How an engineer helped Jonathan to jump
Jonathan (not his real name) will never take his limbs for granted. In fact he will never again jump without thinking twice.
Hearing his story and seeing him stride confidently out of the doctor’s surgery one is left with a sense of amazement at what Jonathan’s determination to walk again, coupled with the brilliance of medical science, can achieve.
In this case another factor played a huge role ‘ the commitment and creativity of a group at the University of Cape Town’s Mechanical Engineering and Orthopaedic surgery departments.
So, how does all of this fit together ‘ a 19-year-old, an orthopaedic surgeon and a mechanical engineer?
About 18 months ago, Dr George Vicatos, a senior lecturer at UCT’s Mechanical Engineering Department, received a call from Dr Keith Hosking, an orthopaedic surgeon who works part-time at Groote Schuur Hospital in Cape Town.
Hosking had a young patient (Jonathan) who urgently needed to undergo surgery to remove a malignant tumour from his thigh and knee joint. A prosthesis could be obtained from overseas, but there was no way that the family or the hospital could afford to foot the bill for the imported implant, which cost in the region of R80 000 and would take six weeks to arrive.
The alternative was having the cancerous leg amputated.
Hosking specialised in tumour and endoprosthetic replacement surgery in the United Kingdom while Vicatos has a unique perspective in biomechanical engineering through his intimate knowledge of anatomy, which he studied at UCT on his own initiative.
Vicatos’ commission was to come up with a replacement ‘bone’ that would slot in between the top of his femur, remaining part of Jonathan’s femur and knee. They designed and manufactured a novel prosthesis – working on such a tight deadline that the tools to insert the implant were manufactured the night before. The total cost of the implant was in the region of R32 000.
‘The doctor told me that he could try this implant (designed by UCT) and that he was 99% sure it would work, but that we would have to take the leg off if it didn’t work,’ said Jonathan.
‘He promised me that I would be able to jump again.’.
Since then, this team have collaborated extensively and another 10 patients have undergone endo-prosthetic replacement surgery – some in their legs, arms or wrists – designed by Vicatos and manufactured by Len Watkins at UCT.
But they have now appealed for funding to continue supplying the fast growing demand for prostheses. One of the latest designs is a complete humerus (upper arm) including the shoulder and elbow joints which will be manufactured in association with a Cape Town foundry.
‘We are currently recovering the costs of the production and material from a nominal fee that is charged per prosthesis.
‘We are in a position where we have the expertise at UCT to design any prosthesis which would meet the patient’s needs,’ Vicatos said.
He added that some parts were exceptionally difficult to manufacture at present, while others could be standardised and produced in various sizes and options in advance so patients need not wait.
‘For this we need facilities and dedicated machinery,’ Vicatos said.
Hosking said they were looking to charitable organisations to assist with further funding in this field.
‘Ultimately we need a managed trust fund to cover the costs for the patients in the public health sector and those in the private health sector not fully covered by their medical aids. The funding to manufacture these implants could mean the difference between amputation and a prosthesis,’ Hosking said.
He said the implants were shown to be more cost effective in the long run than an artificial limb, as it usually needed to be replaced every five years.
‘We use only the best material (FDA approved), and we produce world class components, but we need dedicated machinery to continue,’ Hosking said.
Jonathan, sitting quietly and grinning while Hosking and Vicatos are interviewed, tells of the intense pain shortly after the operation.
‘Sometimes I thought I would never walk again, but I would see people at the physiotherapist struggling as well. I would go home, lock myself in my room and try to stand. First I could stand and later I started taking my first steps, now I can jump.’
Jonathan, an avid sportsman who excelled in soccer, cricket and ballroom dancing, also hopes to return to the dance floor.
‘I told myself that I will dance again,’ he said. – Health-e News Service
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Health-e News is South Africa's dedicated health news service and home to OurHealth citizen journalism. Follow us on Twitter @HealtheNews
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How an engineer helped Jonathan to jump
by healthe, Health-e News
August 5, 2002