Restoring Mobility and Independence Through Expert Fitting
Limb loss, congenital limb differences, stroke affecting mobility, or requiring braces and supports profoundly affect daily life, independence, and identity. Our prosthetics and orthotics services provide expert fitting and ongoing support for artificial limbs, braces, and supportive devices.
You don’t need to travel far from home for fittings and adjustments, expert prosthetists and orthotists providing comprehensive assessment, custom fitting, training, and ongoing support are available right here.
Our Prosthetist & Orthotists
Medical Disclaimer: This information is for educational purposes and does not replace professional medical advice. Please consult with qualified prosthetists/orthotists and your medical team for assessment and individualised device recommendations. Prosthetic and orthotic outcomes vary significantly based on individual factors, realistic expectations are essential.
What Conditions Do We Address?
Below-Knee (Transtibial) Amputation
Most common lower limb amputation level. Preserving the knee joint dramatically improves prosthetic function; walking with a below-knee prosthesis is easier, more energy-efficient, and more natural than with an above-knee prosthesis.
Prosthetic Components:
- Socket (custom-fitted interface between residual limb and prosthesis, proper fit is crucial, preventing pain and skin breakdown)
- Suspension system (holding prosthesis securely, suction, pin lock, or elevated vacuum systems)
- Pylon (structural shaft connectingthe socket to the foot)
- Prosthetic foot (ranging from basic SACH feet to advanced energy-returning carbon fibre feet)
- Cosmetic cover (optional, foam cosmesis matching the other leg’s shape)
Above-Knee (Transfemoral) Amputation
More challenging than below-knee due to loss of the knee joint. Prosthetic knees cannot fully replicate natural knee function; they’re always a compromise, balancing stability (preventing buckling) with smooth natural gait.
Prosthetic Components:
- Socket (particularly challenging to fit, intimate contact with soft tissues of the thigh)
- Suspension (various systems, including suction, belt, or elevated vacuum)
- Prosthetic knee (critical component, ranging from simple mechanical knees to sophisticated microprocessor knees costing hundreds of thousands)
- Pylon
- Prosthetic foot
Hip Disarticulation & Hemipelvectomy
Extremely high-level amputations are rare and extremely challenging. Prosthetic fitting is complex, function is limited, and many patients use wheelchairs as primary mobility.
Bilateral Lower Limb Amputation
Losing both legs is devastating. Bilateral prosthetic use requires extraordinary effort, cardiovascular demand is enormous, balance is extremely challenging, and energy levels often limit functional ambulation to household distances. Many bilateral amputees use wheelchairs for efficiency whilst maintaining prosthetic walking ability for specific situations.
Partial Foot Amputation
Amputations through the foot (transmetatarsal, Chopart, Lisfranc) preserve length and weight-bearing capability. Prosthetic interventions are often custom orthoses or partial foot prostheses fitting inside shoes, providing better function than more proximal amputations.
Upper Limb Prosthetics
Upper limb prosthetics is more challenging than lower limb. Hands perform extraordinarily complex functions, fine motor manipulation, sensory feedback, communication through gesture. Current prosthetic technology cannot replicate natural hand function. Additionally, many upper limb amputees achieve remarkable functional adaptation without prostheses, using their residual limb plus the opposite intact limb creatively.
Lower Limb Orthotics
Ankle-Foot Orthoses (AFOs):
Most common lower limb orthosis. AFOs support ankles and control foot position addressing various conditions:
- Foot Drop
- Ankle Instability
- Post-Stroke Spasticity
- Cerebral Palsy and Paediatric Conditions
- Knee-Ankle-Foot Orthoses (KAFOs)
- Foot Orthoses (Custom Insoles)
- Knee Orthoses
Upper Limb Orthotics
Wrist-Hand Orthoses:
Splints supporting wrists or hands for various conditions including carpal tunnel syndrome (night splints maintaining neutral wrist position), wrist sprains or fractures (immobilisation during healing), arthritis (resting inflamed joints, maintaining functional positions), stroke or neurological conditions (preventing contractures, supporting weak muscles), and post-surgical protection.
Elbow Orthoses:
Supporting elbow injuries or conditions including tennis elbow/golfer’s elbow (counterforce braces), post-fracture immobilisation, post-surgical protection, and contracture prevention after burns or neurological injury.
Shoulder Orthoses:
Abduction orthoses or immobilisation slings for rotator cuff injuries, post-surgical protection, fracture healing, and neurological conditions requiring positioning.
Spinal Orthotics
Cervical Orthoses:
Neck supports ranging from soft foam collars (minimal support, comfort) to rigid cervical collars (Philadelphia collar, Miami J collar, significant motion restriction) for whiplash injuries, cervical spine injuries or surgery, neck arthritis, and torticollis.
Thoracolumbar Orthoses:
Back braces including rigid thoracolumbar orthoses (TLSOs) for spinal fractures, post-surgical support, scoliosis management, and soft lumbar supports for low back pain (limited evidence for effectiveness, often provide comfort and movement awareness more than structural support).
Scoliosis Bracing:
Adolescents with progressive spinal curvature (scoliosis) sometimes wear braces (Boston brace, Milwaukee brace) attempting to slow progression during growth. Bracing doesn’t correct established curvature but might prevent worsening, potentially avoiding surgery. Compliance is challenging, adolescents wearing uncomfortable conspicuous braces for 18-23 hours daily for years requires extraordinary commitment.
Paediatric Prosthetics & Orthotics
Children present unique considerations:
Growth:
Children outgrow devices every 6-18 months, requiring replacements. This creates high ongoing costs but is necessary for proper development and function.
Development:
Devices must support normal developmental progression, enabling crawling, standing, and walking at appropriate ages.
Psychological Adjustment:
Children’s understanding and acceptance of devices evolve with age. Young children often accept devices easily; adolescents might resist devices due to appearance concerns and the desire to fit in.
Family Support:
Parents are crucial partners, maintaining devices, encouraging use, providing emotional support, and advocating for children’s needs.
School Integration:
Ensuring children can participate fully in school activities (physical education, playground, and classroom mobility) requires coordination with schools.
Understanding Prosthetics and Orthotics
Prosthetics and orthotics are related but distinct specialties within rehabilitation medicine.
Prosthetics involves designing, fabricating, and fitting artificial limbs (prostheses) for people who’ve lost limbs due to amputation from trauma (accidents, injuries), disease (diabetes, peripheral vascular disease, cancer, infection), or congenital limb differences (born without all or part of a limb). Prostheses replace missing body parts, restoring mobility, function, and appearance as much as possible.
Orthotics involves designing, fabricating, and fitting external supports and braces (orthoses) for people with musculoskeletal or neurological conditions affecting limb function. Orthoses support, align, prevent deformity, or assist movement in weakened or injured body parts, without replacing them. Common examples include ankle-foot orthoses (AFOs) for foot drop after stroke, knee braces supporting unstable knees, spinal braces, and custom foot orthoses (prescription insoles).
Prosthetists and Orthotists are healthcare professionals who’ve completed specialised training (typically four-year degree programmes) in biomechanics, anatomy, materials science, and clinical assessment. They’re registered with professional bodies and work closely with rehabilitation teams including doctors, physiotherapists, occupational therapists, and counsellors.
Many people don’t realise these specialists exist. When facing amputation or needing mobility supports, patients often don’t know where to turn, what’s available, or how to access appropriate devices. Doctors prescribe prostheses or orthoses, but prosthetists and orthotists are the experts who assess needs, design solutions, fabricate devices, fit them properly, train users, and provide ongoing adjustments and support.
Modern prosthetic and orthotic technology has advanced dramatically. Prosthetic limbs aren’t crude wooden pegs, they’re sophisticated devices using advanced materials (carbon fibre, titanium, silicone), computerised components (microprocessor knees, myoelectric hands), and biomechanical designs mimicking natural movement. Orthoses aren’t simple rigid braces, they’re custom-designed supports optimising function whilst maximising comfort.
But technology is only half the story. Expert fitting, comprehensive training, ongoing adjustments, and psychological support are equally crucial. The most advanced prosthetic leg is worthless if it doesn’t fit properly, causing pain and wounds. The most sophisticated knee brace provides no benefit if the patient doesn’t understand how to use it correctly. This is why specialist prosthetists and orthotists matter, they don’t just provide devices; they provide comprehensive care, ensuring devices actually improve lives.
Limb loss and significant disability profoundly affect physical function, identity, emotional well-being, and independence. Prosthetics and orthotics address the physical aspects, restoring mobility and function through expertly fitted devices. But comprehensive rehabilitation also requires physiotherapy rebuilding strength and teaching mobility skills, occupational therapy adapting daily activities, psychological support managing grief and adjustment, and peer support from others who’ve walked this journey.
Why Choose Botshilu for Prosthetics & Orthotics Services
Obtaining and successfully using prostheses or orthoses requires expert professional support throughout the journey, from initial assessment through device fabrication, fitting, training, and ongoing care.
Botshilu’s Prosthetics & Orthotics services offer:
Qualified Prosthetists and Orthotists:
Our specialists have completed comprehensive training in prosthetics and orthotics, have years of clinical experience assessing diverse needs and fitting various devices, understand biomechanics and gait analysis, and stay current with evolving materials and technologies. When device fit and function determine whether you regain independence or struggle with painful, ill-fitting equipment, expertise matters profoundly.
Comprehensive Assessment:
Proper fitting begins with thorough assessment including detailed history (cause of amputation or condition, timeline, previous devices, medical conditions affecting healing or function, lifestyle and activity goals, work requirements), physical examination (residual limb assessment for prosthetics, length, shape, tissue quality, circulation, wounds or complications; musculoskeletal assessment for orthotics, strength, range of motion, alignment, gait analysis), functional assessment (current mobility level, activities you can and cannot do, barriers to independence), and psychosocial assessment (emotional adjustment, support systems, realistic goal setting).
Custom Device Fabrication:
Prostheses and orthoses are custom-made for each individual, including precise measurements and casting of limbs, selection of appropriate components based on activity level and needs, fabrication using quality materials, initial fitting with careful alignment and adjustments, and static and dynamic fitting assessment ensuring proper function.
Training and Rehabilitation:
Providing devices is only the beginning, users need comprehensive training including prosthetic gait training (learning to walk with artificial limbs, initially with parallel bars, progressing to walking aids, eventually independent walking), strength and conditioning exercises, balance training, functional activities practice (stairs, ramps, uneven terrain, getting up from floor), fall prevention strategies, and donning/doffing training (putting on and removing devices correctly).
This training works in conjunction with physiotherapy; prosthetists/orthotists focus on device function and adjustment; physiotherapists focus on strength, mobility, and functional training.
Follow-Up and Adjustments:
Prosthetic and orthotic needs evolve over time, requiring ongoing care including regular follow-up appointments, checking device fit and function, adjustments as residual limbs change shape (particularly in the first year after amputation), repairs and replacements of worn components, modifications as activity levels or needs change, and upgrading devices as technology improves or lifestyle changes.
Range of Devices:
We provide comprehensive prosthetic and orthotic solutions including lower limb prostheses (above-knee, below-knee, partial foot), upper limb prostheses (transradial, transhumeral, partial hand), lower limb orthoses (AFOs, KAFOs, foot orthoses), upper limb orthoses (wrist splints, elbow supports, shoulder orthoses), spinal orthoses (cervical collars, thoracolumbar braces), paediatric devices (growing children require specialised approaches), and post-surgical orthoses supporting healing after surgery.
Quality Components:
We use high-quality components from reputable manufacturers including advanced prosthetic feet (energy-returning feet for active users, multiaxial feet for varied terrain), prosthetic knees (mechanical knees, hydraulic knees, microprocessor knees for advanced users), suspension systems (suction sockets, pin locks, elevated vacuum systems), comfortable socket interfaces (silicone liners, gel cushions, custom socket designs), modern orthotic materials (carbon fibre for strength and lightness, thermoplastics for custom moulding), and advanced fastening systems (BOA closures, velcro straps, custom buckles).
Multidisciplinary Coordination:
Optimal outcomes require a team approach. Our prosthetists and orthotists work closely with referring physicians managing overall health, surgeons (particularly for amputation patients, coordinating timing and approach), physiotherapists providing mobility training, occupational therapists adapting daily activities, wound care specialists managing residual limb complications, pain specialists managing phantom limb pain and neuropathic pain, and psychologists supporting emotional adjustment.
Paediatric Expertise:
Children with limb differences or conditions requiring orthoses have unique needs, including devices accommodating growth (requiring frequent replacements), child-friendly designs encouraging use, family education and support, coordination with developmental services, and age-appropriate psychological support. Children adapt remarkably well to devices when properly supported.
Your Prosthetics & Orthotics Team
When you’re facing heart or chest surgery, you’re not just seeing one doctor, you’re being cared for by an entire team of specialists working together for your wellbeing.
Prosthetist/Orthotist
Your Prosthetist/Orthotist is a healthcare professional who has completed specialised training in prosthetics and orthotics (typically four-year degree). They’re registered with professional bodies and are experts in biomechanics, gait analysis, materials science, device fabrication, and clinical fitting. Some specialise in either prosthetics or orthotics; others are dual-qualified.
Rehabilitation Team Members
Rehabilitation Team Members collaborate closely, physiotherapists providing mobility training and strengthening, occupational therapists adapting daily activities and recommending assistive devices, psychologists supporting emotional adjustment, social workers connecting to resources and support services, and physicians managing overall medical care and prescribing devices.
FAQ
Frequently Asked Questions
Common Concerns and Honest Answers
Honest answer: not exactly as before. Prosthetic gait differs from natural gait, subtle but noticeable differences in rhythm, symmetry, and effort. Most people achieve functional independent walking, but "normal" depends on definition. You'll walk well enough for daily life, but probably not identically to pre-amputation gait. Very active individuals might achieve near-normal gait patterns, whilst others have more pronounced differences.
Initial walking typically begins the day of prosthetic fitting, in parallel bars with significant support. Independent walking might take weeks to months depending on amputation level, your fitness and health, age, motivation, and prosthetic components. Below-knee amputees often achieve independent walking within 1-3 months. Above-knee amputees need 3-6 months typically. Bilateral amputees take longer, 6-12 months or more.
Properly fitted prostheses shouldn't cause pain. Discomfort during initial adaptation is normal as skin toughens and you build tolerance. But ongoing pain indicates fitting problems requiring adjustment. Never accept persistent pain, it signals problems that will cause skin breakdown, wounds, and inability to use prosthesis. Report pain immediately so adjustments can be made.
Residual limbs undergo dramatic volume changes in first year post-amputation as swelling resolves, muscle atrophies from disuse (despite strengthening exercises, disused muscles shrink), and tissues mature. Sockets require frequent adjustments or replacement accommodating these changes. After 12-18 months, limb volume stabilises, though weight fluctuations still affect fit.
Standard prosthetic components aren't waterproof, electronics are damaged by water, materials deteriorate, suspension systems fail when wet. You remove prostheses for bathing. Waterproof prosthetic covers exist for shower safety. Specialised waterproof prostheses enable swimming but most people don't have these (expensive, usually not covered by medical aids, limited functional advantage for most).
Generally yes, prostheses for medically necessary amputations are covered. However, medical aids impose limits (maximum benefits every 3-5 years, restrictions on component sophistication, co-payments and shortfalls). You might not receive the most advanced components available, medical aids often approve functional prostheses but not cutting-edge expensive technology. Pre-authorisation is essential before proceeding.
Many amputees return to sports and recreation. Running-specific prostheses (blade-style carbon fibre feet) enable running. Specialised feet enable cycling, hiking, some ball sports. Contact sports carry prosthetic damage risk. Swimming requires waterproof prostheses or swimming without prosthesis. Realistic expectations and appropriate component selection matter. Discuss activity goals with your prosthetist.
Depends on clothing, prosthetic type, and observer awareness. Long trousers hide leg prostheses well, most people won't notice unless watching your gait carefully. Upper limb prostheses are more visible. Cosmetic covers improve appearance but add weight and don't perfectly mimic natural limbs. Some people embrace visibility; others prefer concealment. Both approaches are valid.
Not everyone successfully uses prostheses. Factors affecting success include amputation level (below-knee better than above-knee), underlying health (vascular disease, other comorbidities reduce success), age (younger people generally adapt better), motivation and psychological adjustment, quality of rehabilitation support, and prosthetic fit and components. If prosthetic use isn't successful, wheelchairs and other mobility aids enable independence. Prosthetic "failure" doesn't mean personal failure, it means finding what works best for you.
Prosthetic limbs last 3-5 years typically before requiring replacement. Components wear at different rates, feet and sockets wear fastest requiring more frequent replacement; pylons and some components last longer. Children outgrow prostheses every 6-18 months. Medical aids typically authorise replacements every 3-5 years. Between replacements, ongoing maintenance and component replacements keep devices functional.
Evidence varies by condition. AFOs for foot drop, excellent evidence, dramatic functional improvement for most users. Custom foot orthoses, good evidence for some conditions (plantar fasciitis, posterior tibial dysfunction), less clear for others. Lumbar supports for chronic back pain, limited evidence they provide more than placebo/comfort. Discuss evidence for your specific condition with your healthcare provider. Well-fitted devices addressing clear biomechanical problems generally help; devices prescribed indiscriminately might not.
Properly fitted orthoses shouldn't cause significant discomfort beyond initial adaptation. Ongoing discomfort indicates fitting problems. Common issues include excessive pressure points, inadequate cushioning, materials too rigid for your needs, or incorrect biomechanical design. Return for adjustments, don't accept persistent discomfort.
Depends on the condition. Post-surgical orthoses are temporary, worn during healing then discontinued. Developmental orthoses for children might be discontinued once growth stabilises. Neurological conditions requiring long-term support (stroke, cerebral palsy) typically need ongoing orthotic use. Biomechanical problems might improve with strengthening allowing discontinuation, or might be permanent requiring ongoing support. Your prescribing physician and orthotist guide appropriate timelines.