Alisdair Gilbertson -- a senior prosthetist and manager with Ottobock - talks at Meningitis Research Foundation's Life beyond limb loss day - Pushing the Boundaries 2014

1. Advanced Prosthetics
By
Alasdair Gilbertson
Senior Prosthetist ottobock Healthcare

2. Berlin 1919
Duderstadt 2014.
Lower Saxony

3. CAD/CAM
Paralympics service provider
Car components Information Technology

4. Orthotics

5. Specialist Seating

6. Upper limb amputees 11,000
Lower limb amputees 52,000
Number of UK amputees

7. 1000
900
800
700
600
500
400
300
200
100
0
Number
Under
16
16-54 55-64 65-74 75+
Age
Female
Male
Age distribution of UK amputees

8. 60
50
40
30
20
10
0
%
Causes of lower limb amputation
PVD Diabetes +
PVD
Trauma Malignancy Congenital Other
Cause
Aetiology of lower limb amputation

9. Annual number of UK young amputees
200-300 children every year in the UK
• Congenital absence
• Congenital deformity resulting in amputation
• Sarcoma, infection
• Acquired amputation

10. Acquired limb deficiency or amputation is not as common as
congenital limb deficiency in children.
Frequent causes of trauma are hands or feet caught in machinery, or motor vehicle
and lawn mower injuries.
Severe infections and interruptions to the blood supply to limbs, such as occurs in
meningococcal septicaemia, can cause multiple limb loss.
Approximately 3200 cases of bacterial meningitis and associated septicaemia in the
UK each year.
10%-15% of cases result in amputation
Bone or soft tissue tumours may require amputation as a life-saving measure along
with other cancer treatment. Phantom pain can occur after amputation in children
and may require medication along with other types of treatment.

11. • Restore function
• Stabilize joints
• Cosmetic appearance

13. 13
Egyptian prosthetic toe 950-710 BC
Capua Leg 300 BC
World War 1 Circa 1950 gas powered prostheses

15. Residual limb is wrapped in Plaster of Paris
bandage.
Plaster model is modified.

19. 19
Carbon fibre
Titanium
Silicones
Plastics

20. Components

22. Computer Aided Design and manufacture
22
(CAD/CAM)

25. Otto Bock Michelangelo Hand

27. 27
Genium
Genium X3

28. 28
Microprocessor controlled knees
……the next generation.
Gyroscope, Acceleration
Sensor and Angle Sensor
Knee Moment Sensor
AXON Tube Adapter
Hydraulic Cylinder
Battery and Electronics
BluetoothR
Inductive Charging

29. Blue tooth Programming

30. 30
Laser Alignment

33. 33

37. 37

38. 38

39. Getting back to normal life

41. Multi-Disciplinary Team approach
Upper limb Amputee
• Patient
• Rehabilitation consultant
• Prosthetist
• Occupational Therapist
• Parents & Teachers
• Counsellor
Lower limb Amputee
• Patient
• Rehabilitation consultant
• Prosthetist
• Physiotherapist and/or
Occupational Therapist
• Parents & Teachers
• Counsellor

42. Prosthetic management
• Work with your clinical team

44. Problems with wearing a Prosthesis
• Increase in energy levels
• Phantom limb pain
• Folliculitis
• etc

45. 45
Outcomes data
Maintain or improve mobility, socket
comfort, gait and satisfaction as
measured by valid reliable,
standardised outcome measures

46. 46
Outcome are evaluated via patient performance tests and
questionnaires
Performance based tests Self-reported Questionnaires

47. 47
Fitness App for Lower Limb Amputees
• The app consists of 2 modules: “Strength &
Endurance” and “Coordination & Balance”
and offers 16 exercises and three difficulty
levels.
• The exercises require no workout equipment
beyond a cushion or a football, and the
instructions are simple to follow.
• Amputees can take this ‘personal trainer’
with them anywhere, and integrate the
exercises into their everyday fitness or
therapeutic routine.

48. 48

49. Thank You
Any Questions?