WASHINGTON (AP) - Fitting a prosthesis is a complicated business involving numerous parts, a certified prosthetist and, for one U.S. Marine, a three-day trip to Iceland.
The lengths to which Ossur hf., the world's second-largest prosthesis maker, went to accommodate Gunnery Sgt. Angel Barcenas illustrates the U.S. military's wartime clout in the prosthetics industry. The story also shows how one warrior's injuries led to a technological advancement likely to benefit many others.
Barcenas, of Paramount, Calif., lost both legs below the knee when he was wounded July 21, 2006, by an improvised explosive device in Iraq. Treated initially at the National Naval Hospital in Bethesda, Md., he was transferred in September to Walter Reed Army Medical Center for rehabilitation.
Like most of today's war amputees, Barcenas developed a painful condition called heterotopic ossification, characterized by bone spurs growing like sharp fingers into the tissue surrounding the severed ends of his bones.
The problem was worse on his right leg, and the artificial leg increased his discomfort because the Ossur suction system that held it in place featured a seal on the sock-like silicone liner. That seal put pressure directly on the sensitive area, said Ian Fothergill, clinical marketing manager at Ossur North America in Aliso Viejo, Calif.
Michael Corcoran, whose company, Medical Center Orthotics and Prosthetics, provides lower-limb prosthetic services at Walter Reed, said he and the Army insisted on a better product.
'The amount of volume we're doing here gives us leverage,' Corcoran said. 'We called them and said, 'We're not going to use your stuff. We're going to find a way of accommodating this.''
So Ossur, which had already begun designing a liner for heterotopic ossification patients, flew Barcenas and Corcoran to Reykjavik for some hands-on study, Fothergill said.
'We considered it a research-and-development trip,' he said.
As a result, Ossur developed a liner with five to eight of the ring-like seals extending nearly half the length of the 14-inch liner.
'One of our engineers thought it might be a better solution to have multiple seals, and then the pressure on any one seal is reduced,' Fothergill said.
The company will begin clinical trials this summer of a prototype in hopes of standardizing the design for use by a range of patients.
'The military is focused on returning veterans to try to rehabilitate them as quickly and successfully as possible. We try to react to that sense of urgency,' Fothergill said. 'There is a lot we can learn there that we can then apply to the civilian population.'
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