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What is a “prosthesis”? A prosthesis, by definition, is a replacement or artificial body part. For the purpose of this reference, it will most commonly refer to an artificial leg. (Please refer to Commonly Used Prosthetic Words at the end of this reference.) How soon after amputation will I get my prosthesis? This depends on many things: how quickly your incision heals, your general health, your previous activity level, the length and condition of your residual limb, your strength and balance. How can I prepare for my first prosthesis? Using a prosthetic shrinker is a good idea, for the purpose of controlling edema. Additionally, by doing strength and flexibility exercises, you will increase the likelihood of returning to your previous activity level. Your physical therapist will be able to direct you in proper exercises. (The importance of exercise cannot be over stated.) How long does it take after my first appointment to get the prosthesis? The process of fitting and fabricating a prosthesis usually takes a few weeks. The reason for this is simply that each prosthesis fabricated by Cornerstone is custom made for each patient. Componentry often has to be special-ordered for each patient, according to the patient’s height, weight, activity level, shoe size, etc. How many appointments will I need? You will likely need several appointments for the fitting of your first prosthesis. After the first fitting, regular appointments are needed to keep your prosthesis fitting properly. The reason for this is due to shrinkage or atrophy of muscles within the residual limb. You can expect to have a prosthesis that fits better if you have regular adjustments. Who will teach me how to use it? Will it be easy to use? Learning to use a prosthesis takes practice and training. Most people are able to eventually return to their previous activities with practice and physical training. A physical therapist will be the best professional to work with in preparing you for your desired activity level. They will need to work with you over a series of sessions, in training you how to deal with physical barriers in your environment (i.e. curbs, stairs, ramps, and getting in/out of a car). If you have special goals, such as athletic activities, it is very important that you communicate with your prosthetist (ahead of time) so that the prosthesis will be built properly for these activities. Will I be able to walk without a cane? Will I have a limp? The ability to walk without a noticeable limp depends primarily on your strength, balance, and skin integrity. The condition of your residual limb is critical (i.e. is there any nerve damage or skin grafting). And, finally, the fit of the prosthetic socket is also critical, because if you are comfortable, then you will be more likely to maintain your normal activity level. Will I be able to run, like the amputees I see on TV? If you were a runner prior to your amputation, then you will likely be able to return to this activity level. However, if you sustained any nerve damage or skin grafting, then this may complicate your prosthetic use. (Check with your prosthetist.) If you were not a runner prior to your amputation, then it would be appropriate for you to discuss this with both your prosthetist and physical therapist. Can I get a high-tech foot, like some of the athletes use? Your insurance company will determine what type of componentry is allowed, based on your previous activity level, as well as your potential activity level in the future. Can I drive with a prosthesis? This is a very important question. The best answer is for you to contact your local Department of Vocational Rehabilitation, or your physical therapist. How much does a prosthesis cost? The cost of a prosthesis is usually several thousand dollars. However, this will vary according to the type of hardware and componentry used. How do I bathe? It is recommended that you remove your prosthesis for bathing (for bath or shower). Many people use a bench in the shower. Can I get a shower leg? Most insurance companies will not cover an additional prosthesis for the purpose of showering. Ask your prosthetist to check into this if you are interested. What about swimming? It is recommended that you not swim with your prosthesis. Most amputee athletes actually remove the prosthesis at poolside and swim competitively without a prosthesis. Can I get a swim leg? Most insurance companies will not cover an additional prosthesis for the purpose of swimming. Ask your prosthetist to check into this if you are interested. I’ve heard that you can get blisters from a prosthesis – is this true? If your prosthesis is fitting poorly, or if you have fragile skin, blisters can occur. Blisters can usually be avoided by contacting your prosthetist immediately if you experience pain, discomfort, or excessive redness of the skin on your residual limb. Follow-up appointments are very important to keep your prosthesis fitting properly, and to keep you comfortable. How long will the prosthesis last? The hardware in the final prosthesis should last an average of three years, with regular maintenance. There are certainly exceptions to this average. The prosthetic socket often needs to be replaced due to excessive wear, or when it no longer fits properly. In the first stages following amputation, it is common to have several sockets within the first year or two, due to changes in the residual limb. What will my prosthesis look like? The appearance of a prosthesis varies, depending on the size and shape of your residual limb, the componentry used, and whether you choose to have a more natural looking finish or a more “high-tech” looking finish. A prosthesis will never look as realistic as your original or anatomical leg. Typically, there is a trade-off between cosmetic appearance vs. performance. However, you will need to discuss with your prosthetist what is important to you (cosmetic appearance vs. performance). How much will my prosthesis weigh? The weight of your prosthesis will vary according to the level of your amputation, and what type of componentry is attached to your prosthesis. For example, a higher level of amputation (above the knee) will require more prosthetic componentry, and will weigh more than a prosthesis for a lower level amputation (below the knee). However, surprisingly, a prosthesis usually weighs less than the anatomical body part that was removed in amputation. Will the foot move? The prosthetic foot will usually maintain a fixed position when sitting. However, it will cycle through various positions when weight is placed on it during weight bearing (during walking or running). How is the prosthesis made? A prosthesis is usually custom made for each patient. The fabrication of a prosthesis first begins with a mold of your residual limb. This is done with either plaster, fiberglass, or in some cases a computer generated image. A prosthetic socket is then fabricated and attached to a prosthetic foot with hardware. The prosthetic socket is usually made by hand, and the remaining prosthesis is also usually assembled by hand. How can I get more information on prosthetics and amputees? The best place to start is the Amputee Coalition of America (ACA). Website: amputee-coalition.org or phone: 1(888)AMP-KNOW (888.267.5669). COMMONLY USED PROSTHETIC WORDS: Prosthesis: artificial or replacement body part (for the purpose of this reference, this usually refers to a prosthetic arm or leg) Socket: custom molded receptacle on prosthesis where residual limb is inserted Residual Limb: portion of arm or leg remaining after amputation (sometimes referred to as “stump”) Atrophy: natural shrinkage of muscles below the joint following amputation (i.e. calf muscles usually atrophy following amputation below the knee) Prosthetic sock: sock designed to fit over residual limb in order to maintain a snug fitting socket Ply: referring to thickness of prosthetic sock (higher ply number = thicker sock) Liner: usually gel or silicone lined sock that is used over residual limb to protect the skin, and sometimes to suspend the prosthesis Hardware: often same as “componentry” Componentry: this may refer to any given prosthetic “part” used in making a prosthesis (i.e. prosthetic foot, or prosthetic knee Endoskeletal: hardware built internally inside a prosthesis, often adjustable, often hidden inside a soft foam covering Pylon: internal (endoskeletal) hardware, usually in the form of a tube, often made of aluminum, titanium, or composite material Functional Level: A determination of the medical necessity for certain prosthetic components based on the patient’s potential functional abilities. This is based on reasonable expectations of the prosthetist, physical therapist and ordering physician (considering factors including the patient’s past history, current condition, and desire to ambulate). CPO: Certified Prosthetist Orthotist Walking Aid: usually referring to cane, crutches or walker ACA: Amputee Coalition of America Amputation: loss or removal of all or part of limb (often as result of disease or trauma) Contracture: tightening of muscles/tendons thereby causing a loss of range of motion Edema: swelling or excess fluid retention, can be caused by trauma and/or disease Shrinker: sock- or tubular- shaped elastic material used in place of Ace-type bandage (allows more uniform compression to control swelling or edema) Gait: walking (“gait training” usually refers to learning how to use your prosthesis for walking, with assistance from a physical therapist) PT: physical therapist – health professional who uses exercises and other methods to restore/maintain body strength, mobility and function Suspension: the means in which to hold the prosthesis onto the residual limb (often via suction valve or locking mechanism built into the prosthesis)
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