Week 4: Where Can Prosthetics Go??

Hello again!

For this post I hope to discuss the direction prosthetics are moving towards in the future.

Let’s begin with lower limb amputees. At McCleve, I learned of a new innovative operation not currently available within the United States but offered elsewhere known as direct skeletal fixation. This operation fuses a metal rod into the remaining bone fixing it in place as an elongation to replace the missing bone. The procedure allows for more realistic control and feeling of the leg as the prosthetic does not require a suction device to hold it in place. This type of procedure is only in research settings currently in the United States but can be done elsewhere. One such patient flew from the United States to Australia to undergo this operation. While increasing the chances of infection with such a foreign body, the benefits of a successful operation are well beyond that of conventional prosthetics. Another recent innovation in prosthetics comes with the Power Knee which allows patients to use stairs, having a more functional knee. Such a device has its limitations as it is quite bulky but can have such a huge impact allowing users to ascend and descend stairs which normal prosthetics are unable to do. 

The above images show both the X-ray view and the view post operation of the direct skeletal fixation procedure.

I had the opportunity to meet with an Ossur representative, one of the leading companies in prosthetic parts from silicon sleeves to power knees, learning about this new device. In addition I was also shown a new type of prosthetic foot which has a split toe to provide more range of motion and increased balance. Such a small change can have a huge impact on the functionality of the limb. In general, the industry is slowly improving, year after year increasing strength and movement of the device while decreasing the overall weight. 

One very new research project has been able to create a prosthetic leg that is controlled by neural impulses communicating with the leg’s computer. Rather than the myoelectric signals that are currently used in the iLimb device (in upper extremities) this type of leg relies solely on the nerve signals. Another kind of similar cutting-edge form of prosthetic comes in the form of targeted muscle reinnervation (TMR) surgery. By redirecting the amputated nerves elsewhere in the body with functional nerves one can allow the user to control the prosthetic with the activity readings of the redirected nerve. Because the nerve is intact the use of the nerve will cause the movement. Although only research stages such operations and devices could revolutionize the capabilities of prosthetic devices.

Above is an image of prosthetic leg controlled by neural impulses and what nerves it focuses on.

Until next week! 

Sebastien Gilmour 

Images retrieved from: 

http://www.amputeeimplantdevices.com/wp-content/uploads/2014/12/Standing-xray1-e1418430132653.jpg

https://blesma.org/media/231277/IMG_5343.jpg

http://www.proklinik.com.tr/en/prosthetics/lower-extremity/microprocessor-knees/power-knee/

http://www.wired.com/2013/10/is-this-brain-controlled-bionic-leg-the-future-of-prosthetics/