Replacing Limbs, Restoring Function

The orthotists and prosthetists at MOI

I think it’s easy to take our limbs for granted. Just think about how you would perform your basic daily tasks if you couldn’t use one of your legs? Let alone go to work or go on a walk with family? Unfortunately, that’s a reality for many patients around the world who undergo amputations after accidents or due to disease. Thankfully there are people like Mwakasungula and Joyce helping those patients.

Mwakasungula and Joyce demonstrating the function of an above the knee prosthesis

Mwakasungula and Joyce are prosthetist’s, meaning they are experts in the crafting, maintenence, and use of prosthetic and orthotic devices. They not only help in the treatment of amputation patients but also those suffering from a number of neuromuscular disorders including polio, paralysis, cerebral palsy, clubfoot. They trained at the Tanzania Training Center for Orthopaedic Techonologists, known as TATCOT. TATCOT is a world renowned training center, and to my knowledge is the largest in Africa, responsible for training hundreds of technologists from all over the continent and bringing this crucial treatment to thousands of patients.

In a given day at MOI, Mwakasungula and Joyce may see any number of patients, taking molds of someone’s amputated leg, crafting the various parts of the prosthesis (often using machines you would find in workshop or autoshop), or designing casts and molds for children with various orthopedic conditions. Their work is invaluable in helping people recover from injury or receive treatment for any number of orthopedic problems, allowing them back to their previous levels of function

An example of a below the knee prosthesis with a broken foot. Consisting of (from top-to-bottom) the socket, the pilon with adjustable adapters, and the prosthetic foot.

A study conducted between MOI and UCSF on patients with above-knee-amputations (AKA) evaluated the effect of a functioning prosthesis on patients quality of life. The study utilized a quality of life survey called the EQ-5D which scores someone’s quality of life on a scale of 0 (terrible quality) to 1 (perfect, or “normal” quality). Patient’s who received and utilized their prosthetic device nearly doubled their quality of life, with an average increase in quality of life of about 40%. Perhaps most importantly, patients using their prosthesis were able to return to near pre-amputation levels of quality of life, getting back to living their lives to the fullest.

Patient’s who received and utilized their prosthetic device nearly doubled their quality of life, with an average increase in quality of life of about 40%

Reproduced from the study published in the African Journal of Disability. Citation: Von Kaeppler, E.P., Hetherington, A., Donnelley, C.A., Ali, S.H., Shirley, C., Challa, S.T. et al., 2021, ‘Impact of prostheses on quality of life and functional status of transfemoral amputees in Tanzania’, African Journal of Disability 10(0), a839. https:// doi.org/10.4102/ajod.v10i0.839

Another study that I am lending a hand on while here at MOI involves a very similar study design, however instead of looking at AKA patients we are now examining below the knee amputation patients. This study will hopefully enroll over 30 patients between two sites, MOI in Dar Es Salaam and Kilimanjaro Christian Medical College (KCMC) which is the hospital in the northern part of the Tanzania associated with TATCOT. I will traveling up there in just a few weeks to meet with the prosthetists at KCMC so stay tuned!

Until next time,

Jamieson