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Draft:Outline of prosthetics

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The following outline is provided as an overview of and topical guide to prosthetics:

Prosthetics refers to the field of designing, fabricating, and fitting artificial devices, or prostheses, to replace missing body parts. These devices serve various purposes, from restoring functionality to enhancing appearance. Prosthetics is an interdisciplinary field, drawing on medicine, engineering, and material science.Encyclopædia Britannica. (2023). Prosthetics. Retrieved from Britannica.com.

Although prosthetics as a separate discipline separated in the 19th century, information about it can be found in ancient times - from the Greek historian Herodotus,the Roman historian Pliny the Elder and others. Ambroise Paré (1510–1590) is a french surgeon widely regarded as the father of modern surgery and prosthetics. He introduced mechanical prostheses, including hinged artificial limbs, and emphasized anatomical accuracy.Oxford English Dictionary (2023). Definition of "prosthetic". Retrieved from Oed.com.

Branches of Prosthetics

Body Part

  • Upper limb prosthetics: artificial hands, arms, shoulders.
  • Human leg prosthetics: artificial feet, legs, hips.
  • Craniofacial prosthetics: replaces parts of the face (e.g. the nose, ear, jaw)
  • Ocular prosthetics: artificial eyes.
  • Dental prosthetics: dentures, bridges, implants.
  • Breast prosthetics

Function

  • Functional prosthetics: Designed for specific tasks, such as walking, grasping, or lifting.Farina, D., & Aszmann, O. C. (2014). Bionic Limbs: Clinical Reality and Ethical Considerations. Science Translational Medicine, 6(257), 257ps12. ISBN:10.1126/scitranslmed.3008939.
  • Cosmetic prosthetics: Focused on appearance rather than mechanical functionality.
  • Bionic and Robotic prosthetics: Integrate advanced technology for enhanced functionality, often controlled by neural signals.Herr, H. (2009). Exoskeletons and Orthoses: Classification, Design Challenges, and Future Directions. Journal of NeuroEngineering and Rehabilitation, 6(21).ISBN 10.1186/1743-0003-6-21

Components of Prosthetic device

== '''Structural elements:''' ==

  • Prosthetic socket: he socket serves as the interface between the prosthetic limb and the residual limb. It is a critical component that ensures comfort, stability, and functionality. Proper design and fitting are essential to maximize the effectiveness and usability of the prosthesis.
  • Frame or Pylon: the structural element that connects the socket to other components, such as the prosthetic foot or hand. It provides support and stability while maintaining durability and flexibility.
  • Suspension system: secures the prosthetic device to the user's residual limb, ensuring stability and control during activities. It is essential for maintaining proper alignment and comfort.Kuiken, T. A., et al. (2007). Targeted Muscle Reinnervation for Real-time Myoelectric Control of Multifunctional Artificial Arms. JAMA, 301(6), 619–628. ISBN:10.1001/jama.2009.116

== '''Functional elements:''' ==

  • Artificial joints: replicate the movement and functionality of natural joints, allowing users to perform activities such as walking or grasping. They are designed to mimic the biomechanics of joints like the knee, elbow, hip, and ankle.
  • Motors or actuators: used primarily in advanced prosthetic devices to provide powered and controlled movement. They are critical for enabling lifelike motion, particularly in bionic upper-limb and lower-limb prostheses.
  • Sensors for feedback: integrated into prosthetic limbs collect data on the user's movements or environmental factors. These sensors improve functionality and responsiveness, allowing for more intuitive control and real-time adjustments.

=== '''Materials used:''' ===

  • Lightweight alloys (e.g., Titanium, Aluminium): these materials are favored for their strength, durability, and low weight, which enhance the functionality and comfort of prosthetic limbs.
  • Composite materials (e.g., Carbon fibers): carbon fiber composites combine lightweight properties with strength and flexibility, making them ideal for high-performance prosthetics.
  • Silicon and other biocompatible materials: silicon and other biocompatible materials are used for their flexibility, durability, and ability to mimic natural skin and tissue. These materials enhance comfort and integration with the user's body.Atkins, D. J., et al. (1996). Epidemiology of Prosthetic Limb Use and Its Implications for Reimbursement. Archives of Physical Medicine and Rehabilitation, 77(12), 1231–1238. ISBN:10.1016/s0003-9993(96)90152-2.

Manufacturing and Fitting process

=== '''Customization:''' ===

  • Use of measurements and molds tailored to the individual.
  • Application of computer-aided design (CAD) tools for precision namely pecialized software and tools that allow designers, engineers, and prosthetists to create, analyze, and modify prosthetic components digitally.Dillingham, T. R., et al. (2002). Limb Amputation and Limb Deficiency: Epidemiology and Recent Trends in the United States. Southern Medical Journal, 95(8), 875–883. ISBN:10.1097/01.SMJ.0000024966.33276.77.

=== '''Fabrication techniques:''' ===

  • Traditional crafting methods involves skilled artisans manually shaping and assembling prosthetics using materials such as wood, leather, and metal.
  • Modern approaches like 3D printing enables cost-effective, customized prosthetic components tailored to individual needs.

=== '''Fitting and alignment:''' ===

  • Ensuring comfort, functionality, and proper biomechanical alignment positioned to replicate natural joint movement and optimize balance, posture, and gait. Proper alignment minimizes strain on the residual limb and improves energy efficiency during movement. Techniques involve static and dynamic alignment adjustments using specialized tools and equipment.

Advancements in Prosthetic

  • 3D printing: Enables rapid prototyping and cost-effective customization.
  • Neural interfaces: Allow direct brain control of prosthetic devices.
  • Smart materials: Include self-healing polymers and temperature-adaptive materials.
  • Artificial intelligence: For adaptive prosthetic functionality and real-time user feedback.World Health Organization. (2017). Standards for Prosthetics and Orthotics. Retrieved from who.int.

Contributing fields

The field of prosthetics is highly interdisciplinary, drawing from a wide range of scientific, medical, and technological disciplines. The key contributing fields include:

  • Biomedical engineering - development of advanced prosthetic devices, incorporating robotics, materials science, and biomechanical systems in сreation of bionic limbs, integration of sensory feedback, and the use of osseointegration techniques.
  • Anatomy and Psychology - understanding the human body’s structure and function, including the musculoskeletal and nervous systems in designing prosthetics that align with natural movement and ensure compatibility with the user’s body.
  • Materials science - researching and developing materials that are lightweight, durable, biocompatible, and flexible and in introduction of carbon fiber, titanium, and silicone, which enhance functionality and comfort.
  • Mechanical engineering - creating mechanical components and structures for prosthetic devices in development of articulated joints, springs, and energy-efficient designs to improve mobility.
  • Electronics and Computer science - designing systems for myoelectric control, robotics, and integration of Artificial intelligence (AI) in myoelectric limbs, brain-computer interfaces, and adaptive control systems for improved prosthetic functionality.
  • Medicine and Surgery - addressing the medical and surgical aspects of amputation, prosthetic fitting, and patient care in techniques like osseointegration and advancements in surgical procedures for better prosthetic attachment.
  • Rehabilitation Science - assisting individuals in adapting to and using prosthetic devices effectively in development of personalized rehabilitation programs and training to maximize device functionality.
  • Robotics - creating robotic components and systems to mimic natural movements in advanced prosthetic hands and legs with lifelike dexterity and responsiveness.
  • Neuroscience - understanding the brain’s role in motor control and sensory feedback in neural-controlled prosthetics and integration of sensory feedback to restore a sense of touch.
  • 3D printing and Additive Manufacturing - Customizing prosthetics for individual users through precise, cost-effective fabrication techniques in rapid production of prosthetic devices tailored to specific anatomical and functional requirements.
  • Ergonomics and Design - Ensuring prosthetics are user-friendly, comfortable, and aesthetically pleasing in Improved user satisfaction and increased adoption rates for prosthetic devices.
  • Psychology and Sociology - addressing the mental and social challenges faced by prosthetic users in promoting acceptance, self-esteem and social integration of individuals using prosthetics.

Related fields

History of prosthetics

History of Prosthesis

Future of prosthetics

Types of Prosthetic Products

1. Limb prosthetics

Upper limb Prosthetics:

  • Passive Prosthetics: Designed primarily for cosmetic purposes or to stabilize objects (e.g., aesthetic hands).
  • Body-Powered Prosthetics: Operated using cables and harnesses, allowing for basic mechanical control.
  • Myoelectric Prosthetics: Controlled by electrical signals from the user's muscles, enabling precise movements.Sensinger, J. W., & Weir, R. F. (2008). User-Modulated Control of a Proportional Electromechanical Prosthesis. Journal of Rehabilitation Research and Development, 45(6), 743–754. ISBN:10.1682/JRRD.2007.10.0175.
  • Bionic Arms: High-tech prosthetics like the LUKE Arm or Hero Arm that offer advanced features, including multi-articulation, sensory feedback, and intuitive control.

=== Lower limb '''Prosthetics:''' ===

  • Transfemoral (Above-Knee) Prosthetics: Includes a prosthetic knee joint and foot system for walking and running.
  • Transtibial (Below-Knee) Prosthetics: Focuses on providing stability and flexibility for natural movement.
  • Microprocessor Knees (MPKs): Equipped with sensors and AI to adapt to terrain and user activity.
  • Prosthetic Feet: Ranges from energy-storing feet for running to multi-axial feet for uneven surfaces.Highsmith, M. J., et al. (2011). Relationship Between Prosthetic Mobility and Quality of Life Among Veterans with Lower-Limb Loss. Journal of Rehabilitation Research and Development, 48(6), 707–718. ISBN:10.1682/JRRD.2010.09.0175.

2. Prosthetics for Specific Needs

  • Pediatric Prosthetics: Lightweight and adjustable designs tailored for children to accommodate growth and ensure usability.
  • Sports Prosthetics: Specialized devices, such as running blades (e.g., Össur's Cheetah Blade), designed to optimize athletic performance.
  • Waterproof Prosthetics: Resistant to water and corrosion, suitable for activities like swimming or showering.
  • Heavy-Duty Prosthetics: Built for physically demanding environments, such as construction or farming.

3. Functional ProstheticsAmputee Coalition of America. (2023). Limb Loss Resource Center. Retrieved from https://amputee-coalition.org/

  • Activity-Specific Prosthetics: Designed for specialized tasks, including cycling, weightlifting, or playing musical instruments.
  • Prosthetic Hands and Fingers: Multi-functional devices with fine motor control and customizable cosmetic options.
  • Prosthetic Eyes: Custom ocular prostheses created from materials like acrylic or glass for cosmetic purposes.

4. Advanced Prosthetic SystemsKlute, G. K., et al. (2006). Prosthetic Foot and Ankle Mechanisms: A Review of Current Models and Design Trends. Journal of Biomechanics, 39(9), 1585–1592. ISBN:10.1016/j.jbiomech.2005.12.002.

  • Bionic Prosthetics: Utilize robotics, AI, and sensor technology to offer intuitive control and advanced functionality (Luke Arm, Ottobock C-Leg, Hero Arm)
  • Neuroprosthetics: Integrated with the nervous system for control via neural signals (touch, temperature sensations)

Emerging Prosthetic Innovations

  • Soft Robotics: Flexible materials for comfort and adaptability.
  • 3D-Printed Prosthetics: Cost-effective, customized designs for underserved populations.
  • Self-Powered Prosthetics: Use energy from body movements or external sources.Aszmann, O. C., et al. (2015). Elective Amputation and Bionic Limb Reconstruction for Treatment of Peripheral Nerve Injuries and Neuromas. Plastic and Reconstructive Surgery, 136(2), 471–482. ISBN:10.1097/PRS.0000000000001470.
  • Brain-Machine Interfaces: Allow control of prosthetics via neural signals.TouchBionics (Össur). (2023). i-Limb Technology. Retrieved from https://www.ossur.com/en-us/prosthetics/touch-solutions[https://www.ossur.com/en-us/prosthetics/touch-solutions].

Prosthetic Development and development tools

The development of prosthetics involves a multi-disciplinary approach combining engineering, medicine, and advanced technology. The process aims to create functional, comfortable, and user-friendly devices tailored to individual needs. Below is an overview of prosthetic development and the tools and technologies involved.International Society for Prosthetics and Orthotics (ISPO). (2023). Retrieved from International Organization for Standardization

Assessment and Design Requirements

  • Evaluation: The user’s anatomy, mobility goals, and lifestyle are assessed to determine specific prosthetic needs.
  • Tool and Technique: Scanning devices, gait analysis systems, and consultations with medical professionals are used to develop a customized plan for the prosthetic’s functionality and fit.Resnik, L., et al. (2014). Advanced Upper Limb Prosthetic Devices: Implications for Upper Limb Prosthetic Rehabilitation. Archives of Physical Medicine and Rehabilitation, 95(6), 981–991. ISBN:10.1016/j.apmr.2013.06.023.Rehabilitation Institute of Chicago (Shirley Ryan AbilityLab). Prosthetics Research. Retrieved from https://www.sralab.org/[https://www.sralab.org/].

Modeling and Prototyping

  • Digital and Physical models: Prosthetic designs are created using advanced modeling tools:
  • CAD software: Programs like AutoCAD, SolidWorks, and Fusion 360 are employed to develop precise 3D models.DARPA. (2023). Revolutionizing Prosthetics. Retrieved from https://www.darpa.mil/ [https://www.darpa.mil/].
  • 3D scanning: Capture the exact shape of the residual limb for personalized prosthetic designs.
  • 3D printing: Enable rapid prototyping and the production of custom components.International Committee of the Red Cross (ICRC). (2023). Physical Rehabilitation Program. Retrieved from https://www.icrc.org/en [https://www.icrc.org/en].

Material Selection

  • Material Choice: Materials are selected for their durability, weight, and biocompatibility. Common materials include carbon fiber, titanium, and medical-grade silicone.
  • Testing Tools: Material testing systems evaluate strength, flexibility, and compatibility to ensure optimal performance.Open Bionics. (2023). Hero Arm Technology. Retrieved from https://www.openbionics.com/ [https://www.openbionics.com/].

Fabrication

  • Manufacturing Techniques: Prosthetics are constructed using advanced fabrication methods:
  • Additive Manufacturing: 3D printing enables the creation of intricate, customized parts.
  • CNC machine: Precisely cut and shape metals and plastics for structural components.
  • Injection moulding: Utilized for producing components at scale.

Integration of Electronics

  • Advanced Functionalities: Electronic systems enhance the prosthetic’s capabilities:
  • Microcontroller: Devices like Arduino and Raspberry Pi control movements.Ottobock. (2023). Advanced Prosthetic Solutions. Retrieved from https://www.ottobock.com/[https://www.ottobock.com/].
  • Sensory systems: Myoelectric sensors detect muscle signals and convert them into motion.
  • Power management: Batteries and power tools ensure efficient operation of powered prosthetics.

Testing and Validation

  • Performance Evaluation: Prosthetics are tested under real-world conditions to ensure reliability and functionality:
  • Motion Capture Systems: Analyze movement and gait dynamics.Humanity & Inclusion (HI). (2023). Prosthetic Services in Developing Countries. Retrieved from https://www.hi.org/[https://www.hi.org/]
  • Force Plates: Measure weight distribution and pressure during use.
  • Wearable Monitoring Devices: Collect feedback on usage patterns.

Fitting and Customization

  • Adjustments: Prosthetics are fine-tuned for optimal comfort and usabilit:
  • Liner and Socket Design: Tools are used to create interfaces that fit securely and comfortably.
  • Dynamic Adjustment Mechanisms: Allow real-time modifications for improved comfort.Limbs for Life Foundation. Prosthetics Assistance. Retrieved from https://www.limbsforlife.org/[https://www.limbsforlife.org/].

User Training and Rehabilitation

  • Adaptation and Support: Users are trained to maximize the functionality of their prosthetic:
  • Virtual reality (VR): Simulates real-world scenarios to aid training.
  • Rehabilitation robotics: Assists in physical therapy and the development of motor skills.

Prosthetic companies

Prosthetics organizations

Prosthetics competitions

People influential in the field of prosthetics

  • Ambroise Paré regarded as the "father of modern prosthetics," Paré developed advanced limb designs with functional features such as locking mechanisms.
  • James Potts - Creator of the "Anglesey Leg" in 1800, which introduced the articulated knee joint for more natural movement.
  • Dubois L. Parmelee invented the suction socket, a pivotal innovation in prosthetic leg attachment in 1863.
  • Hugh Herr a leading researcher in bionic prosthetics, Herr has developed advanced, adaptive limb technologies at the MIT Media Lab.
  • Aimee Mullins athlete, actress, and advocate who uses prosthetics, Mullins has pushed the boundaries of prosthetic design and aesthetics.
  • Van Phillips (inventor) inventor of the Flex-Foot, a prosthetic foot made of carbon fiber that revolutionized prosthetic performance, especially for athletes.
  • Oscar Pistorius paralympic sprinter who brought attention to the potential of prosthetics in competitive sports with his use of carbon fiber blades.

See also

References

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