Katana VentraIP

Prosthesis

In medicine, a prosthesis (pl.: prostheses; from Ancient Greek: πρόσθεσις, romanizedprósthesis, lit.'addition, application, attachment'),[1] or a prosthetic implant,[2][3] is an artificial device that replaces a missing body part, which may be lost through physical trauma, disease, or a condition present at birth (congenital disorder). Prostheses are intended to restore the normal functions of the missing body part.[4] Amputee rehabilitation is primarily coordinated by a physiatrist as part of an inter-disciplinary team consisting of physiatrists, prosthetists, nurses, physical therapists, and occupational therapists.[5] Prostheses can be created by hand or with computer-aided design (CAD), a software interface that helps creators design and analyze the creation with computer-generated 2-D and 3-D graphics as well as analysis and optimization tools.[6]

For other uses, see Prosthesis (disambiguation).

Transfemoral (Above-knee)

Transtibial (Below-knee)

Ankle disarticulation (more commonly known as Syme's amputation)

Knee disarticulation

Hip disarticulation

Hemi-pelvictomy

Partial foot amputations (Pirogoff, Talo-Navicular and Calcaneo-cuboid (Chopart), Tarso-metatarsal (Lisfranc), Trans-metatarsal, Metatarsal-phalangeal, Ray amputations, toe amputations).

[19]

Van Nes rotationplasty

 – First non-locking below-knee (BK) prosthesis.

Pieter Verduyn

 – Prosthesis made of a wooden shank and socket, a steel knee joint and an articulated foot that was controlled by catgut tendons from the knee to the ankle. Came to be known as "Anglesey Leg" or "Selpho Leg".

James Potts

Sir  – A new method of ankle amputation that did not involve amputating at the thigh.

James Syme

 – Improved upon the Selpho leg. Added an anterior spring and concealed tendons to simulate natural-looking movement.

Benjamin Palmer

 – Created prosthetic with a suction socket, polycentric knee, and multi-articulated foot.

Dubois Parmlee

& Charles Desoutter – First aluminium prosthesis[37]

Marcel Desoutter

Henry Heather Bigg, and his son Henry Robert Heather Bigg, won the Queen's command to provide "surgical appliances" to wounded soldiers after Crimea War. They developed arms that allowed a double arm amputee to crochet, and a hand that felt natural to others based on ivory, felt and leather.

[38]

Patient procedure[edit]

A prosthesis is a functional replacement for an amputated or congenitally malformed or missing limb. Prosthetists are responsible for the prescription, design, and management of a prosthetic device.


In most cases, the prosthetist begins by taking a plaster cast of the patient's affected limb. Lightweight, high-strength thermoplastics are custom-formed to this model of the patient. Cutting-edge materials such as carbon fiber, titanium and Kevlar provide strength and durability while making the new prosthesis lighter. More sophisticated prostheses are equipped with advanced electronics, providing additional stability and control.[56]

Better muscle control of the prosthetic.

The ability to wear the prosthetic for an extended period of time; with the stump and socket method this is not possible.

The ability for transfemoral amputees to drive a car.

Cosmesis[edit]

Cosmetic prosthesis has long been used to disguise injuries and disfigurements. With advances in modern technology, cosmesis, the creation of lifelike limbs made from silicone or PVC, has been made possible.[131] Such prosthetics, including artificial hands, can now be designed to simulate the appearance of real hands, complete with freckles, veins, hair, fingerprints and even tattoos. Custom-made cosmeses are generally more expensive (costing thousands of U.S. dollars, depending on the level of detail), while standard cosmeses come premade in a variety of sizes, although they are often not as realistic as their custom-made counterparts. Another option is the custom-made silicone cover, which can be made to match a person's skin tone but not details such as freckles or wrinkles. Cosmeses are attached to the body in any number of ways, using an adhesive, suction, form-fitting, stretchable skin, or a skin sleeve.

Fit – athletic/active amputees, or those with bony residua, may require a carefully detailed socket fit; less-active patients may be comfortable with a 'total contact' fit and gel liner

Energy storage and return – storage of energy acquired through ground contact and utilization of that stored energy for propulsion

Energy absorption – minimizing the effect of high impact on the musculoskeletal system

Ground compliance – stability independent of terrain type and angle

Rotation – ease of changing direction

Weight – maximizing comfort, balance and speed

Suspension – how the socket will join and fit to the limb

Cost and source freedom[edit]

High-cost[edit]

In the USA a typical prosthetic limb costs anywhere between $15,000 and $90,000, depending on the type of limb desired by the patient. With medical insurance, a patient will typically pay 10%–50% of the total cost of a prosthetic limb, while the insurance company will cover the rest of the cost. The percent that the patient pays varies on the type of insurance plan, as well as the limb requested by the patient.[148] In the United Kingdom, much of Europe, Australia and New Zealand the entire cost of prosthetic limbs is met by state funding or statutory insurance. For example, in Australia prostheses are fully funded by state schemes in the case of amputation due to disease, and by workers compensation or traffic injury insurance in the case of most traumatic amputations.[149] The National Disability Insurance Scheme, which is being rolled out nationally between 2017 and 2020 also pays for prostheses.


Transradial (below the elbow amputation) and transtibial prostheses (below the knee amputation) typically cost between US $6,000 and $8,000, while transfemoral (above the knee amputation) and transhumeral prosthetics (above the elbow amputation) cost approximately twice as much with a range of $10,000 to $15,000 and can sometimes reach costs of $35,000. The cost of an artificial limb often recurs, while a limb typically needs to be replaced every 3–4 years due to wear and tear of everyday use. In addition, if the socket has fit issues, the socket must be replaced within several months from the onset of pain. If height is an issue, components such as pylons can be changed.[150]


Not only does the patient need to pay for their multiple prosthetic limbs, but they also need to pay for physical and occupational therapy that come along with adapting to living with an artificial limb. Unlike the reoccurring cost of the prosthetic limbs, the patient will typically only pay the $2000 to $5000 for therapy during the first year or two of living as an amputee. Once the patient is strong and comfortable with their new limb, they will not be required to go to therapy anymore. Throughout one's life, it is projected that a typical amputee will go through $1.4 million worth of treatment, including surgeries, prosthetics, as well as therapies.[148]

(1768–1854), whose leg was amputated at the Battle of Waterloo

Henry William Paget, 1st Marquess of Anglesey

(1900–74), child survivor of industrial accident

Marie Moentmann

(1958–81), Canadian athlete, humanitarian, and cancer research activist

Terry Fox

(born 1986), South African former professional sprinter

Oscar Pistorius

(1914–2002), WWII veteran, Academy Award-winning actor

Harold Russell

Fayetteville Observer

Afghan amputees tell their stories at Texas gathering

PBS Newshour

Can modern prosthetics actually help reclaim the sense of touch?

Fayetteville Observer

A hand for Rick

Archived 2022-07-18 at the Wayback Machine

What is prosthesis, prosthetic limb and its various component

by Britt H. Young

I have one of the most advanced prosthetic arms in the world – and I hate it

A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions