Health & Medicine

Futuristic bionic knee makes SMUD worker feel ‘whole’

It took a 40-foot fall to set Jonathan Bik on a collision course with the brave new world of the bionic knee.

The fall happened nine years ago when Bik was descending a utility pole during a tryout for a lineman’s job with the Sacramento Municipal Utility District. Bik shifted his weight to a leg that had fallen asleep. The fall proved catastrophic.

He landed feet first, snapping the femoral artery in his right leg. Five surgeries followed over three days in an unsuccessful effort to save the leg, which was amputated above the knee.

Since then the 40-year-old Bik has been the local poster boy for things bionic.

After his accident, he was fitted with what was then the top prosthetic, a microprocessor knee known as the C-Leg. Advanced for its time, the device gave him the mobility he needed to work and exercise effectively.

About two months ago, he moved up to the next level. He was fitted with a hyper-advanced prosthetic called the Genium, whose technological advances resemble something that would be at home on the set of “Terminator” or “RoboCop.” Bik, a Folsom resident, is the first nonmilitary amputee in the region to be fitted with this state-of-the-art prosthetic.

The microprocessor knee technology has afforded him the opportunity to do what he loves most – get sweaty and dirty at a job that has nothing to do with being a pencil pusher. On most days Bik can be found climbing down manholes as a cable splicer for SMUD.

And with the new Genium knee, he does so without betraying a hint that he is an amputee.

That a prosthetic knee can emulate the grace of human movement has everything to do with the employment of gyroscopes, hydraulics and a microprocessor. The latter uses computer code to combine information about what the knee is doing and how to react to it in real time. That means it allows what was not previously possible with a knee prosthetic – moving backward and sideways .

To some who wear a knee prostheses, backward movement might not be that big of a deal. For Bik, who frequently walks backward when unspooling cable at SMUD, it is essential.

“The knee has allowed me to work in the field,” said Bik, who started out at SMUD working in the meter shop, but about 31/2 years ago began training to become a cable splicer. He completed his apprenticeship in December.

Initially, when he realized he would lose his leg, terror set in.

“I was young and active,” said Bik. “I didn’t want to be told I’d have to work at a desk job all day long.”

For Bik, the Genium offers a quantum advancement over the C-Leg.

Only a select few amputees receive microprocessor knees. Candidates must meet demanding criteria.

The highest barrier to entry is cost. The Genium knee – made by a German company called Ottobock – costs roughly $70,000. In Bik’s case, SMUD has agreed to pay for the top-of-the-line prosthetic knees.

Candidates must also show proof of an active lifestyle and work that demands movement.

Bik fit the bill, since he competes in triathlons. And his job at SMUD typically finds him climbing down manholes and into drippy vaults to deal with cables that carry 12,000 to 69,000 volts. He is on a team that is responsible for the underground grid of downtown Sacramento.

The new knee allows him to shift weight and bend – on the fly – by using accelerometers and gyroscopes to calculate ground reaction forces, said Bryan Hayes, co-owner of River City prosthetics, who fitted Bik with the new device.

“This knee knows whether he’s stepping sideways, forward or backward,” Hayes said.

With the older C-Leg, Bik could not take a step backward without danger of falling – the knee would not offer resistance, causing his right leg to buckle, said Hayes.

“The Genium knee has positional awareness ... it adjusts the hydraulic resistance of the knee based on what you’re doing,” Hayes said. “It also allows you to go up and down stairs and ramps very easily.”

The whiz-bang knee is the latest evolution of prosthetic limbs that were first pioneered by the Egyptians. Initially their limbs were made of fiber and worn more for cosmetic value than functionality. Later prosthetics were made of bronze or wood. In modern times, wars have spurred advancements in prosthetic design. The U.S. became a hotbed of prosthesis use during the Civil War, when lead shot wounds demanded more than 30,000 amputations, according to the Department of Veterans Affairs.

There has been rising demand for prosthetic limbs because of injuries sustained by U.S. troops fighting in Iraq and Afghanistan. From 2001 to 2012, more than 1,700 service members in those conflicts had limbs amputated, according to the Congressional Research Office.

The Genium is not the only such microprocessor knee on the market. Models like the Freedom Innovation’s Plié 2.0 knee offer similar benefits, including the option to personalize the metal housing that covers the prosthetic knee and shin.

“All the microprocessor knees have claims to fame, but the Genium remains among the most sophisticated models available to amputees,” said Danielle Melton, a rehab physician and spokeswoman for the Amputee Coalition, an international amputee advocacy organization.

Melton said that next up in the evolution of such knees is the X-3 model, also made by Ottobock, which has recently become available for military amputees.

She said that the X-3 makes another quantum leap in that it is waterproof.

Some day Bik might move to an even higher-tech model, but for now he is happy that the Genium allows him to run, do clean snatches of 350 pounds at a CrossFit gym, and play soccer with his two daughters.

“When I was first fitted with the knee, I was told to walk slow and then start running,” said Bik. He was hesitant to do so at first, because he was used to the limitations of the C-Leg.

“But the thing actually kept up with me. That really shocked me,” he said.

“If I want to go play start-and-stop activities with my kids, like soccer, I can actually run around with the ball. I can stop immediately or slow down, and the knee knows the speed at which I’m moving,” Bik said. “That’s something I could never do before.”

And it also offers him the luxury of climbing stairs without having to swing his leg around to get to the next step.

Last week Bik and his wife went to a movie. Typically they sit near the screen to avoid stair climbing, but this time climbing seemed natural.

“I made my wife sit in the top row because I was climbing with the knee and didn’t want to stop,” he said.

Bik sees his current relationship with his bionic knee as entering the beginning of a beautiful friendship.

“This thing is so advanced, I’m not even scratching the surface of what it can do,” Bik said. “It makes me feels whole.”