What impairment requires the use of the chosen physical aids

AS and A Level Physical Education (Sport & Coaching)

Our elbow is a hinge joint, which means that it can move in only one plane – like a hinge on a door. A joint is where 2 bones meet. Our elbow is a hinge joint made up of the humerus which is the bone of the upper arm, the ulna which is the bone that runs from the your elbow to the tip of your pinky finger at the side of your wrist, and the radius which is the lower arm at the other side of the ulna.

The elbow joint can be permanently damaged through frequent sports injuries such as bad sprains and fractures and through weakening of the joint caused by diseases such as osteoarthritis, which occurs when; the cartilage at the end of the bone becomes worn away. The cartilage acted as a shock absorber, without it there will be more friction and movement will be very painful. And also rheumatoid arthritis which is when the smaller joints become inflamed, tissue grows across the joint and makes movement very difficult, over time the joint can become permanently fused ands o no movement will be possible. The joint can also be damaged by excessive pressure on the surface of the joint, these damages to the joint might also destroy the cartilage, and fractured pieces of cartilage do not normally grow back. When the weakening of the elbow joint is so severe that the elbow is of very little use and is causing too much pain, the elbow joint might be replaced with an artificial one to regain back its power and stop the pain.

During these surgical replacements of the elbow joint, the surgeon removes the damaged bone and cartilage. These removed structures are then replaced by an artificial elbow (prostheses), theses prostheses are designed to be a replica of the original joint and to function just as the old joint did. They are used to restore mobility and movement to the elbow and arm. These surgical operations are effective and are very safe. These prostheses have some inaccuracies such as they might tend to loosen which might cause failure or breaks the artificial elbow joint. With time these prostheses are being developed to suit the human needs and to be more effective than previous ones.

How has it contributed to the improvement of human life and the society in general

After the surgical operation of replacing the damaged joint, most patients recover full control over their elbow and regain back the same power of their old joint, and can do most tasks their original joint did. These prostheses have improved human lives, and the society because it has reduced pain produced by damaged cartilage of joints, and it has also improved the quality of life of patients with diseases such as osteoarthritis and rheumatoid ...

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How has it contributed to the improvement of human life and the society in general

Our joints become worse and wear out with age. During the years artificial elbow joints have been improved to become as durable as the real elbow joint. Old-fashioned artificial joints have only lasted for 10 to15 years or so, which has sometimes returned the patients to their older state of pain bad immobility. This century has witnessed joint replacement for people under the age of 40; these patients under this age have shown to be very energetic and sportive, which has placed more stress on the hardware of the joints, which made surgeons give their immediate attention to improve the durability and life of these elbow prostheses. Surgeons are now aiming to produce elbow replacements that last for 30 years or more.

Comment on the benefits and drawbacks of the use of physical aids

The aim of replacing the damaged elbow joint is to restore comfort, functions and mobility to elbow joints damaged by disease such as arthritis and its different forms. Surgical replacement of the elbow involves the cutting of tendons and bone this might cause a lot of pain, this pain is controlled by pain medication and anesthetics, strong medicine such a morphine are occasionally given to the patient to manage the pain. After the operation other complications and problems might occur, some of these complications are: -

Infection
Loosening
Nerve or blood vessel injury

Infection of the elbow joint can be very serious, infection can happen for the following reasons, the skin covering the elbow is very thin and there is no muscle covering so this makes wound difficulty more common and can result in a serious infection.

Loosening is the major reason behind the failing of most elbow joint replacements this is because the part of the replacement where the metal or cement meets the bone often loosens with time. A loose joint causes too much pain and another surgery might be required to correct the loosening.

Nerve and blood vessel injury might occur because all the large nerves and blood vessels are near or go across the elbow, the surgery take places very near these vessels so they might be injured during the surgery.

How has it been developed with time and what cultural influence have affected its development

People have lost control over their elbow due to many reasons; such as diseases… etc. doctors and surgeons have been working since the early 19th century on artificial elbow joints to help patients regain the power of their old elbow.

The first prosthesis for the upper body was the body-powered elbow; this invention depended on the movement of the shoulder to control the elbow, people using this invention thought that it was difficult to use, because it required unnatural shoulder motion. These complaints led to the desire to make prostheses externally powered and to be less difficult for the people. There had been unsuccessful efforts to use electric power to make the elbow prostheses, by the late 1940’s a doctor called “Melvin Glimcher” started working with a group of researchers to produce a prostheses which would be easier to use, this research led to the creation of the “battery-powered Boston Elbow” this arm used myoelectric actuation for the elbow.

In 1974 a graduate from the Massachusetts Institute of Technology developed the Utah Arm, it was better than the Boston elbow, it was light weight, better appearance, and had increased range of motion, but its disadvantage was its increase in cost and difficulty to use. In 1988 artificial elbow joints were starting to become more developed with the use of more technology and more features.

Patients have been complaining about elbow joints since the beginning of their creation with time they are being developed to suit patients needs. Today elbow prostheses are being developed to be less painful and more durable and to last long.

What moral and ethical consideration could be associated with its development

As we can see from the history of development of elbow joints there wasn’t much competition on different companies producing different kinds of artificial prostheses. This might have affected the price of prostheses. In the beginning prostheses were simple and were fairly inexpensive, but as technology was introduced to the development of prostheses, the price has been exaggeratedly high.

One of the researchers involved in the producing of the Boston elbow had separated from his team and started creating the Utah arm which was better and more useful than the Boston Elbow, but the greed of this researcher had blinded him that his invention had the same disadvantages as the older inventions, which was mainly the difficulty of use and the expensiveness.

Gareth Williams, Biology for You, page138

http://www.mythos.com/webmd/Content.aspx?E=4&P=PRODEV

Biology for You, page 143

http://health.discovery.com/centers/surgery/articles/tamar/hardware/hardware.html

http://www.orthop.washington.edu/faculty/Matsen/elbowarthritis/06

http://www.orthogastonia.com/patient_ed/html_pages/elbow/elbow_arthroplasty.html

http://www.bae.ncsu.edu/research/blanchard/www/465/textbook/otherprojects/2000/prosthetics_00/project/1.html