Innovation in prosthetics and orthotics

As I look back over my 35 years in the field of prosthetics and orthotics research, and consider those years from the point of view of the innovations I have witnessed and participated in, certain insights and influences stand out. They cluster around specific people and projects. Two years in Toronto with Fred Hampton and Colin McLaurin led to the establishment of the Canadian Plastic Syme's Prosthesis, the Canadian Hip Disarticulation Prosthesis, plastic reinforcement of wooden prostheses and conception of the SACH Foot. The products of ten years at Berkeley with Chuck Radcliffe, Leigh Wilson, Bill Hoskinson, Frank Todd, Jim McKinnon and others, included design of the SACH Foot, the Quadrilateral above-knee (A.K.) socket, the Patellar Tendon Bearing below-knee (B.K.) prosthesis; conception of socket standardization, studies of prosthesis alignment and experiences with modular prosthetics. Introduction of modular prosthetics to the clinic, development of the electrical alignment unit, use of semiflexible sockets and work on standard sockets and standard cosmetic restorations were experiences of my 8 years in Winnipeg with Ian Cochrane, Doug Hobson and Reinhard Daher. Invention of Shapeable Matrices, development of Tubular orthotics, development of Computer Aided Socket Design and design of the valgus varus resist knee orthosis are milestones of my Vancouver experiences with colleagues Steve Cousins, Richard Hannah, David Cooper, Carl Saunders and Margaret Bannon over the past 15 years. I have appreciated experiences in projects outside my work environment too. The most recent was the cooperation that developed around Computer Aided Socket Design and Computer Aided Manufacturing between the group at UBC and the groups at University College London and West Park Research, Toronto. I am pleased that cooperation is being extended by new initiatives developing between the original groups and others. I speak of these things to convey to you the team basis for developments and the positive effect cooperation between people has on advances in our field. Those of us who have worked together on various projects functioned best when we recognized and used each others qualities. Among the qualities I am thinking of are drive, curiosity, imagination, persistence, patience, trust, confidence and the ability to share. To keep sweet reasonableness alive between people, participants have had to review their motives and consider the needs of their associates. How these associates functioned varied. Some were definite and decisive. Some pondered things over and came to considered views. Some were very competent at the things they were trained to do. Some inspired new ideas on how to solve the problems we worked on. Some were able to take risks easily. Assertiveness born of clarity of view could sometimes be mistaken for arrogance. While human relations are never without their problems, all of these people enlarged my capabilities and enriched my work life. There have been things I loved doing. Other things I have compelled myself to do. My attachment has been to what I believe were keystone projects, projects that had the potential to generate multiple solutions. In All correspondence to be addressed to Mr. J. Foort, Medical Engineering Resource Unit, University of British Columbia, Shaughnessy Hospital, 4500 Oak Street, Vancouver. B.C. V6H 3N1, Canada.