Prosthetic Breakthroughs Will Benefit Boston Bombing Amputees

April 18, 2013— -- The patients who lost limbs as a result of the Boston Marathon bombings might benefit from the lessons learned in treating soldier amputees injured in Iraq and Afghanistan.

"It's no longer the peg leg mentality," said Matt Albuquerque, president of Next Step Orthotics and Prosthetics, which, coincidently, has an office in Newton, Mass., just a few miles from the Boston Marathon route.

"The misconception is that we are still fitting people with wooden legs, but with the science of prosthetic limbs evolving so quickly in the past 20 years or so, we've gone from wood to robotics," he said.

Albuquerque said that advancements in prosthetic technology often take place during wartime, with the government funding most of the ongoing research.

For example, one prosthetic currently making its way through Food and Drug Administration trials, the Deka arm, was developed by Segway inventor Dean Kamen, thanks to an $18.1 million grant from the Defense Advance Research Project Agency, the defense department's research fund.

Affectionately dubbed "Luke" after the Star War's character Luke Skywalker, the robotic arm was designed to restore functionality to soldiers with upper extremity amputations. The goal of the project has been a thought-controlled arm-and-hand prosthesis that performs, looks and feels like a natural limb.

Nearly 700 people in the United States -- most of them wounded soldiers -- have already been fitted with a prosthetic ankle called the iWalk BiOM. It's considered the first truly "bionic" prosthetic because it is packed with a sophisticated array of computer chips, gyroscopes and a motor. This, according to Dr. Austin Fragomen, an orthopedic surgeon who is a limb salvage and limb deformity correction specialist at the Hospital for Special Surgery in New York City, allows it to operate in much the same way as a flesh and blood human ankle.

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"It's a huge improvement over older style leg prosthetics, which are essentially hinged springs incapable of sensing subtle shifts in movement," Fragomen said. "It's similar to what's been available for above-the-knee prosthetics, but they've applied a more advanced technology to the ankle."

Fragomen, who also works with the Wounded Warrior Project, said the advantages of the BiOM are most apparent during tasks like climbing up and down hills, which, he noted, is one of the most difficult skills for an amputee.

"The BiOM senses changes in incline and decline and makes adjustments accordingly. You can fine tune the movements from an app on your cell phone in real time until it's right," he said.

But the benefits of these new generation bionic limbs go beyond the technological advancements. Fit and comfort have also come a long way.

Prosthetics now fit better, Albuquerque said, largely thanks to new and improved interfaces that insert between the remaining limb and the prosthetic. One type, a suspension sleeve, suspends the socket of the prosthetic. The other type, a liner, provides a layer of padding or cushioning for the residual limb. Both now come in an array of materials and can be customized to the prosthetic and the user.

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