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This article was co-authored by Nicole Moore, Litigation Assistant.
Kennedys Partner and amputation claims lead, Stephen Foster, was recently invited to present the defendant perspective at the Dorset Orthopaedic ‘Real World Rehabilitation Conference’ and Fieldfisher’s ‘Amputee Rehab Conference’.
Both events were well attended with audiences made up mainly of leading clinicians, case managers, amputees and litigation representatives from the claimant and compensator camps. They contained inspiring stories of achievement from amputees, updates on new prosthetics technology from the leading manufacturers and the latest treatment and surgical trends from leading clinicians in the amputee rehabilitation market. Stephen also delivered panel presentations at both events alongside claimant representatives, their clients, clinicians, case managers and an insurer.
Looking back over the various talks across both events, we have identified some recurring themes that provide an interesting insight into trends for those specialising in amputation claims.
Collaboration in early rehabilitation
Encouragingly, it was recurring theme at both events that collaboration between parties can greatly assist the rehabilitation for an amputee. It was evident that it is now widely recognised that getting the acute phase of amputee rehabilitation right can help maximise rehabilitation gains and improve function which can lead to a better quality of life for the amputee. It can also increase independence, help amputees return to work and limit changes to everyday life which in turn can reduce overall indemnity spend for compensators.
It is recognised that there can be barriers and that there is still progress to be made. However, there is clearly a willingness to improve the process and this can lead to benefits for amputees, their representatives and compensators.
Genium X4
In September 2024, the new Genium X4 microprocessor knee was released in the UK. The Genium X4 offers many features designed with the aim of ‘redefining amputee mobility’. At both events, the product manufacturer delivered presentations which showcased the new capabilities of the X4 which are designed to optimise physiological gait, reduce energy expenditure and fatigue during challenging movements. We heard that the device contains upgraded hardware and enhanced software designed to improve an amputees ability to navigate uneven terrain and slopes. The X4 is replacing the Genium X3 and the Genium which are being phased out and it is currently the most expensive knee prosthetic on the market. We heard testimony from users who have trialled the device but as the product is new to the market there is presently limited data regarding the extent of the functional gains for the amputee.
Limb salvage vs elective amputation
In claims involving severe lower limb orthopaedic injuries where there is significant ongoing pain levels, infection or bones failing to unite, we are increasingly seeing clinicians considering whether elective amputation should be explored.
Dr Vijay Kolli and Mr Jonathan Lohn, from The Cleveland Clinic presented on when they might consider elective amputations instead of prolonged limb salvage options. Kim Pickering and Mary Tebb from Dorset Orthopaedic and one of their patients provided an insight into the orthotic options available to claimant’s such as the Reaktiv brace which can help salvage the leg.
New surgical trends – the ‘Starfish’ procedure
We heard about a new surgical technique known as the ‘starfish’ procedure from Moose Baxter from Dorset Orthopaedic. The starfish procedure is designed to improve mobility and comfort for partial hand amputees. It is named for its five-point incision pattern to better distribute soft tissue around the residual limb. Key benefits of the procedure include reduction of sores and infections, skin breakdown and irritation resulting in improved structure of the residual limb. This allows for better prosthetic function, increased mobility and more natural movement.
Comment
The amputation rehabilitation and prosthetics industries continue to evolve and new products and surgical techniques continue to be introduced. When coupled with early rehabilitation, these developments often lead to amputees being able to enjoy greater levels of function, increased independence and improved quality of life. Historically, barriers to rehabilitation and collaboration have surfaced within litigation and still do in certain circumstances. However, the situation is improving and our invitation to both events highlights that there is a willingness on both sides to better understand respective viewpoints and overcome barriers where possible.