Urgency needed for prosthesis advancement 

At the recent TED conference in Vancouver, British Columbia, one of the most memorable and powerful talks was given by a man who had lost both his legs in a climbing accident 30 years ago, Hugh Herr, now head of the Massachusetts Institute of Technology Media Lab’s Biomechatronics group.

His accident had spurred him to develop sophisticated prosthetics, blending the science of organismal and cellular neuromechanics with the technology of a bionic device. Herr stood on the stage wearing limbs that merged muscle stimulation, brain wave actuators and novel materials. They were the coolest artificial leg ever seen. He showed slides of people rock climbing and doing extreme sports with the prosthesis. At the end of his talk, ballroom dancer Adrianne Haslet-Davis, who lost her left leg in the Boston Marathon bombing, performed again for the first time.

However, the sad reality is that, due to cost, these high-tech prosthetics will be out of reach for the vast majority of people. Herr and his team face an uphill struggle to get Medicare’s reimbursement agency, the Center for Medicare & Medicaid Services, to reimburse such devices. The limbs that Herr was wearing have been fitted on nearly 1,000 patients, 400 of whom are U.S. soldiers. Meanwhile, there are 2 million people in the U.S. living with limb loss. Why the huge disconnect?

Whether in medical technology or extreme sports, those who push the limits of existing devices and invent new ones lead the field and drive advances, with the eventual trickle-down effect reaching the masses. In sport, we saw it clearly in San Francisco with the America’s Cup races that used never-before-seen carbon fiber wings on catamarans to exceed the speed of the wind in a sailing race. The technologies developed for that race will revolutionize sailing at every level within a few years.

The advances made by figuring out how to use brain waves and direct nerve-to-muscle connections to permit an amputee to dance again fits into the same category. Whether or not sailing adopts the cool new toys is of no consequence to those outside the narrow world of sailing. On the other hand, whether people can gain access to prostheses that enable them to live and work effectively is of enormous consequence. The question is how to fund advanced bionics without maniacal sports-driven billionaires backing them. In a cost driven world, government health programs will never get the trickle-down approach.

The way I see it, the answer lies in the merging of advanced bionics with inexpensive prosthesis design. Prostheses are bulky, poorly fitting and are nonsmart. The new cool designs have to be applied to the most inexpensive manufacturing processes immediately. The interaction between muscle and prosthesis action has to be simplified to provide prostheses that work better now. And while only 64 percent of the world has access to a toilet, 85 percent has access a cellphone, so the future of smart prosthesis lies in the connection of the prosthesis to the cellphone computer that everyone is carrying.

When those interrelated advances are clearly defined, then governments and individuals will fund leading-edge developments. The future of medical technological advances will depend on defining and developing the immediate interaction between extreme novelty and urgent applicability.

Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco. He pioneers advanced orthopedic surgical and rehabilitation techniques to repair, regenerate and replace damaged cartilage and ligaments. For more info, visit www.stoneclinic.com.

About The Author

Dr. Kevin R. Stone

Bio:
Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco. He pioneers advanced orthopedic surgical and rehabilitation techniques to repair, regenerate and replace damaged cartilage and ligaments.
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