Audience: Middle and High School Students
At the age of 19, Amy Purdy suffered from a deadly blood infection that resulted in her losing her spleen, kidney function, hearing in one ear, and both legs below the knees (as they had to be amputated). Instead of seeing her challenges as setbacks, Purdy showed the world that nothing can limit her. Since her infection, Purdy has used below-the-knee prosthetics and has won three Paralympic medals for snowboarding, advanced to the final round on Dancing with the Stars, and wrote the bestselling book On My Own Two Feet: From Losing My Legs to Learning the Dance of Life. Purdy’s story is just one of millions that prove the power of prosthetics.
Prosthetics are revolutionizing technology as we know it. Prosthetics are artificial devices that are capable of replacing missing body parts that are often lost through either disease, physical trauma, or a condition present at birth. Prosthetics have been a concept for centuries, present in ancient civilizations as cosmetics before transforming into the technologically advanced devices we see today. Biotechnology drives this field. According to the World Health Organization (WHO), though roughly 35-40 million people worldwide require prosthetics, only 1 in 10 people have access to this service. Data reveals that in the United States alone, nearly 2 million people live with limb loss, and this number is expected to double by 2050. While advances in biotechnology have enabled prosthetic technologies to have significantly improved, such as being lighter, some challenges remain, including smooth fitting to the human body. Experts estimate that walking with traditional prosthetics requires twice as much effort and is one-third times slower than walking on two natural legs. Additionally, it is difficult for amputees to sense body position and movement with their prosthetic device. To overcome this, the next step in smart prosthetics that researchers are working towards is a concept called osseointegration, where prosthetic devices are integrated into the body. Prosthetics are undergoing ongoing research.
Timeline:
Though prosthetics are still “evolving,” they have already existed for thousands of years. Here’s a look at the timeline of prosthetics.
950-710 B.C.: Wooden and leather toe created
600 B.C.: Greville Chester toe made from cartonnage
300 B.C.: Capua leg crafted by Romans
460-1000 (Middle Ages): Peg legs and hand hooks common
1400s-1800s (The Renaissance): Copper, iron, and wood prosthetics
1863: Cosmetic rubber hand introduced during Civil War
1945 (Post-WWII era) Prosthetics made from wood and leather
1970s-1990s: Introduction of plastics, polycarbonates, resins, and laminates
2000s: Advanced prosthetics utilizing (artificial) technology
Biotech Innovators and Economic Impact
About 1.9 million people in the United States live with limb loss, which results in a need for prosthetic devices and therefore an increase in the market. A report by Grand View Research estimates that with the existing prosthetics market’s value of 6.92 billion dollars in 2023, it will grow at a compound annual growth rate of 4.4% between 2024 and 2030, driven especially by sports and road injuries and diabetes-related amputations. Prosthetic fittings can dramatically increase the quality of life for people who have limb loss. In one study done in which people had a combat- related major lower-limb amputation, 62%-88% of participants were satisfied with the fit, weight, comfort, ease of donning, appearance, and durability of their prosthesis. Research and development for prosthetics are often funded through government grants and other investments/donations, but affordability is still a huge barrier for many people in need of these devices.
Such significant improvement within the field of prosthetics would not be possible without the immense dedication of numerous people and companies.
Össur (Founder Össur Kristinsson): developed the Rheo Knee, a knee that continuously adapts to an amputee's walking style and environment.
BiOM Ankle System (Hugh Herr, MIT): this system uses a battery-powered “bionic propulsion” which allows for the adjustment of ankle stiffness, power, and position. This system can help the person wearing the prosthetics in moving up and forward as the terrain changes.
DEKA Research & Development Corp. (Founder Dean Kamen) & Mobius Bionics: developed the LUKE arm, the only commercially-available prosthetic arm that has a powered shoulder and ten powered joints. The arm has the ability to extend such that it can reach over the amputee’s head.
Ethical, Legal, and Social Issues
One of the biggest aspects of consideration is accessibility and affordability. Unfortunately, the price of prosthetics ranges from $5,000 to over $70,000, so they are not affordable to everyone, especially not to low-income and marginalized communities. Additionally, concerns regarding ownership of biological materials in prosthetic devices are an ethical challenge as it requires paying detailed attention to consent for using biological materials. It is also crucial to understand society’s attitude towards those with limb loss. For example, those with limb loss, with the same qualifications and skills as their peers, are less likely to be given a promotion or are no longer considered for a job. This prompts people to address inclusivity and acceptance, increasing the importance of informing people regarding artificial devices and other technologies. To ensure safety and success in prosthetics and their continuing development, it is important to have trusted agencies oversee these processes. For example, before prosthetic devices can be marketed within the United States, they must first comply with federal regulations through FDA/CDRH processes. It is important that these agencies first make sure that legal involvement lives up to societal values and equity for prosthetic devices.
Prosthetics play a vital role in millions of people’s lives every day and their capabilities are beyond impressive. It is exciting to see what more prosthetics can do for us as research and technology in this field continues to advance.
Bibliography:
Introduction
Paralympic snowboarder Amy Purdy isn't slowing down | NIH MedlinePlus Magazine. (2023, April 24). NIH MedlinePlus Magazine. Retrieved April 2, 2024, from https://magazine.medlineplus.gov/article/paralympic-snowboarder-amy-purdy-isnt-slowing-down
Background
Can Prosthetic Hands Mimic a Healthy Human Hand? (n.d.). MDPI. Retrieved April 2, 2024, from https://www.mdpi.com/2673-1592/3/1/3
Dutchen, S. (n.d.). Life and Limb | Harvard Medicine Magazine. Harvard Medicine Magazine. Retrieved April 2, 2024, from https://magazine.hms.harvard.edu/articles/life-and-limb
Evidence Summary - Lower Limb Prostheses: Measurement Instruments, Comparison of Component Effects by Subgroups, and Long-Term Outcomes. (n.d.). NCBI. Retrieved April 2, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK531527/
Exploring national human resource profile and trends of Prosthetists/Orthotists in South Africa from 2002 to 2018. (2020, July 29). NCBI. Retrieved April 2, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7480577/
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Prosthetics through the ages | NIH MedlinePlus Magazine. (2023, May 11). NIH MedlinePlus Magazine. Retrieved April 2, 2024, from https://magazine.medlineplus.gov/article/prosthetics-through-the-ages
Quinton, A. (2022, November 28). Making Prosthetic Limbs More Lifelike. UC Davis. Retrieved April 2, 2024, from https://www.ucdavis.edu/health/news/making-prosthetics-more-life-like
Timeline
Timeline: Prosthetic Limbs Through the Years. (2015, March 8). UPMC HealthBeat. Retrieved April 2, 2024, from https://share.upmc.com/2015/03/timeline-prosthetic-limbs-years/
Ethical, Legal, & Social Issues
Lost Body Parts | New York City Employment Discrimination Lawyer. (n.d.). Joseph Kilada, P.C. Retrieved April 2, 2024, from https://www.laborlawfirm.org/lost-body-parts.html
The Ethical Considerations in Prosthetic Research and Development | OP Centers. (2024, January 22). Orthotic and Prosthetic Centers of Florida - OPC. Retrieved April 2, 2024, from https://opcenters.com/the-ethical-considerations-in-prosthetic-research-and-development/
U.S. Food and Drug Administration Regulation of Prosthetic Research, Development, and Testing. (2023, January 6). , - YouTube. Retrieved April 2, 2024, from https://journals.lww.com/jpojournal/fulltext/2010/04000/u_s__food_and_drug_administration_regulation_of.7.aspx
Zepeda, E. (2024, January 11). How Much Is a Prosthetic Leg: Cost and Pricing in 2024. PrimeCare. Retrieved April 2, 2024, from https://primecareprosthetics.com/blog/how-much-does-a-prosthetic-leg-cost-in-albuquerque
Biotech Innovators and Economic Impact
Andrysek, J., & Andrysek, J. (2021, September 21). The Economics of Innovation in the Prosthetic and Orthotics Industry. NCBI. Retrieved April 2, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443472/
(n.d.). Deka Research and Development Corp. Retrieved April 2, 2024, from https://www.dekaresearch.com/
Lost Body Parts | New York City Employment Discrimination Lawyer. (n.d.). Joseph Kilada, P.C. Retrieved April 2, 2024, from https://www.laborlawfirm.org/lost-body-parts.html
Matheson, R. (2014, April 17). Bionic ankle 'emulates nature'. MIT News. Retrieved April 2, 2024, from https://news.mit.edu/2014/hugh-herr-bionic-ankle-emulates-nature-0417
(n.d.). Mobius Bionics. Retrieved April 2, 2024, from https://mobiusbionics.com/
Össur. Life Without Limitations. (n.d.). Ossur. Retrieved April 2, 2024, from https://www.ossur.com/en-us
Prosthetics And Orthotics Market Size & Share Report, 2030. (n.d.). Grand View Research. Retrieved April 2, 2024, from https://www.grandviewresearch.com/industry-analysis/prosthetics-orthotics-market
Prosthesis satisfaction and quality of life in US service members with combat-related major lower-limb amputation. (2022, February 1). PubMed. Retrieved April 2, 2024, from https://pubmed.ncbi.nlm.nih.gov/34789707/
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