By: John Robb, CPO
Reach Orthotic & Prosthetic Services
In recent years, there has been a lot of media publicity around computer controlled prosthetic devices. These devices are quite controversial, both in the health insurance industry and health care community alike. Paired with this improved technology is an increased price tag. Rising healthcare costs across the healthcare continuum fuel discussions as to whether or not these devices improve function consistent with that higher price tag. As a result, microprocessor controlled knees for transfemoral amputees are carefully examined, since they utilize this costly technology.
While it is a reality that microprocessor controlled knees are expensive, they can significantly the improve quality of life for the amputee.
A prosthesis incorporating this technology can cost between $40,000-$120,000, depending on the type of knee and components chosen to complement the knee. There are a variety of these devices on the market, and while most are quality products, each has nuances that make it unique and specific to the patient.
What does this technology do?
The integrated computer helps the prosthesis react to the many different conditions the amputee is exposed to when walking throughout the day. For example, the able-bodied person takes for granted the ability to deal with changing conditions while walking. However, for the amputee, things like carpet, steps, slopes (even subtle), grass, gravel, and crowds can present significant challenges. Conventional prosthetic devices are unable to change and react to these changing environments, creating a problem, since the efficiency with which the knee swings through, and weight bearing, are critically important. The computer, by analyzing data in the knee in real time, predicts what is going to happen on the next step and adjusts the knee resistances accordingly. For the amputee, this superior functionality increases trust in the prosthesis to perform reliably in various conditions.
Who is it right for?
This technology will not help the amputee who is severely physically debilitated or only uses the limb to ambulate in the home on consistent and level surfaces. These devices are generally not designed for high-impact sporting activities, such as running or water sports. However, this device can make a substantial difference in the life of an amputee who regularly walks in the community or has to deal surface changes regularly. Regardless of whether the amputee uses a walker, cane, or other assistive device, it can be the difference in making the transition to an increased level of independence. The literature backs up the benefits of these devices.
What’s the issue?
Because of the cost and moniker of “advanced technology,” most insurances, including Medicare, only make these devices available to the most functional and active amputees. This is unfortunate, because they may be of the most benefit to the amputee whose goals are simply to be efficient while using a cane.
There are questions that remain in all of healthcare. Who are the improving technologies appropriate for, and who’s going to pay for those technologies? In the meantime, prosthetic technology is making great strides in restoring mobility to our patients.
John Robb, CPO is certified by the American Board for Certification in Orthotics & Prosthetics. He has been practicing in orthotics & prosthetics since 1990. He regularly speaks for medical professionals. He currently serves on the board for the Virginia Orthotic & Prosthetic Association and is a member of the medical operations committee for Physicians for Peace. reachops.com
