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Prosthetics, Orthotics, and Implants

Inquiring Minds Want to Know – Prosthetics, Orthotics, and Implants
Audrey Kirchner, CHDS, AHDI-F


These are very exciting topics in medicine as in this arena, there are innovative products being created every day.  The ultimate goal for using artificial devices, body parts, or implantable items is to restore normality to something that is no
longer normal or functional.  They can also be used to restore cosmesis but the driving force behind these it to make someone whole again, or at least the best “whole” that they can be given their individual circumstances.

A prosthetic is generally described as an artificial limb to replace one that is not present on a person’s body for any number of reasons or conditions.  The miracle of prosthetics is that a person who has lost an arm to an MRSA infection,
for example, can have a replacement body part and get back to a normal life.  Dependent upon the type of amputation or deformity today, remarkable things are being done in terms of even grafting donor arms or legs.  Failing that scenario,
someone who has lost a leg or an arm can be fit with a prosthetic that does not just look like a limb but actually restores them to a functional status because it works like the limb lost.  However, they can also look like prosthetics and do
not need to look like a “normal” body part.  This brings to mind the advertisements of someone who is a leg amputee running on a prosthetic leg.  There can be nothing more inspiring than that!

When we transcribe reports about joint replacements, we learn about a multitude of prosthetic parts that can be implanted into the body.  These take the place of native anatomy and give a patient back the ability to perform activities
of daily living in many cases.  For instance, we can have a unicompartmental arthroplasty where only part of a knee is replaced and the patient can go back to playing golf or walking.  Or in another case, there may be the need for a total
hip replacement where all the components must be replaced, but again, the possibility exists for that person to get on with his or her life thanks to prosthetic body parts.   

Prosthetics do not stop at arms and legs though. There are many other types of prosthetics.  We might also think of some of these as implants.  Prosthetic eyes including scleral buttons give cosmetic relief to someone who has lost
an eye or even has a misshapen or microscopic globe.  There is a newer prosthetic eye on the market that actually restores a small amount of vision for someone who is blind and further down the road, the goal is to connect this type of “bionic”
eye to the nervous system, thus restoring full sight.

Technically, dentures (artificial teeth) are considered prosthetic devices.  They replace a person’s natural teeth, in part or completely, dependent upon the state of their natural dentition.  They can be removable or permanently
affixed in someone’s mouth.  The same is true of many prosthetics. Some will be permanently fixed or attached while some will be removable. Some devices, such as penile prosthetics, are implanted inside the body and may work in conjunction
with a pump or other tubing to perform a specific function. 

An orthotic is an external orthopedic appliance that is usually fabricated to control movement of specific body parts. When we think of orthotics, the first thing that usually comes to mind is a brace of some sort.  There can be dynamic
orthoses (those that allow movement) and static orthoses that provide more rigid support (and thus no movement for that body part). Orthoses in many cases are used to help heal something, whether it is inflammation, tendinopathies, muscle tears,
fractures, et cetera.  We can see them in reports about cervical spine injuries, ankle fractures, or even hip procedures for postoperative care. Whereas a prosthetic is a replacement part for something, an orthotic is something that helps a condition
get better or disappear by some kind of support.  They can also take the form of dental or even podiatric applications such as night guards for the mouth or heel lifts or insoles for shoes. 

Implants are used across many body systems and are used for various medical conditions.  We note breast implants used for breast augmentation (to give someone larger breasts) while in another report, we transcribe about breast implants
being inserted at the time of mastectomy as a reconstructive adjunct to the oncologic procedure of removing the cancerous breast. 

An implant can also apply to dental procedures or ophthalmologic procedures.  Dental implants or “prosthetic teeth” have a root just like a real tooth but they are manmade.  They are individual teeth, unlike dentures.  Upon doing
a cataract extraction, the implantation of an IOL (intraocular lens) means that the patient now has an implanted lens in his or her eye to increase vision. 

Ostomies are another type of implant.  The patient usually has something removed or altered surgically due to disease or malfunction (such as a partial or total colon resection) and instead of evacuation by normal routes, a bag or appliance
is attached to the body and drains to the outside of the body.  The same would be true of a bag for the urinary bladder.  By virtue of being connected to an internal body part in some fashion in order to perform its function, these products
become implants or at least devices that promote function of the body’s altered function. 

Cochlear implants are another example of an implantable device that is inserted in the ear that replaces the function of a damaged middle ear and aids someone with hearing.

The field of prosthetics, orthotics, and implants is growing every day as modern medicine strives to create better products or products that not only function but look lifelike.  A great resource for finding these devices is a listing
under durable medical equipment such as those for insurance companies but Google searching will also provide unlimited information and even videos on some of these fascinating products.