Benefits and Drawbacks: Understanding the Pros and Cons of Prosthetics

The decision to use a prosthetic device comes with “pros and cons.” To understand how prosthetics can impact life in terms of mobility, autonomy, and finances read our analysis that provides insights without adding fluff, helping you consider what prosthetic use would mean for you or a loved one.

Key Takeaways

  • Prosthetic devices are essential for restoring lost functionality and independence, categorized into upper limb, lower limb, and craniofacial prostheses, each with unique benefits and challenges such as limited range of motion and requirement for meticulous fitting and alignment.
  • Though prosthetic limbs enhance mobility, increase independence, and improve psychological well-being, users often face discomfort, skin irritation, and financial burdens due to high costs, ongoing maintenance, and inadequate insurance coverage.
  • Technological advancements in prosthetics, including myoelectric control, 3D printing, and brain-computer interfaces, offer potential for enhanced functionality; however, ongoing care, rehabilitation, and coping strategies remain critical for the long-term success and well-being of prosthetic users.

Understanding Prosthetic Devices

Selection of various mechanical prosthetic feet - Photo Ottobock
Selection of various mechanical prosthetic feet – Photo Ottobock

Prosthetic devices, such as prosthetic legs, are instrumental in regaining lost functionality and independence for individuals with amputations or congenital limb deficiencies. These devices are not just a physical aid; they also show the power of scientific innovation.

Prosthetic devices are primarily divided into three categories: upper limb, lower limb, and craniofacial prostheses. Each category is designed to address specific physical needs and restore functionality for users. Each category caters to a specific type of limb loss, with unique sets of advantages and challenges.

Upper Limb Prosthesis

Upper limb prostheses are specifically created to replace missing arms, hands, or fingers. They are tailored to the individual’s unique needs and provide functional and cosmetic benefits. They are primarily categorized into body-powered and myoelectric types, with the latter functioning through electrical signals from the user’s remaining muscles.

Despite the advancements in technology, prosthetic arms today cannot fully replicate the mobility and grasp patterns of a natural arm. The success of a prosthetic hand in daily function hinges heavily on the integrity and performance of the shoulder and elbow joints of the amputee. Furthermore, users often experience discomfort due to factors like the weight of the prosthetic arm and the physical strain needed to control its movements.

Lower Limb Prosthesis

Lower limb prostheses are created with the intention of restoring both the functional and cosmetic aspects of the lower limb by replacing missing or damaged legs, feet, or toes, such as in the case of an amputated leg. They are designed to provide individuals with improved mobility and appearance. The type of lower limb prosthesis prescribed depends on the level of amputation and may include specific components like SACH feet, patellar tendon-bearing sockets, and various prosthetic legs/knees.

The fabrication and fitting process of a prosthesis is a long procedure that includes bench alignment, static and dynamic alignment during fitting sessions, and making final adjustments during the rehabilitation program. The interface materials and pylon/frame materials can vary from soft to hard, including options like silicone and thermogel liners, and aluminum or titanium frames, respectively, all chosen during the multidisciplinary prescription process tailored to the individual’s needs.

Craniofacial Prosthesis

Craniofacial prostheses are designed to replace missing or damaged parts of the head and face, such as ears, noses, or eyes, helping to restore the facial features of individuals. The design of these prostheses aims to achieve a natural appearance through the matching of skin color and texture, and functional integration with the patient’s existing anatomical structures.

Anaplastologists, specialists trained in art, anatomy, and material sciences, primarily use silicone rubber to create these realistic-looking craniofacial prosthetics for soft tissues. They can be attached to the face either through medical-grade adhesive, which can be less reliable under certain conditions, or via bone-integrated implants known as osseointegration, which provides a more secure fit.

However, these prosthetics undergo degradation over time, typically requiring a remaking every two years to maintain their appearance and function.

The Advantages of Prosthetic Limbs

While prosthetic devices present challenges, they also offer significant benefits to the users. Modern prosthetics are designed to mimic the appearance and function of natural limbs, aiding in the restoration of lost functions and contributing to the user’s sense of normalcy.

Prosthetic devices can provide users with the benefits like these:

  • Greater mobility, allowing them to perform daily tasks more easily
  • Increased employment opportunities
  • Greater social participation, enhancing the user’s sense of purpose and community involvement

These benefits contribute to improving the overall quality of life for prosthetic device users.

Enhanced Mobility

Prosthetic limbs, also known as artificial limbs, significantly improve mobility for amputees, facilitating movements and tasks that would otherwise be challenging. Through their design, these devices aim to mimic the function of the amputated limb, restoring the ability to walk, run, and navigate varied terrains.

Amputees, including bilateral amputees, using prosthetic limbs are also able to engage in sports and physical activities, which can lead to mood improvements and a healthier lifestyle. Furthermore, a significant proportion of lower limb amputees who rely on wheelchairs may experience a reduced quality of life and higher healthcare costs compared to those who use prosthetic limbs.

Increased Independence

Prosthetic limbs enable individuals to perform a wide range of activities independently, reducing reliance on assistive devices or personal assistance. This greater sense of personal autonomy and control over their lives can lead to a more positive outlook and resilience in the face of challenges.

However, bear in mind that discomfort from prosthetic limbs can significantly impact the user’s work and social life, affecting employment and the ability to participate in hobbies and maintain independence.

Psychological Well-being

Beyond the physical benefits, prosthetic limbs also have a profound impact on psychological well-being. They can help individuals overcome the psychological challenges associated with limb loss, such as:

  • despair
  • depression
  • nervousness
  • anxiety
  • loss of self-esteem
  • stigma
  • isolation

Adapting to prosthetics can facilitate a healthier mourning process for those who may experience shock, anger, grief, and non-acceptance following limb loss. The use of prosthetics assists in the gradual accommodation of a new self-representation, aligning the ‘internal self’ with the ‘external self’ for regaining a sense of normality, while also providing continuity with the former self. This process is significantly enhanced by the support from family, friends, and therapists, which is crucial in developing a positive self-representation post-amputation.

The Disadvantages of Prosthetic Limbs

Man sitting down pulling up the sleeve on his prosthesis getting ready to ride his bike
Man sitting down pulling up the sleeve on his prosthesis getting ready to ride his bike

Despite the numerous benefits of prosthetic devices, we must also acknowledge the challenges they can present. Some of these challenges can include:

  • The high cost and lack of insurance coverage, which can be a significant barrier for individuals who require these devices.
  • Prosthetic limbs can cause discomfort to the user and generally require maintenance, both of which incur additional costs.
  • These devices often have a limited range of motion, which restricts the users’ ability to perform certain movements as compared with a natural limb.

Limited Functionality

While they aim to mimic natural limbs, prosthetic limbs often lack the range of motion and fine motor control of the remaining limb, impacting the ability to perform complex activities such as self-care and interaction with the environment. Individuals with upper-limb prostheses tend to experience greater dissatisfaction with the restoration of function due to more pronounced limitations.

Challenges with prostheses can include:

  • Motion-selection time delays
  • Lack of sensory feedback
  • Difficulties with consistent signal capture
  • Factors such as socket fit and sweating

To compensate for the limited functionality, prosthetic users often execute more discrete submovements, including finger movement, when performing tasks, leading to a longer time to reach for and grasp objects.

Discomfort and Skin Irritation

Discomfort and skin irritation are common challenges faced by prosthetic users. Ill-fitting prosthetic sockets can lead to pain, discomfort, and skin conditions, causing users to stop using their prosthesis. A poorly fitted body-powered prosthesis harness may require a tight fit on the body, which can cause significant discomfort and potentially result in the user abandoning the device.

Additionally, the first indicators of skin problems due to prosthetic use are redness and a burning sensation, escalating to pain, swelling, the formation of blisters, and development of ulcers, eventually leading to more serious skin damage and possible infections. Skin irritation and damage are more likely where there is an abundance of tissue at the end of the bone, in areas of loose or burned skin, skin grafts, thick or deep scars, and around bony prominences.

Financial Burden

The financial burden associated with prosthetic devices is a significant disadvantage for many. Myoelectric prostheses are significantly more expensive than body-powered systems due to their complex technology involving motors and batteries. Beyond their purchase cost, the maintenance and repair costs of myoelectric prostheses are considerable, often due to their higher likelihood of breakdowns compared to simpler prostheses.

Furthermore, individuals without Medicare or Medicaid may face additional financial hardship as commercial insurance does not always cover the full costs of prosthetic limbs. Prosthetic users often encounter indirect costs such as travel expenses, lost income from time out of work, and out-of-pocket spending, which are expenses not always covered by insurance.

Technological Advances in Prosthetics

Product shot of Ottobocks Meridium Foot which is a microprocessor foot - Photo Credit Ottobock
Product shot of Ottobocks Meridium Foot which is a microprocessor foot – Photo Credit Ottobock

Despite the challenges, there are exciting developments in the field and e´merging prosthetic technologies include:

  • Osseointegration, which involves direct implantation into the remaining bone of a residual limb. Whch has evolved significantly the last couple of years with new procedures. Devices that integrate with a residual limb through direct implantation into the bone and electronic connection with the nerves which can help getting back the sense of touch.
  • 3D printed components
  • Bionic prostheses

State-of-the-art prosthetic limbs with advanced materials and technology can provide sensory feedback, contributing to a more natural walking experience and improved prosthetic control. We will now further elaborate on these technological advancements.

Myoelectric Control

Pattern recognition in myoelectric controls uses advanced algorithms to interpret multiple EMG signals for more nuanced and simultaneous control of prosthetic functions. Targeted muscle reinnervation (TMR) improves myoelectric prosthetic control by enhancing the signal strength and control intuitiveness through surgical redirection of nerves to remaining muscles.

Implantable myoelectric sensors (IMESs) transmit EMG signals wirelessly from within the muscle to the prosthesis, leading to higher signal-to-noise ratios and more reliable control. However, there are also some difficulties to consider. Myoelectric prostheses can be uncomfortable due to the need for an intimate fit, which may not be well-tolerated by fragile skin or may be affected by scar tissue and excessive sweating.

3D Printing

3D printing is revolutionizing the production of prosthetic devices. Computer-aided design and customized fittings ensure that prosthetic limbs are tailored to individual needs, enhancing mobility and functionality.

3D printing allows for the creation of prosthetic devices with dynamic behaviors, such as sockets that are stiff in some areas and flexible in others for cushioning. The rapid and precise scan-to-print process of 3D printing facilitates quick design iterations to improve the fit of prosthetic devices, a significant advantage for children who may outgrow their prostheses.

Brain-Computer Interfaces

Brain-Computer Interfaces (BCIs) have the potential to revolutionize prosthetic devices, offering greater functionality and control. Technologies are advancing to connect prosthetic devices, such as legs, to the patient’s nervous system, enhancing their ability to ‘feel’ the movements of the prosthesis.

Researchers are creating BCIs that enable individuals with paralysis to control computer interfaces or prosthetic limbs, thereby expanding the functionality of these devices. BCIs can be integrated into robotic limbs to grant users a synthetic sense of touch, drastically improving the user experience. However, despite their promise, most BCI systems remain experimental with challenges like:

  • interpreting unique individual brain signals effectively
  • ensuring long-term reliability and stability
  • minimizing invasiveness and discomfort
  • improving the speed and accuracy of signal processing

Prosthetic Care and Rehabilitation

Man wearing a running blade working out on the treadmill
Person in a running blade taking a run

Prosthetic care and rehabilitation are crucial elements in the journey of prosthetic users. Preventive measures for prosthetic care include:

  • Adherence to good stump hygiene
  • Maintaining interface and socket fit
  • Stable body weight
  • A nutritious diet
  • Well-managed blood sugar
  • Correct prosthesis alignment

Working closely with healthcare providers ensures the proper care and maintenance of prosthetic devices, which is crucial for the long-term functionality and comfort of the prosthesis.

Physical Therapy

Physical therapy for amputees consists of:

  • Exercises improving joint movement
  • Muscle strengthening and stretching for functional activities
  • Neuromuscular reeducation
  • Virtual reality exercises

Adopting an outcomes-focused approach during prosthetic training can accelerate skill acquisition, leading to faster and more confident movement and increased independence for amputees.

Early provision of prostheses, coupled with rehabilitation, can significantly reduce healthcare costs, lower the risk of complications, and improve the functional status and mobility of amputees.

Ongoing Adjustments

Ongoing adjustments and regular consultations with healthcare providers are crucial to ensure the prosthesis fits well, functions properly, and does not cause health issues like skin irritation or pain.

New amputees should have follow-up appointments about every six months, while those with at least one year of prosthetics use should schedule annual check-ups. Rehabilitation programs include training protocols that are adjusted based on the individual’s progress, prosthesis type, and specific needs.

Coping Strategies

Amputees need to adopt therapeutic approaches, such as discussing emotions, practicing self-care, and utilizing relaxation and mindfulness exercises to manage the psychological and physical challenges of limb loss and prosthetic use.

Setting meaningful, attainable goals and maintaining a structured daily routine are crucial steps in rehabilitation that can boost confidence, provide distraction, and improve both mental and physical well-being.

Engaging in meaningful life activities is key for amputees to re-establish a sense of normality, self-worth, and to demonstrate that their identity is not defined by limb loss.

Frequently Asked Questions

What are the disadvantages of prosthetics?

Prosthetics may cause skin irritation, discomfort, and limited mobility. Overall, they can be expensive to maintain and replace.

What are some pros of prosthetics?

An osseointegrated prosthesis offers several benefits, including improved comfort and mobility.

Do prosthetics give an unfair advantage?

Studies have shown that prosthetics worn by disabled sprinters do not confer a speed advantage and may even reduce top speed. In fact, athletes using prostheses were found to have slower performance in various aspects of sprinting.

What are the cons of current prosthetic control movement methods?

The cons of current prosthetic control movement methods include electrode failure, signal deterioration over time, and abnormal signals that can discourage users from using the prosthetic devices.

What are the primary categories of prosthetic devices?

The primary categories of prosthetic devices include upper limb, lower limb, and craniofacial prostheses. These categories cover a wide range of prosthetic needs.

Key Takeaways

  • The loss of a limb can lead to profound psychological distress, including depression and body image disturbances, necessitating support from both personal connections and mental health professionals.
  • Phantom limb pain, prevalent in amputees, is a complex issue that can exacerbate depression and requires comprehensive management including medication, therapy, and alternative treatments.
  • Effective coping strategies after amputation involve positive thinking, vocational rehabilitation, and seeking professional mental health care to adapt to life changes and maintain emotional well-being.

Conclusion

In conclusion, while prosthetic devices present both advantages and challenges, the benefits they offer in terms of mobility, independence, and psychological well-being are significant. Moreover, with the rapid advancements in technology, the future of prosthetics looks promising. It’s important to remember that every journey is unique, and each individual’s experience with prosthetics will differ, but with the right support and resources, individuals can navigate this journey with resilience and confidence.

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