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July 28, 2014

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The body unlimited: Technological advances change life for those with disabilities — and without

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Christopher DeVargas

A look at the orthotics and prosthetics lab and workshop at Precision Orthotics & Prosthetics Las Vegas, Tuesday, June 10, 2014.

Making Prosthetics

Prosthetist Kevin Bidwell works on a molded cast of a clients amputated limb, which will be used to create an exact fitting prosthetic limb for the client. Tuesday,  June 10, 2014. Launch slideshow »

The images are astounding: Las Vegas’ own Amy Purdy dancing on prosthetic legs; survivors of the Boston marathon attacks going back to work with man-made arms; Paralympic athletes on Bladerunner feet beating able-bodied runners to the finish line; a paraplegic in an “Iron Man” suit opening the World Cup soccer championship.

There was a time not so long ago when people with missing limbs were relegated to lives in wheelchairs and diminished opportunity. Not anymore.

Today, doctors can manipulate the human body in amazing ways — implanting joints, limbs and parts to return movement, function and appearance, and fashioning futuristic devices that rival, and in some cases exceed, real flesh and bones.

Experts say more than 50 percent of the human body can be replaced with mechanical organs or electronic implants.

For some — a senior receiving a hip implant or a disabled person getting a new spinal disk — the prostheses are medically necessary. For others, they are psychological, cosmetic or just convenient.

Advances in technology have given people in need or want of prosthetics newfound hope and ability in engineered bodies. The field is advancing at warp speed, propelled by doctors, researchers and Hollywood special effects groups.

Researchers envision even able-bodied people in the not-so-distant future lining up for prostheses to simplify tasks or improve the way they work and play. Prosthetics designers already have created apparatuses with cellphone chargers, laser pointers and magnifying glasses.

An Austrian man who injured his hand in a motorcycle crash last year chose to amputate his damaged limb and replace it with a bionic fitting. He now can open a bottle quickly and tie his shoelaces. His was the second elective amputation his doctor performed.

DID YOU KNOW?

Veterinarians in Thailand fashioned an enormous prosthetic leg for Motola, an elephant who lost a foot when she walked over a landmine. She needed three years of practice to master the leg.

This summer, the military plans to test a suit that will encase soldiers in a computer-powered exoskeleton with bulletproof body armor and built-in weaponry that developers say will improve their survivability and give them a tactical advantage.

Las Vegan Eddie Garcia, a quadriplegic whose limbs were removed because of complications from flesh-eating bacteria, already has seen significant advancements in prosthetic technology in a little more than a year.

Garcia’s first legs required the support of a walker and gave him a gait “like Frankenstein,” he said. His new legs have microprocessors in the ankles that allow his feet to adjust to changes in terrain, similar to human ankles.

“Just the way the technology is advancing, I’m excited to see what’s in the future,” Garcia said.

Garcia turned down an experimental hand transplant to see what’s next in the world of prosthetics. He’s waiting for lightweight prosthetic hands that he can operate with his mind.

“I might be the next real-life Iron Man,” Garcia said.

Prostheses also are becoming much more affordable with advances in battery technology and 3-D printing. People across the globe have begun to fashion amazingly effective do-it-yourself devices.

“Some people feel like their life was taken away from them,” said Jimmy Colson, CEO of Precision Orthotics & Prosthetics in Las Vegas. “But we’re able to give it back.”

For the dogs: Neuticles, ears

DID YOU KNOW?

An avid bike rider and former welder who lost a finger in a shooting accident made a prosthetic digit from bicycle parts, while a woman whose foot was crushed in a car crash made a prosthesis from Legos. For Halloween, the same woman made a fake leg from pumpkins.

Think prostheses are for humans only? Think again.

Neuticles — prosthetic testicular implants for animals — help neutered dogs and cats feel whole again. They’re also available for bulls, horses and other domesticated animals.

A National Institutes of Health study found that many male dogs seemed depressed after getting neutered. While the evidence is mostly circumstantial, many pet owners report that their animals appear to regain their energy and a sense of general happiness after having Neuticle surgery.

Introduced in 1995, the prostheses grew in popularity in 2010 when Kim Kardashian had them implanted in her dog during an episode of “Keeping up with the Kardashians.” In their 18-year existence, Neuticles have been implanted in 500,000 animals.

The company also has a new invention: PermaStay, ear implants to help straighten bent, folded or broken dog ears.

What the future holds

DID YOU KNOW?

Close to 1,800 soldiers returned from Afghanistan and Iraq with missing limbs, and more than 300 have returned to active duty with the help of prostheses.

Experts are creating mind-blowing prostheses that are expanding the boundaries of what people — both disabled and not — can do. Consider:

• Monitor glucose with tattoos: Diabetics soon may be able to monitor their glucose level with a tattoo. A Northeastern University professor invented tattoo ink that uses implanted conductive, fluorescent and nanoparticle materials to track health indicators in people’s bodies. The goal is to create an app that will work with the tattoos to enable people to continuously monitor their biometric levels.

• Prostheses that feel: Doctors are developing prostheses that can feel sensations. Prototypes allow wearers to identify shapes when holding blocks. The ultimate goal is to integrate artificial body parts into a person’s nervous system.

• Keypad arm implants: Imagine cellphone buttons lighting up the palm of your hand or a touchscreen on your forearm. Engineers are working to make both a reality. Scientists at Carnegie Mellon University and Microsoft Research designed a system that uses a person’s skin as an input device for electronics such as cellphones, MP3 players and gaming consoles. An armband uses a tiny projector to beam a digital interface onto your skin, then determines where you tapped based on differences in your anatomy. A Bluetooth connection sends the information to your device.

• Morphing prostheses: Scientists are developing computer-controlled compliant prostheses that can morph and change shape. One example: a robot arm that’s malleable so its fingers can fit through tiny openings and grasp unusual shapes.

• Mind-controlled limbs: Engineers have brought mind-controlled prostheses out of the lab and into the marketplace. Patients paralyzed from the neck down have shown they can move prosthetic arms with their minds. One woman picked up a bottle of coffee and drank it without help for the first time in 15 years. Electrodes implanted in her brain directed the arm via computer.

How medical science rebuilds the body

Prostheses — artificial body parts and implants — have been used for thousands of years. Today, state-of-the-art medical and manufacturing techniques give doctors the tools not only to re-create missing limbs and organs, but to restore function. What’s shown here is only a sampling of some of the types of artificial replacements medical science can offer patients.

• COST: When it comes to cost, prostheses are much like cars. They can be fairly cheap or wildly expensive, depending on the features you choose. A prosthetic arm can cost from $2,000 to $20,000; a leg, from $4,500 to $50,000. A large part of the cost comes from the fact that each prosthesis must be custom-made to fit its recipient.

• LONGEVITY: Prosthetic limbs typically last three to five years, although they can last longer. Most are built specifically for a person’s body type, so changes in weight, height or physical activity can affect their longevity.

• CAUSES: About 1.7 million Americans are amputees, according to a 2013 study by NetWellness. Almost 80 percent of those amputations result from vascular disease, including diabetes. The rest are attributed to trauma or illnesses, such as cancer.

• ADVANCES: Improvements in medical techniques have made the replacement of hips and knees, for example — which, not long ago, represented very serious surgery — a matter of routine. And improvements in materials and manufacturing techniques make it possible for those artificial joints to last years longer than those implanted even five years ago.

    • Legs: The competition blade

      Invented in 1984, Flex-Foot Cheetah limbs have gained national attention in the past few years, largely because of South African double amputee Oscar Pistorius’ success using them on the track. Pistorius is a world-record-setting Olympic sprinter who was accused of murdering his girlfriend last year.

      Bladerunners,” as they are called, are made out of carbon-fiber-reinforced polymer, an extremely strong but light material that’s also used for baseball bats, bicycles and helmets. Depending on a person’s size and weight, 30 to 90 sheets of polymer epoxy are layered and formed into solid, slightly C-shaped limbs. They cost $15,000 to $18,000 per leg.

      Ninety percent of Paralympics runners use a version of the Flex-Foot design, and critics have argued it gives them an unfair advantage against able-bodied athletes.

      The feet of the prostheses give slightly on impact, creating a spring-like effect that propels wearers forward. Though nimble, these bladelike feet also can be brittle and have been known to snap.

    • Arms: The tentacle

      Kaylene Kau, a recent graduate of the University of Washington’s Industrial Design program, conceived this tentacle-like prosthesis as a replacement for the user’s nondominant hand. The idea was to give the user good dexterity and a strong grip with a simple, durable mechanism — and to break from the notion that the prosthesis must resemble the limb it’s meant to replace.

    • For men: penis

      Full male genitalia can be fashioned from silicone gel and designed to match different skin colors. They can be held on by strap or harness or affixed with silicone medical adhesive. Testicular prostheses also are available.

      In addition, a prosthesis can help improve the function of an existing penis. Men suffering from erectile dysfunction can have a penile prosthesis surgically implanted as a form of treatment. The simplest procedure involves placing two malleable rods into the body, leaving the penis permanently semi-rigid.

    • Breasts: Silicone or foam

      Reconstructive surgery isn’t the only option for women who undergo single or double mastectomies. Prostheses can offer a simpler, surgery-free option for replicating natural breasts.

      There are lightweight models made of foam or fiberfill that women typically use immediately after surgery, and silicone models more suitable for long-term use since they best replicate the look and feel of natural breast tissue. Both types slip into a specialty bra.

      Some prosthetic breasts stick directly to a woman’s body with adhesive, but they are susceptible to coming undone in very hot water or during vigorous physical activity.

    • Exterior: Face, eye, skin

      Patients who have suffered severe facial injury — whether from car crashes, gunshot wounds or disease — have more options available than ever before. Sophisticated computer modeling and microsurgery techniques allow surgeons to reconstruct missing facial bones and cartilage, and synthesize realistic silicone skin.

      Advances in miniature electronics have produced some of the most amazing prosthetic developments of all — replacement eyes that can actually see. German researchers last year debuted the Alpha IMS retinal prosthesis, which helps restore vision in damaged eyes. A small metal chip, powered by a battery kept in the patient’s pocket, is implanted in the back of the person’s eye to stimulate his or her brain with 1,500 electrodes.

      When it comes to skin, prostheses most often are used for passive devices resembling fingers, toes or ears that don’t move. Manufacturers typically make a mold of an existing digit or lobe, then fashion a silicone match. The inside is painted rather than the outside to prevent damage from water, detergents or scrubbing. The prostheses can include hair, veins, tattoos and freckles, and paintable acrylic nails can be added to fingers and toes.

    • Spine: New disks, bones

      Artificial replacements for the cushioning discs between the vertebrae (spinal bones) have been around since the late 1980s. More recently, replacements for the more delicate cervical (neck) discs have been rolled out.

      In more unusual treatments, doctors are using titanium bones to replace ribs or to correct spinal deformities.

    • Heart: New valves

      There are two main types of heart valve prostheses: mechanical and tissue. They’re required when patients suffer from valvular heart disease, meaning one or more of their heart valves fails.

      Tissue valves, which are slightly more common, are heart valves taken from animals. The valves are treated, then implanted into patients. Pig valves are selected most often because they most closely resemble human valves.

      Mechanical heart valves use man-made materials to help pump blood through damaged valves. They used to be designed using a small silicone ball inside a wired cage, but the procedure had a high mortality rate. More recently, doctors began using self-expanding rings to replaced damaged valves because they more closely mimic human anatomy.

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