The University of Southampton

Author: Celine Mason

Apocalyptic Prosthetics: How realistic are prosthetics in tv shows?

Posted on by

Recently I have been watching the tv show Alice in Borderland, which is set in an abandoned, seemingly post-apocalyptic Tokyo, where players have to complete dangerous to survive. One character, Akane Heiya, has a transtibial amputation due to an injury from a game and uses a running blade. I decided to look into how realistic her prosthetic is.

Obtaining the prosthesis

Since I was watching the show around the time I attended the lectures on prosthetics, it made me wonder where Akane was able to get a prosthesis, since I learnt from the lectures that the sockets are usually made custom for the shape of the residual limb. From further research, I also found that the residual limb often changes shape in the healing process and loses volume, and liners are worn between the limb and the socket to protect the skin which are changed daily (1). Akane wears bandages between her skin and the prosthetic, which could be changed regularly, but I don’t think it would have been feasible for her to find a fitting socket.

Akane uses bandages to protect her skin.

I did not think it would be realistic for her to find a running blade in an abandoned city. From looking into the availability of running blades I came across the Blade Library. This is a facility near the Toyosu Running Stadium in Tokyo which allows amputees to try running blades (2). There are 24 blades available to rent, as well as fitting workshops and and monthly runs to learn how to use blades (3). In the context of the show, it may have been possible for Akane to find a fitting blade here but would probably require prior knowledge of its location. However, I do think that the concept of a blade library is a really good resource to make running more accessible to amputees.

More about the Blade Library in Tokyo.

Using the prosthesis

The prosthetic that Akane uses is a Flex-Foot Cheetah design (4). It is a carbon fibre running blade that is attached to the socket with a pylon connector (5). The curved blade stores the potential energy from the user stepping down into the blade and uses this energy to propel them forward (5). Akane uses a C-shaped blade, which is better for long-distance running than the J-shaped sprinting blades (6).

How a running blade works in comparison to an able-bodied athlete.

Although running blades are lightweight and durable, they are not made to be used as an everyday leg as Akane does. Running applies pressures to the residual limb in different areas than walking does, so wearing the wrong prosthetic for either activity can cause discomfort (7). They are usually slightly longer than the standard prosthetic to account for impact when running, and require slightly different alignment, so the knee has to remain bent whilst walking or standing (7).

Akane travel across different terrains and there does not seem to be a sole attached to her blade, so she probably would not have good traction on many of these surfaces. In the real world, Nike has developed interchangeable soles for running blades that can be clipped on and off for different terrains. These include rubber soles for the road and spikes for athletic tracks (8). These also help protect the blade to help them last longer.

Akane uses her blade on a variety of terrains: jumping on cars, the forest floor, concrete, and climbing trees.
 Nike Sole 2.0 x Össur Running Blade. The sole clips onto the blade with options for a rubber or spiked sole.

Is Akane’s prosthetic realistic?

No, I don’t think that Alice in Borderland portrays a very realistic use of prosthetics, but I did enjoy looking more into prosthetic availability and finding out about the Blade Library. I think they could have included some scenes of her getting used to having a prosthetic and finding ways to get around some of the challenges to make it seem more authentic.

References

1. Infinite Technologies. Below Knee Leg Prosthetics. Infinite Technologies Orthotics and Prosthetics. [Online] [Cited: March 22, 2023.] https://www.infinitetech.org/below-knee-leg-prosthetics/.

2. Bailey, Joan. Athletic Prosthetics in Japan: Pioneers Pushing Boundaries. Japan Endless Discovery. [Online] [Cited: March 22, 2023.] https://www.japan.travel/en/tokyo2020/athletic-prosthetics-in-japan/.

3. Blade Library. Blade Library. Blade Library. [Online] [Cited: March 22, 2023.] https://bladelibrary.jp/en/.

4. Ossur. Flex-Foot CheetahÂŽ. Ossur. [Online] [Cited: March 22, 2023.] https://www.ossur.com/en-gb/prosthetics/feet/flex-foot-cheetah.

5. National Paralympic Heritage Trust. Running Blades and their evolution. National Paralympic Heritage Trust. [Online] [Cited: March 22, 2023.] https://www.paralympicheritage.org.uk/running-blades-and-their-evolution#:~:text=Blades%20are%20prosthetic%20lower%20limbs,include%20%C3%96ssur%20and%20Ottobock..

6. Lacke, Susan. The Science and Controversy of Running Blade Prosthetics. triathlete. [Online] December 6, 2020. [Cited: March 22, 2023.] https://www.triathlete.com/culture/the-science-and-controversy-of-running-blade-prosthetics/#.

7. Gane, Jamie. Running – Blade XT vs Standard Prosthetic Foot. Jamie Gane Adaptive Athlete. [Online] February 14, 2018. [Cited: March 22, 2023.] http://www.jamiegane.com/blog/2018/2/14/running-blade-xt-vs-standard-prosthetic-foot.

8. Fox, Brinkley. Road Ready: Nike Sole 2.0 x Össur Running Blade. Nike. [Online] October 18, 2021. [Cited: March 22, 2023.] https://www.nike.com/gb/a/proof-of-concept-nike-sole-ossur-running-blade.

An injection that heals hearts

Posted on by

From the lectures on tissue engineering, I found the idea of fixing the body with the same materials that make up the body really interesting, and how this can help with rejection which is faced by foreign materials in the body. This led me to look more into recent advances in tissue engineering, where I came across this news article about a new biomaterial with the potential for healing damaged heart tissue after a heart attack.

What is it?

A team at the University of California San Diego has developed a new hydrogel, which is a polymer chain complex that can hold a lot of water. The hydrogel contains extracellular matrix (ECM), from the myocardium, or heart muscles. The ECM has been decellularized to isolate the matrix, enzymatically digested, and fractionated. In the body, cells exist inside a matrix, which contains proteins and other molecules to give structure to tissues and aid in cell communication. The original hydrogel that was developed was too large to target leaky blood vessels. This issue was solved by centrifuging the gel in its liquid stage to remove larger particles.

A hydrogel being made.

How does it work?

The hydrogel is injected intravenously, taking advantage of the bloodstream to access hard to reach organs. After a heart attack, gaps form between the endothelial cells which line blood vessels. When the hydrogel reaches the damaged tissue, it binds to these cells, bridging these gaps and promoting new cell growth and repair, and also reducing inflammation. The gel takes roughly 3 days to degrade after administration.

In their initial clinical trial, the gel was directly injected into the heart muscle. This came with the disadvantage of having to wait at least a week after the heart attack, as injecting the damaged tissue by needle directly after is likely to do more harm than good. Intravenous injection can be done immediately. The hydrogel can then work together with other treatments such as angioplasty or a stent. In addition, the gel is more evenly distributed around the tissue rather than being concentrated around the site of injection.

The Next Steps

This new way of administering the gel has been successfully tested on rodents and pigs to treat damaged heart tissue. The research group are looking to get authorisation from the FDA to perform human trials, with plans to start in the next couple of years. They are also exploring the potential of the hydrogel to treat other inflammatory diseases such as traumatic brain injury and pulmonary arterial hypertension with preclinical trials on rodents.

In the UK there are around 100,000 hospital admissions every year for heart attacks- or one every five minutes. Over the past 50 years, there has been major advances in treatment and survival. In the 19080s roughly 25% of people having a heart attack would die, nowadays, if treated quickly, the chance of dying during a heart attack is 2-4%. In the future this number will hopefully reduce even more with advances in bioengineering.

References

British Heart Foundation, 2023. UK Factsheet. [Online]
[Accessed 9 March 2023].

Spang, M. T. et al., 2022. Intravascularly infused extracellular matrix as a biomaterial for targeting and treating inflamed tissues. Nature Biomedical Engineering, 29 December, Volume 7, pp. 94-109.

Thomas, M., n.d. Focus on: Heart Attacks [Interview] n.d.

University of California – San Diego, 2023. Groundbreaking Biomaterial Heals Tissues From the Inside Out. [Online]
Available at: https://scitechdaily.com/groundbreaking-biomaterial-heals-tissues-from-the-inside-out/ [Accessed 8 March 2023].

Why am I taking Engineering Replacement Body Parts?

Posted on by

I do natural sciences, and this is a compulsory module in the third year. At first I was a bit confused why I had to do this module, since it doesn’t have a lot to do with what I usually study. In fact, up until a couple of months ago I thought the compulsory module would be ‘Life in the Cosmos’ which I was really excited to do. However, after attending the introductionary lecture, I am beginning to appreciate that this module will draw from a variety of disciplines and will give me insights into other subjects. I am particularly interested in the ethics lectures since this is not something that I have studied before.

In Natural Sciences I am free to choose modules from a variety of courses- for me that’s mainly biology and marine biology. Right now I am doing a project looking at the protein prophenoloxidase in crustaceans, which is part of their immune system.

One type of replacement body part that I have seen in practice is lens replacement surgery which my mum had a few years ago to treat cataracts. It was really cool to watch how someone who had relied heavily on glasses and contact lenses for over forty years suddenly be able to have the freedom to be able to see clearly without anything. Even something as simple as washing her face without having to worry about getting her contact lens wet has made a huge difference to her life.