. This is where clinical requirements are translated into the geometry of the AFO. Unlike a workflow that moves quickly from a physical cast to manual modification, a digital workflow allows the clinician to develop, review and refine the design before the physical device is manufactured.

CAD provides the ability to modify the geometry digitally and see the design evolve from overall contour and trimlines to relief areas, wall thickness and regional stiffness

With a digital design platform such as BenX, the clinician can work directly with the patient's digital anatomy and control important design parameters including overall contour, trimlines, relief areas, wall thickness and regional stiffness. The objective is not simply to reproduce the patient's anatomy, but to modify that anatomy-derived geometry according to the clinical requirements of the AFO. This creates a more deliberate design process: the clinician can start with patient-specific anatomy, apply clinical modifications, evaluate the resulting geometry and refine the design before committing to manufacturing.

An AFO does not necessarily need to behave identically across its entire structure. Different areas may have different functional requirements, and digital design makes it easier to explore those differences while maintaining a continuous overall geometry. This can create opportunities to balance: Support + stiffness + weight + comfort rather than treating the AFO as a uniform shell.

But there is an important caveat. More control doesn't automatically mean better clinical outcomes. The clinician still has to decide what should be changed and why. That is why we believe good digital orthotic software should not force clinicians into rigid presets. The technology should give the clinician room to apply their own assessment and experience.