Imagine losing a limb—and learning to make the transition from that traumatic and life-changing event to regaining functionality with a prosthesis: from surgery, healing, and recuperation to accepting and adjusting to the new reality, learning about prosthetics options, and heading down that road.
In the United States alone, approximately 185,000 people experience amputation every year. Timothy Nelson, director of orthotics and prosthetics at Audubon Orthotic & Prosthetic Services in Colorado Springs says, “In the U.S., some 1.7 million people live without a limb... There are multiple reasons an amputation becomes necessary, including disease, trauma, or congenital disorders, but most patients in need of prosthetics are the result of diabetes or vascular disorders.” It is also important to note that the world of prosthetics has come a long way in recent years and covers a lot of territory.
Every amputation recovery and prosthesis fitting is unique, but all prostheses have the same general parts, says Eric Neufeld, chief prosthetist and patient champion with Agile Orthopedics. “The socket is the interface between the residual limb and the rest of the prosthesis. Attached to the socket are components like a knee, shin section, and foot. The difference between ‘everyday’ and ‘sport-specific’ prostheses is the components.” He explains, for example, that an everyday prosthetic foot can be used on even ground, stairs, ramps, and uneven terrain, whereas a sport-specific or running prosthesis utilizes a blade-style foot designed for running, which would be difficult to use at slower speeds or up hills.
“Body-powered devices refer to upper extremity devices,” Neufeld adds, “which harness power from body movements to activate cables and pulleys in order to operate elbows and hooks or hands. A cosmetic prosthesis is one that isn’t functional, but rather takes the general shape of a missing limb and, in some cases, contains details like hair and freckles.”
Nelson says a significant factor in determining a successful prosthetic fit is the health of the patient prior to the amputation with post-op physical therapy being very important. “Motivation of the patient and strong support of family and friends can never be overemphasized,” he says, adding that a patient’s healthcare network may include “the surgeon, prosthetist, physical therapist, occupational therapists, and many other healthcare professionals. The patient may need to find local support groups to meet people who are going through or have gone through similar procedures.”
Patient-centric care is, of course, a high priority for prosthetics providers. Colorado Springs resident and business co-owner Melissa Stockwell knows firsthand what is involved in the amputation-to-prosthesis journey. When she was just 24 years old and an Army officer, she lost her left leg to a roadside bomb in Iraq. Fifty-two days and many surgeries, infections, and blood transfusions later, she stood up for the first time on her above-the-knee prosthetic leg. She hasn’t stopped moving since. Stockwell and her husband, Brian Tolsma, co-founded Tolsma/Stockwell Prosthetics, which opened a year ago in Colorado Springs, and in addition to working closely with prosthetics and orthotics patients, Stockwell is training for this summer’s Tokyo Paralympic Games as a paratriathlete.
Walking into Tolsma/Stockwell Prosthetics doesn’t feel like going to a doctor’s office. “There’s no reception desk,” says Stockwell, “it’s a very family centered office. We want our patients to come and feel comfortable.” Part of what makes working in this field so rewarding for the team of Stockwell and Tolsma (both certified prosthetists) is literally helping people get back on their feet. “And there’s no reward like it,” says Stockwell. Tolsma/Stockwell serves pediatric patients, elite athletes, and anyone in between. “We are a patient-first practice and customize our devices to the needs of the patient.”
Agile Orthopedics recently expanded to Colorado Springs and is the only prosthetic provider in the state to offer mobile services. “Before creating Agile Orthopedics,” says Neufeld, “I discovered that nearly 50% of prosthetic office appointments resulted in a ‘no show.’ After speaking with patients who missed their appointments, the reason sounded so simple; the majority of mobility-impaired patients struggled to find convenient transportation to appointments, couldn’t miss a day of work, or given today’s pandemic, felt they were too high risk for office exposure.” The company currently has six mobile clinics to serve patients in their homes. The mobile model, says Neufeld, has helped Agile achieve a less than 1% no-show rate.
Advances related to the prosthetics themselves include lightweight composites and metals, such as titanium and aluminum, which have allowed for more durability and function, says Nelson. “The advancements in materials paired with new technology, including microprocessors, help to assist with gait and other safety aspects. The newer materials and components can help mimic a response that may have been generated by the original limb.”
Nelson adds that the current state of the art in the prosthetics field includes an emergence of more microprocessors and robotic technology. “Much of this technology is still in the developmental stage and is cost prohibitive at this time,” he says. “Many private insurance carriers and Medicare have strict guidelines on what they will reimburse for prosthetic devices. With the everchanging landscape of healthcare reimbursement and costs, only time will tell if most of the new advancements will make their way into mainstream usage.”
The field of prosthetics is constantly evolving, says Nelson, “so it is exciting to see what the next progression will be.”