SAN FRANCISCO, Calif. (Ivanhoe Newswire) — Nearly two million Americans currently use a prosthetic device. And as a result, a new push in research is advancing the technology for artificial limbs. One of them is called osseointegration. It‘s set to revolutionize the lives of some amputees.
For most of us, lifting 90 pounds is not easy. But, imagine doing it with only one leg. It’s one of the many challenges Munya Mahiya has tackled thanks to a near bionic prosthetic.
“I’d say, it’s amazing. I used to use the socket prosthetic. I couldn’t sit in it for a long time. It would just pop off,” Munya shared.
The switch came for Munya when he discovered a cutting-edge procedure at UC San Francisco called osseointegration. It borrows the basic concept used for a dental implant.
“For patients with amputation, we are now able to secure the titanium implant directly to a person’s thigh bone or femur, and directly connect it to an external prothesis. This allows the patient to walk much better and much more comfortably,” explained Richard J O’Donnell, MD, Professor of Clinical Orthopaedic Surgery, UCSF.
Munya continued, “I have better control of my prosthetic because it’s like now connected to my skeletal frame.”
To get to that point, a team of doctors led by O’Donnell performed the osseointegration over a multiple phase process.
“The first time they go in, they hollow out the bone and they put in a fixture that stays in your bone and they try to make sure that the bone grows around it,” stated Munya.
“Six months later the stage two surgical procedure takes place with some skin grafting,” Dr. O’Donnell said.
That’s followed by a fitting for a short prosthetic.
“So, essentially what we had to do was relearn how to stand on my knees,” said Munya.
After six short weeks, Munya received his permanent prosthetic.
“It makes it a lot more easy,” smiled Munya.
Osseointegration is an invasive process. So, doctors recommend it first to those who don’t have a comfortable fit with a traditional socket prosthetic. And for those patients, like Munya, the benefits are worth it. The prosthetic always attaches correctly, remains in place, and is free from pain. In addition to UCSF, John Hopkins, Walter Reed and St. Luke’s in Denver also offer osseointegration.
Contributors to this news report include: Jennifer Winter, Producer; Roque Correa, Editor; and Rusty Reed, Videographer.
OSSEOINTEGRATION: NEARLY BIONIC!
BACKGROUND: A prosthetic is an artificial substitute or replacement of a part of the body. It’s a custom fit artificial limb, known as “prostheses.” A prosthesis can improve the function and lifestyle of a person who has lost a limb. The prosthesis must be a unique combination of appropriate materials, alignment, design, and construction. Prosthetics used for lower limb loss can help with stability in standing and walking, shock absorption, energy storage and return, cosmetic appearance, and even running, jumping, and other athletic activities. Prosthetics used for upper limb loss can help with reaching and grasping, occupational challenges including hammering, painting, or weight lifting, and activities of daily living like eating, writing, and dressing. A person may have been born with limb deficiency or have experienced amputation due to trauma, cancer, infection, or abnormalities in blood vessels or nerves.
VARIOUS TYPES OF PROSTHESES: There are two types of transradial prostheses, or an artificial limb that replaces an arm missing below the elbow. The cable operated limb works by attaching a harness and cable around the opposite shoulder of the damaged arm. The myoelectric arm works by sensing when the muscles in the upper arm moves, causing an artificial hand to open or close. A transfemoral prosthesis is an artificial limb that replaces a leg missing above the knee. A patient must use approximately 80% more energy to walk than a person with two legs. The newer designs include hydraulics, carbon fiber, mechanical linkages, motors, computer microprocessors, which give more control to the user. A transtibial prosthesis is an artificial limb that replaces a leg missing below the knee. Patients usually regain normal movement faster than someone with a transfemoral amputation, due in large part to retaining the knee, which allows for easier movement. A transhumeral prosthesis is an artificial limb that replaces an arm missing above the elbow. These patients experience some of the same problems as transfemoral amputees, due to the similar complexities associated with the movement of the elbow. This makes mimicking the correct motion with an artificial limb very difficult.
TAILORING TREATMENT: The greatest limiting factor of transplantation is the patient’s tolerance to the immunosuppression treatment that is required. Specialists at Johns Hopkins are designing, and continually refining, a groundbreaking protocol of minimal immunosuppression. “Because side effects and drug toxicities are minimized, this protocol could open up the field of extremity transplantation to become more mainstream,” said Gerald Brandacher, MD, Professor of Plastic and Reconstructive Surgery. The milder protocol involves an antibody to deplete immune cells at the time of transplantation, followed by a single immunosuppressive agent at low levels immediately after surgery. Then, bone marrow cells from the donor are infused two weeks later to modulate, rather than suppress, the recipient’s immune system. W.P. Andrew Lee, MD, Hand and Reconstructive Surgeon, said, “There are other centers in the world that perform hand and face transplants, but our program is unique in using an immuno-modulatory protocol that minimizes the side effects of medications for the transplant recipients. We believe it is a critical aspect to make these types of transplants widespread,”.
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