1 | [footer text here] 2/22/2018 Matthew Garibaldi, MS, CPO Director Assistant Clinical Professor Richard Nguyen, CPO Clinical Chief Advances in Prosthetic Technology UCSF Osher Mini-Medical School for the Public “ Presentation Title 2 Any sufficiently advanced technology is indistinguishable from magic. Arthur C. Clarke Advances in Prosthetic Technology 3 What is a Prosthesis? Definition: an artificial device to replace or augment a missing or impaired part of the body
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2/22/2018
Matthew Garibaldi, MS, CPODirector
Assistant Clinical ProfessorRichard Nguyen, CPO
Clinical Chief
Advances in Prosthetic TechnologyUCSF Osher Mini-Medical School for the Public
“
Presentation Title2
Any sufficiently advanced technology is indistinguishable from magic.
Arthur C. Clarke
Advances in Prosthetic Technology3
What is a Prosthesis?
Definition: an artificial device to replace or augment a missing or impaired part of the body
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Presentation Title4
What is a Prosthesis?Internal vs. External Prosthesis
Presentation Title5
What is a Prosthesis?Restoration vs. Functional
Presentation Title6
What is a Prosthesis?External Functional Device
Prosthesis Orthosis
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Advances in Prosthetic Technology7
Anatomy of a Prosthesis
-Socket: human interface
What makes up a prosthetic device
Advances in Prosthetic Technology8
Anatomy of a Prosthesis
-Socket: human interface
-Joint Replacement: elbow or knee
What makes up a prosthetic device
Advances in Prosthetic Technology9
Anatomy of a Prosthesis
-Socket: human interface
-Joint Replacement: elbow or knee
-Terminal Device: hand or foot
What makes up a prosthetic device
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Advances in Prosthetic Technology10
Prosthetic Sockets
Advances in Prosthetic Technology11
Historical Perspective on SocketsCarved Wooden sockets
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology12
Modern Prosthetics
Hand Cast
- Plaster
- Positive model
- Vacuum form
- Test socket
- Final socket
Taking a manual mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology13
Modern Prosthetics
Hand Cast
- Plaster
- Positive model
- Vacuum form
- Test socket
- Final socket
Taking a manual mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology14
Modern Prosthetics
Hand Cast
- Plaster
- Positive model
- Vacuum form
- Test socket
- Final socket
Taking a manual mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology15
Modern Prosthetics
Hand Cast
- Plaster
- Positive model
- Vacuum form
- Test socket
- Final socket
Taking a manual mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology16
Modern Prosthetics
Hand Cast
- Plaster
- Positive model
- Vacuum form
- Test socket
- Final socket
Taking a manual mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology17
Modern Prosthetics
Digital Scan
- 3D Digital Scan
- 3D CAD model
- Foam carving
- 3D print
Digital mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology18
Modern Prosthetics
Digital Scan
- 3D Digital Scan
- 3D CAD model
- Foam carving
- 3D print
Digital mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology19
Modern Prosthetics
Digital Scan
- 3D Digital Scan
- 3D CAD model
- Foam carving
- 3D print
Digital mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology20
Modern Prosthetics
Digital Scan
- 3D Digital Scan
- 3D CAD model
- Foam carving
- 3D print
Digital mold of the residual limb
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology21
Modern Prosthetics
Transtibial Socket Design
- Paltellar Tendon Bearing
- Total Surface Bearing
- Elevated Vacuum
- Adjustable
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology22
Modern Prosthetics
Transtibial Socket Design
- PTB
- Total Surface Bearing
- Elevated Vacuum
- Adjustable
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology23
Modern Prosthetics
Transtibial Socket Design
- PTB
- Total Surface Bearing
- Elevated Vacuum
- Adjustable
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology24
Modern Prosthetics
Transtibial Socket Design
- PTB
- Total Surface Bearing
- Elevated Vacuum
- Adjustable
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology25
Modern Prosthetics
Transfemoral Socket Design
- Quad
- Ischial Containment
- VECTR
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology26
Modern Prosthetics
Transfemoral Socket Design
- Quad
- Ischial Containment
- VECTR
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology27
Modern Prosthetics
Transfemoral Socket Design
- Quad
- Ischial Containment
- VECTR
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology28
Modern Prosthetics
Transfemoral Socket Design
- Quad
- Ischial Containment
- VECTR
Socket Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology29
Future Prosthetics Eliminating the socket
Socket
Joint
Terminal Device
Upper Extremity
Osseo Integration - OPRA
- Fixture
- Abutment
- Axor II
Advances in Prosthetic Technology30
Future Prosthetics Eliminating the socket
Socket
Joint
Terminal Device
Upper Extremity
Osseo Integration - OPRA
- Fixture
- Abutment
- Axor II
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Advances in Prosthetic Technology31
Future Prosthetics Eliminating the socket
Osseo Integration - OPRA
- Fixture
- Abutment
- Axor II
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology32
Future ProstheticsEliminating the socket
Socket
Joint
Terminal Device
Upper Extremity
Osseo Integration - OPRA
- Fixture
- Abutment
- Axor II
Advances in Prosthetic Technology33
Future ProstheticsEliminating the socket
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology34
Prosthetic Knees
Advances in Prosthetic Technology35
Historical Perspective
Mid – late 1500s
- Ambroise Pare
-French army barber/surgeon
-Father of modern amputation surgery
-Introduced modern amputation procedures
-Created ground breaking above-knee devices such as a locking knee joints for stability during stance.
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology36
Modern Prosthetics
Knees
- Mechanical
- Hydraulic
- Microprocessor Controlled
- Powered
Knee Joint Technology
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology37
Modern Prosthetics
Knees
- Mechanical
- Hydraulic
- Microprocessor Controlled
- Powered
Knee Joint Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology38
Modern Prosthetics
Knees
- Mechanical
- Hydraulic
- Microprocessor Controlled
- Powered
Knee Joint Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology39
Modern Prosthetics
Knees
- Mechanical
- Hydraulic
- Microprocessor Controlled
- Powered
Knee Joint Technology
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology40
Modern Prosthetics
Knees
- Mechanical
- Hydraulic
- Microprocessor Controlled
- Powered
Knee Joint Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology41
Future Prosthetics
Future Technology
- Bionic Powered Knee/Foot
Knee Joint Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology42
Prosthetic Feet
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Advances in Prosthetic Technology43
Historical Perspective
17th – 19th Century
- 1858, Douglas Bly
- “Dr. Bly’s Anatomical Leg”
- Ankle joint formed by ivory ball
- Vulcanized rubber foot
- Revered as most complete and success invention ever attained in artificial limbs
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology44
Modern Prosthetics
Feet
- Conventional feet (CF)
- Energy-Storage-and-Return (ESR)
- Articulated Feet
- Dynamic Response
- Microprocessor Controlled Feet
- Bionic feet
Prosthetic Foot Technology
Socket
Joint
Terminal Device
Upper Extremity
Advances in Prosthetic Technology45
Modern ProstheticsProsthetic Foot Technology
Socket
Joint
Terminal Device
Upper Extremity
Feet
- Conventional feet (CF)
- Energy-Storage-and-Return (ESR)
- Articulated Feet
- Dynamic Response
- Microprocessor Controlled Feet
- Bionic feet
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Advances in Prosthetic Technology46
Modern ProstheticsProsthetic Foot Technology
Socket
Joint
Terminal Device
Upper Extremity
Feet
- Conventional feet (CF)
- Energy-Storage-and-Return (ESR)
- Articulated Feet
- Dynamic Response
- Microprocessor Controlled Feet
- Bionic feet
Advances in Prosthetic Technology47
Modern ProstheticsProsthetic Foot Technology
Socket
Joint
Terminal Device
Upper Extremity
Feet
- Conventional feet (CF)
- Energy-Storage-and-Return (ESR)
- Articulated Feet
- Dynamic Response
- Microprocessor Controlled Feet
- Bionic feet
Advances in Prosthetic Technology48
Modern ProstheticsProsthetic Foot Technology
Socket
Joint
Terminal Device
Upper Extremity
Feet
- Conventional feet (CF)
- Energy-Storage-and-Return (ESR)
- Articulated Feet
- Dynamic Response
- Microprocessor Controlled Feet
- Bionic feet
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Advances in Prosthetic Technology49
Modern ProstheticsProsthetic Foot Technology
Socket
Joint
Terminal Device
Upper Extremity
Feet
- Conventional feet (CF)
- Energy-Storage-and-Return (ESR)
- Articulated Feet
- Dynamic Response
- Microprocessor Controlled Feet
- Bionic feet
Advances in Prosthetic Technology50
Upper Extremity Prosthetics
Advances in Prosthetic Technology51
Historical Perspective
Early 1500s
- Gotz Von Berlichingen
- German engineering
- Articulated hands
- Mechanical masterpieces
Socket
Joint
Terminal Device
Upper Extremity
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Advances in Prosthetic Technology52
Historical Perspective
World War II
- 1929 – 1945
- U.S. Gov. brokered deal with military companies to improve prosthetic function
- Marked the beginning of the era of modern prosthetics
