Insights into lower-limb prosthetics

Dr. Anthony McGarry and Dr. Kevin Murray are Teaching Fellows at the University of Strathclyde, leading a team of four students from the university and two Indian students from Manipal Institute of Technology on a visit to Mukti Clinic in Chennai. The Mukti project is organised by a team of students and staff from the Department of Biomedical Engineering at the University of Strathclyde. Mukti is a charitable organisation supporting amputees and those affected by polio. Treatment is free, and the clinic treats around 30 patients each day. All funding for the project is raised by staff and students from the first four years in the Department of Biomedical Engineering undergraduate B.Sc. Honours course. These projects help students gain insights into global challenges and the positive and lasting change they can bring about.

Developing low-cost alternatives for those who are unable to access mainstream services is important. Photo: Special Arrangement

This year, a number of new knee joints have been specifically designed for the low-income clinic. The Remotion knee joint was provided by D -REV ( and components were provided by the University of Strathclyde, Mukti and Bhagwan Mahaveer Viklang Sahayata Samiti (Jaipur foot). A limited number of these components were fitted to assess the feasibility of fitting this type of limb in the clinic, as well as to produce educational resources for use in similar clinics worldwide.

Dr Anthony McGarry and Dr Kevin Murray answer a few questions about prosthetics.

What is the function of these new knee joints and how are they different from the previous joints?

The new knee joint is a low-cost alternative that mimics the anatomical knee and can be fitted into a modular system which allows easy/accurate alignment to ensure improved gait (manner of walking). Knee joints available at present are locked, are not interchangeable and the patients’ gait pattern is consequently poor.

What are the improvements made in the new prosthetics?

The patient can walk with a free knee joint that flexes/extends similar to the normal knee during gait. The knee has in-built stability to reduce the likelihood of falls.

What are the challenges in making prosthetics?

Every patient has to be treated individually when it comes to the socket being fitted to the stump. This is a highly skilled process which should result in a comfortable prosthesis. The types of component fitted will only be successful if the socket is a comfortable fit.

Are there any challenges uniquely faced by polio patients?

The main challenge appears to be an ability to access high-quality, low-cost provision of customised orthoses which require trained orthotists to assess and fit [the joint] along with appropriate technical support.

Have the Paralympics helped the cause of people with prosthetic limbs?

The Paralympics has brought to the attention of the greater public that with the correct support it is not what a person with a disability can’t do but what a person with a disability can do.

If prosthetics can increase the number of people with a disability who can return to work and provide for their families, then, there would be fewer requirements for assistance from the state.

What was your experience in India?

The Strathclyde Team, which is on an annual visit to Mukti, always has a very enjoyable experience and appreciates the hospitality shown by their hosts. We are aware of the range of Prosthetic/Orthotic services available in India especially in the NGO category. It will be important to develop low-cost alternatives that can provide improved treatment to the large number of individuals who are unable to access mainstream services.

We enjoyed the day of collaborative study between Strathclyde and IIPO students. The aim of the day will be to task the students with the development of low-cost Prosthetic and Orthotic solutions for a range of disabilities and amputation levels. Tony and I lead the discussions on a range of topics including data capturing concepts (how to capture the shape of a stump or limb) and recent developments in the use of low-cost clinical gait analysis.

Is it possible to have prosthetics like that of the villain in the Kingsmen? (the lady with knives in her prosthetic legs)

Yes, it is possible to customise the appearance of a prosthesis to suit the requirements of the individual patient…at a cost.

Keywords: Anthony McGarry, Kevin MurrayUniversity of Strathclyde, Mukti Clinic, polio, Remotion knee joint, Bhagwan Mahaveer Viklang Sahayata Samiti, prosthetics