Technology

  1. Following are the two technologies for prosthetics
    1. Jaipur Foot Technology
    2. Western Technology
    Jaipur Foot Technology:
  2. BMVSS uses the famous Jaipur Foot. It is the parent body for Jaipur Foot.
  3. Jaipur Foot is technically distinct from other foot / limb technologies. Jaipur Foot was developed at the S.M.S. Medical College Hospital, Jaipur in 1968 by a group of eminent Orthopedic surgeons and highly innovative craftsmen. The subsequent developments, in the technology were under aegis of BMVSS.
  4. Like all lower limb prosthesis, the Jaipur Foot / Limb Technology has three vital components namely –
    • Prosthetic Foot
    • Knee Joint
    • Socket & Shank
  5. The Jaipur Foot Technology for all these three components is unique and innovative.
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    Jaipur Prosthetic Foot –
  1. The Jaipur Foot is the only non-articulated foot in the world that provides mobility in all three planes i.e., Dorsi-flexion, Inversion / Eversion and transverse rotation.
  2. The Jaipur Foot enables amputees to walk on normal ground; walk on uneven ground; run; trek; swim; squat; sit cross legged; dance; and work in wet muddy fields etc. With it, a below knee amputee can climb a tree or a mountain also. It can be used with or without shoes.
  3. Jaipur Foot is a universal foot. Jaipur Foot is like human foot or bio-mimieic, unlike most of the western designed limbs which are activity specific.
  4. Jaipur Foot is today the most widely used prosthetic foot in the world.
  5. The impact of the Jaipur Foot was vividly described in the Time Magazine – USA (Fall 1997 issue) – “People who live inside the world’s many war zones from Afghanistan and Rwanda may never have heard of New York or Paris but they are likely to know a town in Northern India called Jaipur. Jaipur is famous in strife-torn areas as the birthplace of an extraordinary artificial limb known as the Jaipur Foot, that has revolutionized life for millions of landmine amputees. The beauty of Jaipur Foot is its lightness and mobility – Those who wear it can run, climb trees and pedal bicycles and its low price”.
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    Knee Joint –
  1. Most above knee amputees in India and the developing world are traditionally fitted with single axis knee joint largely because of its low cost & simple design. However, this design imposes major gait limitation. The western knee joints available are extremely costly and beyond the reach of most of the amputees.
  2. BMVSS was also using the single axis knee joint till a collaboration with the Stanford University USA which led to the development of a joint based on the Polycentric concept.
  3. The Stanford Jaipur Knee known as the Jaipur Knee mimics normal gait by providing stance phase stability & swing phase response.
  4. The design of Jaipur Knee consists of an upper & lower body block, two side linkages, a mid-linkage, held together by four steel shoulder bolts. The body blocks have threaded segments for socket & pylon attachment. It is manufactured by CNC machine from oil impregnated nylon.
  5. This knee joint has been fitted to over 30,000 patients with very satisfactory feedback. Outcome measured in terms of acceptability, compliance, durability & performance is very positive.
  6. The Stanford-Jaipur Knee Joint or Jaipur Knee Joint has been hailed by the TIME Magazine – USA (November 23, 2009 issue) as one of the 50 Best Inventions of the world in the year 2009. (the copy of the TIME Magazine USA (23rd Nov 2009) is enclosed. This appreciation is not available to the western four-bar polycentric knee joint.
  7. The knee joint has now been further modified to make it interface with universal prosthetic componentry. The joint can interface with all socket designs whether thermoplastic or laminated. At the distal end it can be connected to any prosthetic foot designs using standard foot pyramid.
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    Socket –
  1. Although the principles of measurement, mould talking &fabrication at BMVSS are the same as in the western technology, the Jaipur Limb Technology is unique on account of the fabrication processes & materials used.
  2. The use of High Density Polyethylene (HDPE) pipe was pioneered at BMVSS. HDPE is light weight; has a high impact resistance; and high tensile strength. It is an inert material and is not affected by climate change. The use of HDPE pipes results in seamless and very strong sockets / shanks. The skin colour of the HDPE pipes obviates the need for additional cosmetic cover. Using HDPE pipes, the fabrication time is cut short drastically as compared to lamination or thermoforming of sheets. The enables BMVSS to cater to a very large number of amputees.
  3. Depending on the amputee indications, open ended as well as total contact sockets, exo-skeletal and endo-skeletal designs, are used at BMVSS.
  4. The fabrication time of a custom-made below knee artificial limb in one day and that for above knee takes two days. Being the fastest, the Jaipur Foot Technology is called the Rapid Fit Technology. The standard time taken by most of the limb fitting centres around the world takes several weeks or in some cases months.
  5. The average normal life span of a Jaipur Foot / artificial limb is between 3 to 4 years depending on use. This has been again and again verified, the last report in this regard, being of well-known Indian Institute of Health Management Research (IIHMR). International guidelines state that all assistive devices should last for three years and the Jaipur Limb conforms to them.
  6. For BK protheses and MOU have sign with Japanese company under with part of the socket, total contact socket would be made digitally through 3D printing equipment this would integrate the Japanese digital technology and jaipurfoot technology and unmatched combination.
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    Western Technology:
  1. Very briefly, in the western technology, an artificial limb is made with SACH Foot.
  2. Jaipur Foot is closest to human foot in terms of functions, flexions and cosmesis. Following is the comparison between Jaipur Foot and SACH Foot –
    3. # Features SACH Foot Jaipur Foot
    I Range of Motion
    Dorsiflexion – +
    Inversion- Eversion – +
    Transverse rotation – +
    Inversion- Eversion – +
    II Function
    Squatting – +
    Adapting to uneven terrain – +
    Cross-legged sitting – +
    Kneeling – +
    Barefoot walking – +
    III Alignment options
    With shoes + +
    Without shoes – +
    IV Appearance Shaped like a shoe last Shaped like the human foot
    V Durability
    VI Life 1 year 3 years
    Shoe cover Required Not Required
  3. A bio-mechanical comparison of Jaipur Foot / with SACH and Seattle Foot (mostly used in USA) was carried out by Liverpool Hospital, UK by Prof. Klenerman et al. The results showed that the performance of the Jaipur Foot was more natural and nearer to the normal foot as compared to the SACH and Seattle Foot.
  4. It is also worth mentioning that Jaipur Foot manufactured by Bhagwan Mahaveer Viklang Sahayata Samiti (BMVSS), Jaipur, has been given Indian Standard Institute Certificate, which is a high standard and the Jaipur Foot pieces are subject to regular inspections to ensure its high quality.
  5. In the western technology, the socket is generally made of poly-propylene or carbon fiber to make it strong, a costly and time consuming process with no extra advantage in terms of weight of the socket.
  6. In case of Jaipur Foot / Limb, as stated earlier, socket is made of High Density Polyethylene (HDPE) Pipe, which is also very strong. Its cost is a fraction of the cost of poly propylene or carbon fiber socket. Thirdly, since HDPE pipe is used (instead of wrapping of the sheet on the positive mould, as is required in the Western System), there is no joint in case of HDPE Pipe socket of Jaipur Foot / Limb. Technology.
  7. For the above-knee artificial limbs of Jaipur Foot variety, mostly uses Jaipur-Knee (developed by Stanford University, USA as stated earlier). This is a four-bar polycentric knee joint, which in the words of TIME Magazine USA (issue 23rd Nov 2009), is one of the 50-Best Inventions of the world for the year 2009. This cannot be said about the polycentric knee joint of the western world.
  8. The time taken to fabricate and deliver, the western limb is at least several weeks and, in some cases, several months. Compared to this, Jaipur Foot / Limb, can be generally fabricated and delivered just in one or two days as already stated.
  9. Besides, the average cost of Jaipur Foot / Limb is just about US$ 100 as against US$ 10,000 for a comparable limb in the USA.
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