Osseointegrated prostheses for rehabilitation following amputation : The pioneering Swedish model.

The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program. The standard implant design of the OPRA system and surgical techniques are described as well as the special rehabilitation protocols based on surgical sites. The results of long-term follow-up for transradial, transhumeral, and thumb amputee operations are briefly reported including the prospective study of transfemoral amputees according to OPRA protocol. The importance of refinement on implant designs and surgical techniques based on the biomechanical analysis and early clinical trials is emphasized. Future aspects on osseointegration surgery are briefly described, including novel treatment options using implanted electrodes

Introduction to Prosthetic Limbs

Approximately 2 million people in the Unites States alone have had an amputation, and many of these people use a prosthetic limb daily. The prosthetic limb, which began as a primitive device, is now a highly sophisticated piece of technology. It is because of many devoted scientists that we now have access to this life-transforming device. There are many causes for amputation; a few causes included disease, accidents, and congenital conditions. Although missing a limb can be life-altering, health care teams consisting of physicians, physical therapists, and orthotists are dedicated to helping people return to everyday activities and to excel in their pursuits

An adaptive hybrid control architecture for an active transfemoral prosthesis

The daily usage of a prosthesis for people with an amputation consists of phases of intermittentand continuous walking patterns. Based on this observation, this paper introduces a novel hybrid architectureto control a transfemoral prosthesis, where separate algorithms are used depending on these two differenttypes of movement. For intermittent walking, an interpolation-based algorithm generates control signals forthe ankle and knee joints, whereas, for continuous walking, the control signals are generated utilizing anadaptive frequency oscillator. A switching strategy that allows for smooth transitioning from one controllerto another is also presented in the design of the architecture. The individual algorithms for the generation ofthe joints angles’ references, along with the switching strategy were experimentally validated on a pilottest with a healthy subject wearing an able-bodied adapter and a designed transfemoral prosthesis. Theresults demonstrate the capability of the individual algorithms to generate the required control signals whileundergoing smooth transitions when required. Through the use of a combination of interpolation and adaptivefrequency oscillator-based methods, the controller also demonstrates its response adaptation capability tovarious walking speeds

Towards a Smart Semi-Active Prosthetic Leg: Preliminary Assessment and Testing

This paper presents a development of a semi-active prosthetic knee, which can work in both active and passive modes based on the energy required during the gait cycle of various activities of daily livings (ADLs). The prosthetic limb is equipped with various sensors to measure the kinematic and kinetic parameters of both prosthetic limbs. This prosthetic knee is designed to be back-drivable in passive mode to provide a potential use in energy regeneration when there negative energy across the knee joint. Preliminary test has been performed on transfemoral amputee in passive mode to provide some insight to the amputee/prosthesis interaction and performance with the designed prosthetic knee

An adaptive hybrid control architecture for an active transfemoral prosthesis

The daily usage of a prosthesis for people with an amputation consists of phases of intermittent and continuous walking patterns. Based on this observation, this paper introduces a novel hybrid architecture to control a transfemoral prosthesis, where separate algorithms are used depending on these two different types of movement. For intermittent walking, an interpolation-based algorithm generates control signals for the ankle and knee joints, whereas, for continuous walking, the control signals are generated utilizing an adaptive frequency oscillator. A switching strategy that allows for smooth transitioning from one controller to another is also presented in the design of the architecture. The individual algorithms for the generation of the joints angles’ references, along with the switching strategy were experimentally validated on a pilot test with a healthy subject wearing an able-bodied adapter and a designed transfemoral prosthesis. The results demonstrate the capability of the individual algorithms to generate the required control signals while undergoing smooth transitions when required. Through the use of a combination of interpolation and adaptive frequency oscillator-based methods, the controller also demonstrates its response adaptation capability to various walking speeds

Virtual prototyping of a semi-active transfemoral prosthetic leg

This article presents a virtual prototyping study of a semi-active lower limb prosthesis to improve the functionality of an amputee during prosthesis–environment interaction for level ground walking. Articulated ankle–foot prosthesis and a single-axis semi-active prosthetic knee with active and passive operating modes were considered. Data for level ground walking were collected using a photogrammetric method in order to develop a base-line simulation model and with the hip kinematics input to verify the proposed design. The simulated results show that the semi-active lower limb prosthesis is able to move efficiently in passive mode, and the activation time of the knee actuator can be reduced by approximately 50%. Therefore, this semi-active system has the potential to reduce the energy consumption of the actuators required during level ground walking and requires less compensation from the amputee due to lower deviation of the vertical excursion of body centre of mass