General information about prosthesis from history to the future. Ask by e-mail to download: eminecan06[at]gmail.com

1. 2009

3. What is Prostheses?

4. History

5. Types of Prosthesis

7. Prosthesis After Tomorrow

8. QUESTIONS & COMMENTS

9. REFERENCES

10. REFERENCES OF IMAGESDEC-2009 2 CONTENT img1

11. What is prostheses? PROTHESIS (plural Prostheses): Artificial devices that provides a replacement for the amputated part of the body. 3 img2 The Greeks had a word for it:prostithenai, πρόσθεσις from pros "to" + tithenai "to put, place" prostithenai"add to,“Meaning "artificial body part" is first recorded 1706.[1] img3 History  DEC-2009

12. History ‘Missing a limb has been a problem since humankind is on earth.’ img 4 img 5 This prosthetic toe dates back to between 950 and 710 B.C. Götz Von Berlichingen with the Iron Hand 3500 BCAn Indian poem, Rig-Veda, is the first recorded document about a prosthesis. The poem tells the tragic story of Queen Vishpla, a warrior, who lost her leg in battle. After the battle, she had an iron prosthesis made, and she was able to go back to battle. The Roman general named Marcus Sergiusguided his troops against Carthage in the Second Punic War and suffered over 20 injuries, including the loss of his right arm. An iron hand was created so that he could fight for the rest of the war. 1st C BCArcheologists discovered bronze peg prosthetic. Although it was rusted, it is the oldest usable artifact of a prosthetic. 1508The German knight Götz von Berlichingen (1480-1562) . He had to have his right arm amputated after the Battle of Landshut. Gotz had two prosthetic iron hands to replace his right arm. 1529Ambroise Pare introduced amputation to the medical community. He is considered the father of prosthetics. In 1536, he made an artificial limb for the arm and elbow and created other limbs later. 1696Pieter AndriannszoonVerduyn, a Dutch Surgeon, developed the first non-locking prosthesis for below the knee. This is the basis for the current joint and corset prosthesis. 1843Sir James Symedescribed his method for ankle amputation. Before this procedure, the technique used amputated at the thigh. By amputating at the ankle, the patient could have the possibility to walk again. The longer leg length allowed an artificial foot to bear a typical weight[2], [3], [4], [5]. img 6 Ambroise Paré /French Army Surgeon, 1564 Most famously attributed to seafaring pirates, peglegs with wooden cores and metal hands shaped into hooks have actually been the prosthetic standard throughout much of history [5] img 7 History-cont’d  DEC-2009

13. History-cont’d

14. History-cont’d

15. History-cont’d 1861-1865The American Civil War caused the start of the Americanprosthetics field. It is reported that there were atleast 30,000amputations on the union side alone. In 1866, North Carolina became the first state to start a program to give artificial limbs to thousands of amputees after the war. [3] American prosthetists remained a very independent, competitive group, rarely working with surgeons let alone each other. Amputee casualties in the U.S. (4,403) were much fewer than the British (42,000) and European armies (100,000). This resulted in European prosthetists jumping ahead in experimentation of their American counterparts. [4] 1939-1945 World War II Veterans found the current technology insufficient, those in the medical field saw the need for necessary advancements.The United States government made a deal with some military companies to improve prosthetics rather than weapons. 1914-1918World War I İmg 8 The government standardized prosthetics training, instead of the previous apprenticeships, as well as increased funding for engineering research at universities. Because of the expanded awareness, people started to understand more about artificial limbs. [3] İmg 9 İmg 10 İmg 11 John W. January with prosthetic legs at a Meeting of Former Prisoners of Civil War (c. 1880s-90s) Corporal Garrett S. Jones, an amputee who was injured in 2007 by an insurgent’s bomb during his unit’s deployment to Iraq, shows his prosthetic leg. Spc. Donald Reas Axtell practices moving with a pair of prosthetic legs at the Center for the Intrepid in San Antonio. Both of Axtell's legs were amputated from the hip down last fall after he was injured by a rocket blast in Iraq. DEC-2009

16. History-cont’d

17. History-cont’d In Ottoman Empire, in 1898 Dr.Robert Rieder from BonnUniversity was brought to Istanbul to make some reforms to Turkish Medical Education. While he was controlling the construction of Gulhane Medical School he fell and broke his leg and hip. For his needs first workshop studies were started on prosthesis and orthosis. The treasurer of II.Abdülhamit, Sadettin Pasha, broke his leg and had 3 amputation. He needed prosthesis, thus 4 army officers were sent to Paris for one year -prosthesis study. Naval officer Hüseyin Rıfat turned back and established the first prosthesis workroom called Tersane-i Alatı Nazikiye. After 1914 it belongs to Gülhane Hospital. During the World War I, the lost limbs onTrablus, Çanakkale and Arabia fronts increased the improvement of prosthesis in Ottoman Emp. Naval Officer Kazım Elgün has sent to Vienna for 4 years to learn prosthesis and when he turned back worked a lot with Prof. Dr. Besim Ömer Akalın [6], [7]. İmg 12 II.Abdülhamit İmg 13 Dr.Robert Rieder İmg 14 DEC-2009

18. 10 Types of Prosthesis İmg 15 İmg 19 İmg 39 İmg 16 INTELLIGENT Knee Prosthesis İmg 17 İmg 20 İmg 18 DEC-2009

19. 11 Specifications of Intelligent Knee Prosthesis Vid 01 İmg 21-22-23-24-25 İmg 26 DEC-2009

20. 12 Devices on the marketCompeting companies&Products The Icelandic company Ossur Rheo Knee The German company Otto Bock C-leg The Japan company Nabtesco Hybrid Knee İmg 27 İmg 29 İmg 31 İmg 28 İmg 30 İmg 32 DEC-2009

21. 13 Devices on the marketCompeting companies&Products Cont’d Comparison Among High-end Knee Joints[8] Hybrid-Knee C-Leg İmg 28 Rheo Knee İmg 30 İmg 32 İmg 35 İmg 33 İmg 34 13 DEC-2009

22. 14 Devices on the market Aproximate Retail Prices Hybrid-Knee C-Leg Rheo Knee İmg 30 İmg 32 İmg 28 EuropeGenerally retail prices are ~16.000 € and directly sales to the patient is 30.000 € Turkey 15.000 € -? 33.000 € If an intelligent knee prosthesis will be produced in Turkey (with R&D), its possible retail price will have been 6.000 euro. İmg 36 İmg 37 İmg 38 DEC-2009

23. 15 Prosthesis Tomorrow In general for Limb Prosthesis: The near future improvements in the field of... TIME TO SENSE ! APPEARANCE > Prostheses are started to be designed imitatively as the human body. > Prosthesis design will create ‘a new art’ and prosthesis will reflect the personality of the patients ( not so near ) INTELLIGENCE > Prostheses are being more intelligent with ‘microprocessor controlled’ technology, > with this intelligence, functionality will be as smooth as real biological movements especially in lower extremittees. > Extra monitors like heart beat-body temperature can be placed on prostheses and this makes them superior than real limbs. İmg 40 İmg 42 İmg 41 İmg 43 DEC-2009

24. 16 Prosthesis Tomorrow Upper Extremittees İmg 44 Vid 2 İmg 45 İmg 46 Vid 3 DEC-2009

25. 17 Prosthesis After Tomorrow ReGENeration? İmg 47 DEC-2009

26. 10/9/2009 18 Prosthesis After Tomorrow Scientific researches may find the secret...

27. 10/9/2009 19 Prosthesis After Tomorrow who knows?

28. 20 Prosthesis After Tomorrow 1529 1898 İmg 48 DEC-2009

29. 21 Questions & Comments THANKS! It can be hard but not impossible. Emine CAN Istanbul TechnicalUniversity Biomedical Engineering Programme eminecan06@gmail.com DEC-2009

30. REFERENCES [1] http://www.etymonline.com/ [2]http://www.uihealthcare.com/depts/medmuseum/wallexhibits/body/histofpros/histofpros.html [3] http://www.unc.edu/~mbritt/Prosthetics%20History%20Webpage%20-%20Phys24.html[4] http://www.izmitortopedi.com/tarihce.php [5] http://health.howstuffworks.com/prosthetic-limb.htm/printable [6] Alsancak Serap, ‘Ortez Protez Tarihçesi’ , Ankara Üniversitesi Dikimevi Sağlık Hizmetleri Meslek Yüksek Okulu Yıllığı Cilt 1 Sayı1 2000, s 31. [7] Türk Protez-Ortez Bilim Derneği http://www.turkprot.org/Tarihce.html [8] Nabtesco Product Line 2009-Presentation p 60/80 10/9/2009 22

31. 10/9/2009 23 REFERENCES of IMAGES Cover Image - http://www.spectrum.ieee.org/robotics/medical-robots/winner-the-revolution-will-be-prosthetized 1st Slide:Img 1 www.ossur.com2nd Slide:Img 2 www.ottobock.com Img 3 www.ottobock.com 3rd Slide: Img 4 http://health.howstuffworks.com/prosthetic-limb.htm/printable Img 5 http://en.wikipedia.org/wiki/Götz_von_Berlichingen Img 6 http://www.uihealthcare.com/depts/medmuseum/wallexhibits/body/histofpros/histofpros.html Img 7 http://themixtapemonster.wordpress.com/2009/08/05/where-you-at-wednesday-cast-of-hook/ 6th Slide: Img 8 http://www.univie.ac.at/cga/art/history.html Img 9 http://www.bouhammer.com/2008/10/27-marine-amputee-rejoins-battalion-returns-to-combat-after-near-death-experience/ Img 10 http://www.lubbockonline.com/slideshows/100908/341958851/slide2.shtml Img 11 http://drx.typepad.com/psychotherapyblog/2009/02/vintage-photos-john-january.html 8th Slide: Img 12 http://tr.wikipedia.org/wiki/Dosya:Abdulhamit.jpg Img 13 http://www.istanbul.edu.tr/itf/index.php?option=com_content&view=article&id=9&Itemid=51&showall=1 Img 14 http://www.tttk.org.tr/english.htm

32. REFERENCES of IMAGES 9th Slide:Img 15 http://bangalore.citizenmatters.in/articles/view/784-heart-valve-ramani?page=3 Img 16 http://www.bilgiara.com/bilgi/scft-dis-protezleri/ Img 17 http://eyeconcern.com/services Img 18 http://health.howstuffworks.com/prosthetic-limb.htm/printable Img 19 http://dspace.mit.edu/bitstream/handle/1721.1/36852/BE-441Fall2003/NR/rdonlyres/Biological-Engineering-Division/BE-441Fall2003/6FA78714-5E4F-4A16-9BDE-7600CA14115B/0/chp_artificial_hip.jpg Img 20 http://www.360oandp.com/Technology-Prosthetic-Heart.aspx Img 39 http://www.kewei-rising.com/images/car_2.jpg 10th Slide: Img 21-22-23-24-25 www.ottobock.com Img 26 Hacettepe Universitesi EEM - Akdoğan Kurtuluş E., “Mikroişlemci Tabanlı Uyarlamalı Diz Eklem Tasarımı” ppt, p 10.Vid 01 www.ottobok.com 11th Slide: Img 27-28 www.ossur.com Img 29-30 www.ottobock.com Img 31-32 www.nabtesco.com12th Slide: Img 33 www.nabtesco.comImg 34 www.ossur.comImg 35 www.ottobock.com13th Slide: Img 36 www.nabtesco.com Img 37, 38 www.ottobock.com14th Slide: Img 40 -41-42 http://www.swisswuff.ch/tech/?p=35 Img 43 www.ottobock.com

33. REFERENCES of IMAGES 15th Slide: Img 44 http://medgadget.com/archives/2008/02/update_dean_kamens_luke_arm.html Img 45-46 www.ottobock.com Vid 2 http://www.youtube.com/watch?v=R0_mLumx-6YVid 3http://www.youtube.com/watch?v=GRuizeW-3Hc 16th Slide: Img 47 http://www.amputee-coalition.org/inmotion/nov_dec_07/history_prosthetics.html 19th Slide:Img 48 www.ottobock.com