VA Puget Sound Veteran receives first personalized 3D printed prosthetic socket
For years, retired Air Force Staff Sgt. William Stuart endured pain from a lump on his foot, brushing it off as just another battle scar from his time in service. But when he finally sought help, doctors diagnosed him with cancer.
Two days later, he was medevacked out, and his foot and ankle were amputated. Decades later, Stuart is at the forefront of personalized care as the first Veteran to receive a revolutionary 3D printed prosthetic socket fabricated using an entirely VA integrated workflow.
It was the VA Puget Sound Health Care System X_Labs team that pioneered the new integrated workflow leading to the VA’s first-ever definitive 3D printed transtibial socket using digital tools customized for Veterans—an innovation that Stuart would become the first recipient of. Along with spearheading the development, X_Labs also coordinated the collaboration across the VA and private sector to bring this groundbreaking prosthetic solution to life.
For Stuart, the opportunity to be the first Veteran to receive this cutting-edge prosthetic socket was deeply meaningful. “It was an honor,” he said, recognizing that participation would help pave the way for other Veterans to benefit from this breakthrough technology.
“The process began with the X_Labs team designing a streamlined, integrated process that allowed experts across multiple VA facilities and industry partners to contribute seamlessly,” said VA Puget Sound X_Labs Product Development Engineer Alex Berardo-Cates, who headed up the transtibial socket workflow for the prototype. “We sourced industry experts—HP, Red Duke Strategies and Radii Devices—to complement and expedite our VA capabilities through an integrated workflow.”
Roseburg VA Health Care System’s Prosthetist and Orthotist George Gregory, who works at the Eugene Clinic where Stuart is enrolled for care, first gathered key data on residual limb shape, Veteran needs and activities, wearability requirements, any sensitive areas of the limb using a diagnostic check socket—essentially a custom blueprint for the internal shape of the final socket. This data was then sent to the VA’s Northwest Integrated Network (VISN 20) Central Fabrication Unit (CFU) where it was cast with plaster to create an exact internal mold. This mold was then 3D scanned to generate a digital model of the final shape in preparation for 3D printing.
Once scanned in 3D, the digital model was refined by VISN 20 CFU Certified Orthotic and Prosthetic Technician Matt Kovari, who used it to 3D print the socket out of a high-performance plastic. At this stage, Stuart’s socket was further personalized—not just for fit, but also with meaningful details: the U.S. Air Force emblem was imprinted on the front, and wings were added to the back.
From there, industry partner HP finished the part and enhanced the socket’s durability and aesthetics, applying a specialized dye and vapor smoothing process before returning the final socket to VISN 20 CFU for assembly. Once assembled, the device was sent back to Gregory at the VA Eugene Community Clinic where Stuart tried it on the for the first time. With his feedback guiding refinements, they perfected the socket by the third iteration, achieving an optimal balance of comfort, function and personalization.
Maintaining all the benefits of the VA digital infrastructure, the VA Puget Sound X_Labs Team built the toolsets and workflow from the ground up, ensuring robust data and network security. Everything was tested and documented so it can be replicated across the VA, to support personalized health care solutions for Veterans and their providers who would like to access these tools and resources.
“Our goal is to support the best Veteran outcomes,” added Berardo-Cates. “We also want to support and empower our clinicians with the best possible tools and resources available.”
VA Puget Sound X_Labs hopes to finalize the protype before the end of the year, laying the groundwork for its availability across VA nationally in 2026. “Once we feel we’ve mastered this socket – we would like to move to another device. It is a big investment on the front end, with long-term, lasting returns,” added Berardo-Cates.
This achievement—driven by VA Puget Sound X_Labs from concept to completion—marks a turning point in Veteran prosthetic care, showcasing the VA’s ability to lead in medical innovation while improving the lives of those who served. As Stuart put it, “Makes me feel great that the VA is on top of technology and wanting to improve the lives of Veterans. I think it is wonderful.”
Through its innovations arm—X_Labs—VA Puget Sound is an early adopter of 3D printing technology in several medical applications and seen as a leader in the field. With groundbreaking technology—from the new transtibial socket to creating a recipe for living bio-printed bone—it is reshaping how prosthetics are designed, offering Veterans across the country additional solutions and resources to address their unique needs.
And for Stuart, it’s not just a personal victory—it’s a glimpse into the future of Veteran health care.
VA Puget Sound provides comprehensive care to approximately 160,000 Veterans across the Pacific Northwest enrolled with a primary care team at one of its care sites: two main campuses (American Lake and Seattle), six outpatient clinics (Mount Vernon, Oak Harbor, Olympia, Port Angeles, Puyallup and Silverdale) and two Community Resource & Referral Centers (Georgetown in Seattle and Renton). For more information visit www.va.gov/puget-sound-health-care or call 800-329-8387. For Veterans in Crisis, please use the Veterans Crisis line at 988 (press 1).