Modern (1940’s-present)

51 Prosthetics

Rachel Jones

Introduction

When people think of prosthetics most people have an image in their head of a very complex robotic limb with fully functional joints, elbows, wrists, fingers, knees, etc. However, prosthetics are so much more than that and have come an extraordinarily long way. Thinking about peg legs for example, like the ones seen on so many cartoon pirates. Not everyone would associate them with the word prosthetics, but before their were robotic arms and artificial heart valves, there were peg legs. Prosthetics, simply put, are any artificial body part. Prosthetics are important because they make life easier for anyone that has to struggle because of losing functionality or losing a body part as a whole. Prosthetics have developed a lot in recent years because of technological advancements. This chapter will discuss how technology has made those improvements and how this has impacted society as a whole. 

Connection to STS

Prosthetics are greatly involved in today’s society. Whether it is because of a traumatic injury, a fetal disease like cancer, or a birth defect, prosthetics make people’s lives easier. They allow them to better function within society and not have to struggle as much trying to overcome such a difficult obstacle. As time progresses and the mechanics of prosthetics progress so do the looks. While the main goal is functionality these prosthetics start to look increasingly real. That way anyone using one feels less alienated out in public and is not embarrassed or worried about what other people might say or think. These advancements make prosthetics more accurate and better to use; however, because they are newer and require advanced technology, they are something that many people cannot afford. Many people who might benefit from it are unable to because it is an expensive device and process. This is an issue when it comes to many of the newer discoveries of modern technology in the medical field is that it is simply too expensive for most people to afford, like has been shown previously like chapter 112 of this textbook which addresses that very issue pertaining to physical therapy. 

Prosthetics

Prosthetics started out being made with wood and glue and were very immovable. They were made with glue, metal, wood, and leather up until the 20th century. However, between the 15th and 19th century artificial limbs “could rotate and bend using cables, gears, cranks, and springs” (U.S National Library of Medicine). This is referring to more of the larger limb prosthetics. Each specific wing of prosthetics have all evolved in different ways that fit with that type. For example looking at the stapes prosthesis, many different materials, shapes, and sizes have been used for this surgery in the past to try to determine what the best outcome is. For example from these trial and errors it is lead to believe that smaller piston diameters can lead to lower risk of hearing loss (Sevy A, Arriaga M).  Another example of a different field of evolution is the artificial heart valve. Early models like Harken’s caged-ball and Braunwald’s flexible-leaflet valves, were basic and very simplistic compared to modern ones. The goal was to have something to easy to implant, durable, and less likely to cause blood clotting. Which is why after many different designs one of the most popular is St. Jude Medical bileaflet valves because of their positive performance and low clotting risk. However, this does not mean that there are still possible new designs being tested in attempt to improve the design even more (Collins Jr, J). This is the whole idea behind the evolution of each of these pieces and processes is that they might slow down, but they will most likely never stop improving. The last example of this is about upper limb prosthesis but more specifically of the humerus because the main is with trans humeral prosthesis is the weight. This is important because too light or too heavy can negatively impact the overall balance or functionality (Segura D, Romero E, Abarca VE, Elias DA).  Different pieces of prosthetics are improving everyday in functionality, durability, and lack of later complications. The more these pieces improve, the better suited they are for each individual of society. These numerous improvements are able to happen because of the improvements that technology has made along with it. The technological advancements are just as important to the development of prosthetics as a whole as the physical prosthetic pieces are because the technology is what making designing, and building them possible and also is what makes them function properly.  For example one of the most revolutionary technological advancements to prosthetics was the 3D printer. This has made the building of the piece much faster and simpler and overall more practical. The overall goal is to further use this to make prosthetics more affordable and accessible especially to children (Manero A, Smith P, Sparkman J, Dombrowski M, Courbin D, Kester A, Womack I, & Chi A,). A similar example to this is the discovery that was made by researcher from MIT and Brown University when they developed  magnetomicrometry as an improvement to the current surface EMG controlling prosthetics with electrodes. Instead  magnetomicrometry uses small magnetic beads to track muscle movement with better accuracy (Brown University). The more the technology improves, both the technology of the prosthetics, and the technology involved in the designing and building process, the more they improve, the more functional they will be. However depending on the adjustments made, this could either make them more accessible to the public, or much less accessible because of increase in prices. However, regardless the field of prosthetics is getting more and more accurate everyday and helping so many people who need it.

Conclusion

Prosthetics can be life-changing and sometimes life saving for people who need them. The development of science is what makes that possible. Every step, leap, and bound ever made in the medical field is because of modern science along with modern technology. That bettering technology caused the betterment of the study and development of prosthetics which furthermore can attribute to the betterment of society by making it easier for individuals to continue living in everyday life giving them the physical capabilities of everyone else. However more advancements leads to higher costs which blocks anyone who may not be able to afford it. Solving this issue would lead to overall further development of society giving help to anyone who needs it without the financial restrictions or burdens. 

References

Collins Jr, J, The evolution of artificial heart valves. The New England Journal of Medicine. 1991. 324(9), 624-626. doi:https://doi.org/10.1056/NEJM199102283240908

Sevy A, Arriaga M, The Stapes Prosthesis: Past, Present, and Future, Otolaryngologic Clinics of North America. 2018; 15(2):393-404.https://doi.org/10.1016/j.otc.2017.11.010.

Segura D, Romero E, Abarca VE, Elias DA. Upper Limb Prostheses by the Level of Amputation: A Systematic Review. Prosthesis. 2024; 6(2):277-300. https://doi.org/10.3390/prosthesis6020022

Manero A, Smith P, Sparkman J, Dombrowski M, Courbin D, Kester A, Womack I, & Chi A, Implementation of 3D Printing Technology in the Field of Prosthetics: Past, Present, and Future. International journal of environmental research and public health. 2019; 16(9). https://doi.org/10.3390/ijerph16091641

U.S. National Library of Medicine. (n.d.). Prosthetics through the ages | NIH MedlinePlus Magazine. MedlinePlus. 2023. https://magazine.medlineplus.gov/article/prosthetics-through-the-ages

Researchers develop new technology that could enable better control systems for prosthetic limbs. Brown University. 2022.https://www.brown.edu/news/2022-10-31/magnetomicrometry

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