The University of Southampton

Author: Mikayla Colegrave

Learning Life in Sport with One Less Limb

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A backstory…

When I was young, my Granny lost her arm to amputation. Since then, I’ve watched her struggle, relearn, and grasp the basic skills to be able to live an almost normal life again. I’ve always been proud of how she reshaped her life, and since mine revolves so much around sports, I couldn’t imagine coping with a lost limb. This is until I met South African elite para-triathlete, Mhlengi Gwala. He told me about his backstory how he tragically lost his leg and the work he’s done to get to where he is today. I instantly became fascinated with the rehabilitation he endured so I explored deeper into it.

WARNING: Sensitive Content.
A short video on Mhlengi Gwala’s Backstory.

The Road to Recovery

Prediction times for the return to sport after amputation were studied by Matthews et al. I learnt that it’s hard to give an exact period on how long amputation recovery will take, let alone getting back into sports. This is due to factors like what limb was amputated, stump length, the cause, and sport. Think about when you were a baby, you learnt to walk before you learnt to run. The same idea applies to athletes with leg amputations. According to Pam Health, there’re 3 main components to the healing process:

  1. Physical therapy and rehabilitation
Methods of rehabilitation for walking, using bars (left) and a treadmill (right)

During surgery, all unwanted parts of the bone and muscles are removed, and the healthy muscle is reattached to the remaining bone. The amputees need to rebuild strength and flexibility within these muscles and learn to use their prosthetic (if one’s needed) with the help of physiotherapists and rehabilitation teams. 

  1. Managing the risk of complications
Different amputation complications

Commonly, amputees will run into complications during recovery. These include things like infection, stump pain, phantom pain, etc, which require additional treatment.   

  1. Gaining mobility and independence
An amputee living independently

Lastly, when the amputee becomes confident enough with the new adjustments, they’re able to live independently. In Mhlengi’s case, he knew that he wanted to get back to racing, and I believe that having something to work towards helped him through recovery and to become a new upcoming para-triathlete.

Is the Price of Sporting Prosthetics Fair?

Prosthetic for Running

I mentioned that I was studying biomedical engineering to Mhlengi, who replied “You’re going to be rich, these aren’t cheap”. According to Alan Hutchison, a leg prosthetic can cost up to $60,000. Shocked, I researched why, looking specifically at running prosthetics. A para-athlete with a leg amputation will generally have two different prosthetics because when running or jumping, you’re applying a larger impact force onto your legs. The sporting prosthetic must be able to withstand this, therefore it’s constructed into a curve using carbon fibre and custom-made to fit the stump depending on size, shape, and whether the amputation occurred above or below the knee. Taking these into account, it makes sense why the prosthetic is expensive but it’s still debatable whether this price is too high, especially for someone who’s already faced tragedy. Luckily for Mhlengi, he had many supporters on his side who helped him get to where he is today. 

Summary

I’ve always respected para-athletes for what they do, but I’ve never appreciated the process they endure to be able to do these things. Through this research, I’ve realised that “getting back on your feet” takes a lot of patience, not only through rehab but also in acquiring the prosthetic to begin with, however, it’s amazing what can be achieved when you’re driven by the things you love.

The Complications Caused by Implant failure

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My Experience with Implants

What’s every teenager’s worst nightmare? To me, it was being told at the young age of 13 that I was missing 2 adult teeth! But why was this such a bad thing? Because the corresponding milk teeth would eventually become too weak, fall out, and nothing would grow back. 9 years later brings us to now, and unfortunately, that dreaded day came. Luckily for me, the medical world has advanced, and dental implants exist, meaning I don’t have to be ‘toothless forever’, or so I thought. 

Recently, 1 out of my 2 implant screws decided it was going to fail and fall out causing a delay in receiving my new teeth. I felt this massively inconvenienced me as I now must remain ‘toothless’ for a little longer. However, this experience had me thinking about the bigger picture of implant failure and I realised that my implants were only for cosmetic purposes. What if my implant was for my knee or hip and that was to fail? How much of an inconvenience would that be? Intrigued, I decided to dive deeper into the topic.

Implant Failure in Joint Replacements

An X-ray showing a hip replacement

From reading this article by Steven Richard Knight et al, I’ve learnt that, amazingly, hip replacements date back to over 100 years ago when the first surgery took place in 1891 in Germany. Ever since then total joint replacement has advanced in the materials being used, the surgical techniques and technology. This has helped with the life expectancy of the implants which ultimately has reduced the percentage of failure seen today. Although it’s not foolproof yet. 

X-ray of a knee replacement

Joint replacements are mostly seen in people over 60 due to factors such as osteoarthritis. However, they aren’t uncommon in the younger generation.  In a study by Lee E Bayliss et al, I found it interesting that you are more likely to experience implant failure if you’re younger. After further reading, I started to understand why this is the case. Imagine living a day in the life of a 20-year-old and then a day as an 80-year-old. I’m sure you will agree that these days are substantially different. At 20, you’re going to be more active which causes the implant to be put under more strain. This causes the bone to wear down causing it to loosen and fail. However, aseptic loosening isn’t the only reason for implant failure. Other factors such as infection can also be a cause which you can find out more about here.

The Complications of Major Implant Failure and How it is Resolved

Example of where joint implant failure can occur in the hip

When my implant was failing it was obvious to detect as it started to rise out of my gum until it eventually fell out. However, I began to wonder how you would be able to tell if an implant placed inside your bone was failing.  I did some research on the symptoms and it explained how you would experience severe pain and instability in that joint. Imagining what that would be like I decided that although I felt very inconvenienced, it was minor compared to this. These patients would have to endure 1-2 more surgeries to receive joint revision and I only have to wait for the bone to heal before replacing my dental screw. However, even though implants come with a risk of failure, I think it’s incredible that doctors can fix these problems and I think it’s a risk worth taking.  

A Shock to the system!

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Can a spinal cord a spinal cord stimulator be the answer to many people’s dreams? A recent study by Michael Nolan explores a new and exciting treatment to help cure Parkinson’s Disease.

Marc Gauthier was diagnosed at the young age of 36 years old with Parkinson’s Disease. This made life difficult for him and walking became a massive task. he thought he would live the rest of the his life with the fear of losing balance and falling uncontrollably. However, life became easier for him when an experimental medical procedure gave him mobility back allowing him to live life to the fullest again!