Advanced Prosthetics

By

Alasdair GilbertsonSenior Prosthetist ottobock Healthcare

Berlin 1919

Duderstadt 2014. Lower Saxony

CAD/CAM

Information TechnologyCar components

Paralympics service provider

Orthotics

Specialist Seating

Upper limb amputees 11,000

Lower limb amputees 52,000

Number of UK amputees

01002003004005006007008009001000

Number

Under16

16-54 55-64 65-74 75+

Age

Female

Male

Age distribution of UK amputees

0

10

20

30

40

50

60

%

PVD Diabetes +PVD

Trauma Malignancy Congenital Other

Cause

Aetiology of lower limb amputation

Causes of lower limb amputation

200-300 children every year in the UK

• Congenital absence• Congenital deformity resulting in amputation• Sarcoma, infection• Acquired amputation

Annual number of UK young amputees

Acquired limb deficiency or amputation is not as common as congenital limb deficiency in children.

Frequent causes of trauma are hands or feet caught in machinery, or motor vehicle and lawn mower injuries.

Severe infections and interruptions to the blood supply to limbs, such as occurs in meningococcal septicaemia, can cause multiple limb loss.

Bone or soft tissue tumours may require amputation as a life-saving measure along with other cancer treatment. Phantom pain can occur after amputation in children and may require medication along with other types of treatment.

Approximately 3200 cases of bacterial meningitis and associated septicaemia in the UK each year.

10%-15% of cases result in amputation

• Restore function • Stabilize joints • Cosmetic appearance

13

Egyptian prosthetic toe 950-710 BCCapua Leg 300 BC

World War 1 Circa 1950 gas powered prostheses

Residual limb is wrapped in Plaster of Paris bandage.

Plaster model is modified.

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Carbon fibre

Titanium

Silicones

Plastics

Components

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Computer Aided Design and manufacture (CAD/CAM)

Otto Bock Michelangelo Hand

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Genium

Genium X3

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Microprocessor controlled knees……the next generation.

Gyroscope, AccelerationSensor and Angle Sensor

Knee Moment Sensor

AXON Tube Adapter

Hydraulic Cylinder

Battery and Electronics

BluetoothR

Inductive Charging

Blue tooth Programming

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Laser Alignment

Genium. Walk naturally..wmv

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http://www.luxuo.com/wp-content/uploads/2012/08/Aimee-Mullins.jpg

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Getting back to normal life

Multi-Disciplinary Team approach

Upper limb Amputee

• Patient• Rehabilitation consultant• Prosthetist• Occupational Therapist• Parents & Teachers• Counsellor

Lower limb Amputee

• Patient• Rehabilitation consultant• Prosthetist• Physiotherapist and/or Occupational Therapist• Parents & Teachers• Counsellor

Prosthetic management

• Work with your clinical team

Problems with wearing a Prosthesis

• Increase in energy levels• Phantom limb pain• Folliculitis• etc

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Outcomes data

Maintain or improve mobility, socket comfort, gait and satisfaction as measured by valid reliable, standardised outcome measures

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Outcome are evaluated via patient performance tests and questionnaires

Performance based tests Self-reported Questionnaires

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Fitness App for Lower Limb Amputees

• The app consists of 2 modules: “Strength & Endurance” and “Coordination & Balance” and offers 16 exercises and three difficulty levels.

• The exercises require no workout equipment beyond a cushion or a football, and the instructions are simple to follow.

• Amputees can take this ‘personal trainer’ with them anywhere, and integrate the exercises into their everyday fitness or therapeutic routine.

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Thank You

Any Questions?