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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.

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.

Branches of Prosthetics

By Body Part

  • Upper limb prosthetics: Includes artificial hands, arms, and shoulders.
  • Human leg prosthetics: Includes artificial feet, legs, and hips.
  • Craniofacial prosthetics: Replaces parts of the face, such as the nose, ear, or jaw.
  • Ocular prosthetics: Commonly referred to as artificial eyes.
  • Dental prosthetics: Includes dentures, bridges, and implants.
  • Breast prosthetics: Used after mastectomy or lumpectomy.

By Function

  • Functional prosthetics: Designed for specific tasks, such as walking, grasping, or lifting.
  • Cosmetic prosthetics: Focused on appearance rather than mechanical functionality.
  • Bionic and Robotic prosthetics: Integrate advanced technology for enhanced functionality, often controlled by neural signals.

Components of Prosthetic device

  • Structural elements:
    • Prosthetic Socket- critical component of any prosthetic limb. It serves as the interface between the prosthetic device and the residual limb, ensuring comfort, stability, and functionality. Proper design and fitting of the socket are essential for the effectiveness and usability of the prosthesis.
    • Frame or Pylon - structural component of a prosthetic limb that provides support, stability, and connection between the prosthetic socket and other components, such as the foot or hand. It plays a crucial role in ensuring that the prosthesis functions effectively while maintaining durability and flexibility.
    • Suspension system - essential component of a prosthetic limb, responsible for securely attaching the prosthetic device to the user's residual limb. It ensures that the prosthesis stays in place during various activities, providing stability, comfort, and control.
  • Functional elements:
    • Artificial joints - components of prosthetic limbs that replicate the function of natural joints, allowing for movement and flexibility. They are critical in prosthetics as they enable users to perform a wide range of activities, from walking to grasping objects. Artificial joints are designed to mimic the biomechanics of natural joints such as the knee, elbow, hip, and ankle.
    • Motors or actuators - critical components that provide powered and controlled movement to prosthetic joints, enabling lifelike and functional motion. They are used primarily in advanced or bionic prosthetic devices, particularly in upper-limb and lower-limb prostheses.
    • Sensors for feedback - devices integrated into prosthetic limbs to gather data about the environment, the prosthesis's position, or the user’s movements. They play a critical role in improving the functionality, responsiveness, and user experience of advanced prosthetics by enabling more intuitive control and real-time adjustments.
  • Materials used:
    • Lightweight alloys (e.g.,Titanium, Aluminium) - widely used in prosthetics due to their exceptional combination of strength, durability, and low weight. These materials enhance the functionality, comfort, and longevity of prosthetic limbs.
    • Composite materials (e.g., Carbon fibers) - widely used in prosthetics due to their unique combination of lightweight properties, strength, and flexibility. These materials are particularly favored in high-performance and advanced prosthetic designs.
    • Silicon and other biocompatible materials - widely used in prosthetics to enhance comfort, functionality, and integration with the user's body. These materials are particularly valued for their flexibility, durability, and ability to mimic the properties of natural skin and tissue.

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.
  • 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.

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.
    • 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.

2. Prosthetics for Specific Needs

  • Pediatric Prosthetics:
    • Smaller, lighter designs tailored for children with adjustable components to accommodate growth.
  • Sports Prosthetics:
    • Specialized devices, such as running blades (e.g., Össur's Cheetah Blade), designed for athletic performance.
  • Waterproof Prosthetics:
    • Resistant to water and corrosion, ideal for swimming or showering.
  • Heavy-Duty Prosthetics:
    • Built for users in physically demanding environments like construction or farming.

3. Functional Prosthetics

  • Activity-Specific Prosthetics:
    • Designed for specific tasks such as cycling, weightlifting, or playing musical instruments.
  • Prosthetic Hands and Fingers:
    • Multi-functional hands with fine motor control and cosmetic designs for aesthetic appearance.
  • Prosthetic Eyes:
    • Custom-made ocular prostheses for cosmetic purposes, often made from acrylic or glass.

4. Advanced Prosthetic Systems

  • Bionic Prosthetics:
    • Utilize robotics, AI, and sensors for intuitive control and functionality.
    • Examples include:
      • LUKE Arm (formerly DEKA Arm): Provides precise motorized control.
      • Ottobock C-Leg: Features real-time adaptation to walking patterns.
      • Hero Arm: Affordable bionic arm for partial hand or arm amputations.
  • Neuroprosthetics:
    • Connected to the nervous system for control via neural signals.
    • Provide sensory feedback, such as touch or temperature.

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.
  • Brain-Machine Interfaces: Allow control of prosthetics via neural signals.

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.

  1. Assessment and Design Requirements
    • Evaluate the user’s anatomy, mobility goals, and lifestyle needs.
    • Scanning devices, gait analysis systems, and input from medical professionals.
    • A customized plan outlining the device's functionality and fit.
  2. Modeling and Prototyping
    • Create digital or physical models of the prosthetic limb or device:
      • CAD Software: Computer-Aided Design tools like AutoCAD, SolidWorks, or Fusion 360 for creating precise 3D models.
      • 3D Scanners: Capture the exact shape of the residual limb for a tailored fit.
      • 3D Printers: Rapidly produce prototypes or final components.
  3. Material Selection
    • Choose materials that balance durability, weight, and comfort:
      • Material Testing Systems: Evaluate the strength, flexibility, and biocompatibility of materials like carbon fiber, titanium, and medical-grade silicone.
  4. Fabrication
    • Manufacture the prosthetic using advanced techniques:
      • Additive Manufacturing (3D Printing): Produces intricate and customized parts.
      • CNC Machines: Precisely cut and shape materials like metals or plastics.
      • Injection Molding: Used for components requiring large-scale production.
  5. Integration of Electronics
    • Embed sensors, actuators, and control systems for advanced prosthetic functionality:
      • Microcontrollers: Devices like Arduino or Raspberry Pi for controlling prosthetic movements.
      • Sensor Systems: Myoelectric sensors to detect muscle signals and convert them into prosthetic motion.
      • Battery and Power Management Tools: Ensure the efficient operation of powered prosthetics.
  6. Testing and Validation
    • Evaluate the prosthetic’s performance under real-world conditions:
      • Motion Capture Systems: Analyze the user’s movement and gait.
      • Force Plates: Measure the distribution of pressure and weight during use.
      • Wearable Monitoring Devices: Track usage patterns and collect feedback.
  7. Fitting and Customization
    • Adjust the prosthetic for optimal fit and comfort:
      • Liner and Socket Design Tools: Create components that interface with the user’s body.
      • Dynamic Adjustment Tools: Real-time adjustment mechanisms for enhanced comfort.
  8. User Training and Rehabilitation
    • Help the user adapt to the prosthetic and maximize its functionality:
      • Virtual Reality (VR) Systems: Simulate scenarios to train users in a controlled environment.
      • Rehabilitation Robotics: Support physical therapy and motor skill development.

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

  1. Encyclopædia Britannica. (2023). Prosthetics. Retrieved from Britannica.com.
  2. Oxford English Dictionary (2023). Definition of "prosthetic". Retrieved from Oed.com.
  3. ^ Farina, D., & Aszmann, O. C. (2014). Bionic Limbs: Clinical Reality and Ethical Considerations. Science Translational Medicine, 6(257), 257ps12. ISBN:10.1126/scitranslmed.3008939.
  4. 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
  5. 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
  6. 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.
  7. 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.
  8. World Health Organization. (2017). Standards for Prosthetics and Orthotics. Retrieved from who.int.
  9. Ziegler-Graham, K., et al. (2008). Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation, 89(3), 422–429. ISBN:10.1016/j.apmr.2007.11.005.
  10. 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.
  11. 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.
  12. Amputee Coalition of America. (2023). Limb Loss Resource Center. Retrieved from https://amputee-coalition.org/
  13. Klute, 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.
  14. 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.
  15. TouchBionics (Össur). (2023). i-Limb Technology. Retrieved from https://www.ossur.com/en-us/prosthetics/touch-solutions.
  16. 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.
  17. International Committee of the Red Cross (ICRC). (2023). Physical Rehabilitation Program. Retrieved from https://www.icrc.org/en .
  18. DARPA. (2023). Revolutionizing Prosthetics. Retrieved from https://www.darpa.mil/ .
  19. Rehabilitation Institute of Chicago (Shirley Ryan AbilityLab). Prosthetics Research. Retrieved from https://www.sralab.org/.
  20. Open Bionics. (2023). Hero Arm Technology. Retrieved from https://www.openbionics.com/ .
  21. Ottobock. (2023). Advanced Prosthetic Solutions. Retrieved from https://www.ottobock.com/.
  22. Humanity & Inclusion (HI). (2023). Prosthetic Services in Developing Countries. Retrieved from https://www.hi.org/
  23. Limbs for Life Foundation. Prosthetics Assistance. Retrieved from https://www.limbsforlife.org/.
  24. International Society for Prosthetics and Orthotics (ISPO). (2023). Retrieved from International Organization for Standardization
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