The prosthetic funding model is outdated and unfair

After months in a wheelchair, Angela Oakley is walking again, slowly descending the front steps of her parents’ house in Edmonton’s Highlands neighbourhood as she makes her way to a physiotherapy appointment at the Glenrose Rehabilitation Hospital.

Angela Oakley walks her dog, Gretchen, in Edmonton while using her new microprocessor knee.
Angela Oakley walks her dog, Gretchen, in Edmonton while using her new microprocessor knee.

Oakley, a veterinarian who lives in Grande Prairie, Alta., started battling a bone infection in her left leg when she was in vet school in 2010. After scores of surgeries and having part of her leg amputated a few years ago, she became an above-knee amputee in March.

Last week, after months of complications and pandemic-related delays, she finally received a new prosthetic knee that should allow her to walk, cross-country ski and ride horses again. A longtime multi-sport athlete, she also has dreams of representing Canada at the Paralympic Games.

Her mobility, however, comes at a high price. Her new knee costs about $57,000 and Alberta Aids to Daily Living, the provincial program that funds medical equipment for long-term disabilities, will pay no more than $6,000.

If she lived in England, her prosthetic limb would be fully covered. But in Alberta and other Canadian provinces, amputees are responsible for paying most of the cost.

“How many Albertans can turn around and drop $50,000 on a knee?” Oakley said during an interview with CBC News last week.

Oakley, who launched a petition advocating for prosthetic funding changes and contacted Alberta’s health minister, believes the current funding structure is outdated and unfair, preventing amputees who cannot afford limbs they need from doing activities they love and fully contributing to their communities.

In a country known for its universal health care system, “we’re letting all of these people down,” she said.

Angela Oakley says she needs a computerized leg prosthesis to walk safely, but Alberta is funding only a fraction of the cost.

Why are some knees so expensive?

There are generally two types of prosthetic knees: mechanical and microprocessor.

A mechanical knee replaces the knee joint with a mechanical hinge, but a microprocessor — also known as “computerized” — knee is much more sophisticated — and expensive.

With a computer and sensors, a microprocessor knee automatically adapts to real-time information about the user’s gait and walking speed.

“How many Albertans can turn around and drop $50,000 on a knee?” – Angela Oakley

For some amputees, a cheaper mechanical knee is sufficient, but not for Oakley, who is highly active with a physically demanding job. She also felt unsafe using a mechanical knee because of the nerve damage and lack of muscle strength in her left leg.

“I didn’t have the quadriceps strength to swing it through and lock it,” she said. “When I would step, the knee wouldn’t be locked, so it would just collapse out from under me.”

Oakley was shocked to learn that microprocessor knees cost from $35,000 to $95,000, and that the most she would receive from Alberta Health is a $6,000 grant covering about 10 per cent of the cost.

As a below-knee amputee, she only paid a $500 deductible for prosthetic components.

Friends, family and colleagues helped her raise money through a crowdfunding campaign and other online fundraisers, but she was only able to pay for the microprocessor knee thanks to her employer contributing the rest.

Her new knee won’t last forever either. Oakley, 32, expects she will need five to eight replacements over her lifetime, as prosthetic knees usually last six to 10 years.

Oakley managed to pay for her knee, but amputees who cannot afford them often end up using prosthetics that are less suited to their bodies, she said.


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