The prostheses are being used only for research, since they require more testing to be considered for F.D.A. approval, but research participants have already achieved a “biomimetic gait.” This makes it the first leg design that allows users to walk approximately as quickly and unthinkingly as anyone else—a feat that Herr described as “more than I had expected in my wildest dreams.”
Galchen points out that the M.I.T. prosthesis is “not just about microprocessors, carbon fibre, and titanium.” It “required the engineering of much more familiar materials: muscles, tendons, and bones.” Herr, in close collaboration with Shriya Srinivasan and Tyler Clites, who were then graduate students in Herr’s lab, teamed with plastic surgeon Matthew Carty, at Brigham and Women’s Hospital, to develop a new approach to amputation. The new approach is called the Ewing amputation, named after Jim Ewing the first patient to undergo the procedure. Galchen describes it:
According to a description of what would become known as the Ewing amputation, the surgeon makes a “stairstep incision” over the shin using a scalpel. The relevant part of the limb is “exsanguinated.” A flap of skin is peeled back to expose the leg muscles. Care is to be taken, the account notes, to isolate the saphenous vein and a nearby nerve. This is only the beginning of what is simultaneously a delicate, gruesome, and revolutionary surgical procedure; one of the required tools is a bone saw.
My favorite sentence in “Leg Work” is Galchen’s description of Carty: “When I first met Matthew Carty, a tall plastic surgeon with gray hair and bright-blue eyes, he had just returned from a twelve-hour breast-reconstruction surgery, and I could still see the imprint of magnification glasses on his face.” That noticing of “the imprint of magnification glasses on his face” is inspired. It’s pure Galchen.
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