It was perfect day to be living next to a golf course: 78 degrees ... minimal breeze ... a few wispy clouds lacing the bright blue sky.

        So Jean Smolders strolled off his deck to take a few practice swings along the 14th fairway at Beckett Ridge Country Club in West Chester Township. On days like this, a golfer could play all day.

Jean Smolders adjusts the pressure on his VASS prosthetic limb. (Michael Snyder photo) | ZOOM |

        Now, so can Mr. Smolders, thanks to an advance in artificial limbs that experts say ranks among the field's most important breakthroughs in a decade.

        The device is called the Harmony vacuum-assisted socket system, made by TEC Interface Systems of St. Cloud, Minn. Mr. Smolders calls it a wonder.

        For Mr. Smolders, this translates into playing a full 18-hole round of golf without removing his leg to change prosthetic socks. It also means he can putter around the kitchen for as long as it takes to enjoy cooking. As a 12-year-old boy growing up in Holland, he broke his leg jumping off a roof. The bone never healed properly, resulting in severe osteoporosis and years of pain when he walked.

        Mr. Smolders moved to Cincinnati in 1986 as part of a company transfer. He considered another round of corrective surgery. But rather than endure months of pain and life on crutches for a process that doctors predicted had a low chance of success, Mr. Smolders opted to have his leg amputated in 1995.

        “It was the first time since I was 12 that I could walk without pain,” he said.

        “I can play 18 holes with no problem at all,” Mr. Smolders said.

        Nationwide, an estimated 1.2 million people live with amputated limbs, according to the National Limb Loss Information Center. The Harmony limb serves the most common group of amputees — people who lose part of their leg due to complications from diabetes, bone cancer and other diseases.

        “In my estimation, this is a major step forward,” said Rich Rosenberg, an orthotist who runs the R.J. Rosenberg Orthopedic Lab in University Heights.

        Typically, amputees who have lost their lower leg rely on orthotists to custom-fit sockets that link their residual limb to a variety of artificial lower leg and foot designs.

        The trouble has been that few designs have allowed amputees to wear their limbs in comfort for daylong periods, especially for people with physically active lifestyles.

        Tissues at the end of an amputated limb are not designed to handle long periods of friction. Sweat can build up. Meanwhile, the pressures of wearing a prosthetic device force fluids out of the residual limb, which affects the fit by causing the limb to shrink as much as 12 percent during the day.

        For years, amputees have coped with these fluctuations by adding thicker prosthetic socks over the residual limb. But removing an artificial limb to add or change socks often annoys the amputee and sometimes leads to embarrassing situations.

        The Harmony system claims to offer a better way. The device uses a vacuum pump built into the leg in combination with a gel-filled urethane liner in the socket to provide a constantly adjusting fit.

        The vacuum device reduces variations in limb volume and helps wick away sweat. The gel liner helps reduce pressure points that can injure tissue, Mr. Rosenberg said.

        With a better fit, users say they can walk with a more normal gait. They also report a better sense of the location of their artificial limb as they walk, which helps prevent falls.

        Since December, when the device was introduced locally, Mr. Rosenberg has fitted 14 people with the Harmony limb — one new amputee and 13 other Tristate residents who came in to replace their prostheses.

        “This is completely out-of-the-box. It's the biggest development since silicone suction sockets were introduced in the 1980s,” Mr. Rosenberg said.

        Experts outside of Cincinnati also praise the Harmony system, including Jack Uellendahl, former research consultant for Northwestern University's Prosthetics Research Laboratory and director of prosthetics and orthotics at the Rehabilitation Institute of Chicago. Mr. Uellendahl now works in Phoenix for Hanger Prosthetics and Orthotics, the nation's largest group of orthotic labs.

        “It's still a fledgling development but the Harmony system seems to be a real breakthrough,” he said.

        The device cost him about $17,000, and was covered by Mr. Smolders' insurance, but coverage can vary among insurers.

        Mr. Smolders predicts the device would be even more useful for people who lose a leg to diabetes.

        “Many diabetics don't have as much sensation in their legs as I have. So they can't feel it as well when the limb starts to slip and their skin starts to chafe,” he said

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