Editor’s Note: Dr. Geier is director of MUSC sports medicine and an orthopaedic surgeon. He writes a sports medicine column for The Post and Courier.

Normally a sprinter beating an Olympic qualifying time would not generate much interest outside of die-hard track and field enthusiasts. But when Oscar Pistorius broke 45.30 seconds in the 400 meters recently, the sports world started to notice. If the sprinter considered South Africa’s sexiest celebrity breaks that mark again in the adidas Grand Prix next month and qualifies for the Olympics, casual sports fans everywhere will pay attention. Why? Oscar Pistorius has no legs.

The 25-year-old sprinter was born without fibulas, which are the long bones on the outside of the legs. His parents were forced to make a difficult choice to have a surgeon amputate both of his lower extremities 0below the knees when he was just 11 months old. They decided early amputation would allow him the best chance to learn to walk normally.

Pistorius not only learned to walk on prosthetic limbs within the first years of his life, but he ultimately became an elite athlete. Competing with carbon-fiber blades called Flex-Foot-Cheetahs, he is a four-time gold medalist at the Paralympic Games in the 100, 200, and 400-meter distances. In 2005, he began competing against able-bodied sprinters and challenging their times.

In 2007, the International Association of Athletics Federations asked Pistorius to undergo a series of tests. Dr. Peter Bruggemann at the Cologne Sports University reported that Pistorius’s prosthetic limbs gave him a “bouncing” locomotion that required a lower metabolic cost than able-bodied runners. Consequently the IAAF banned him from able-bodied competitions.

Pistorius underwent a second series of tests at Rice University and appealed to the Court of Arbitration for Sport. The arbitrators ruled that the data showed Pistorius used the same amounts of oxygen and “fatigued normally” over the course of an entire 400-meter race. He won the right to compete against able-bodied sprinters despite his Cheetahs.

Unfortunately, that ruling did not end the debate over whether Pistorius has a competitive advantage. The second team of scientists had dissenting opinions. One of those scientists, Peter Weyand, a professor of applied physiology and biomechanics at Southern Methodist University, has publicly argued that Pistorius does, in fact, have an advantage.

Weyand points out that the team of scientists at Rice only had to refute the original finding of lower oxygen consumption. He argues that they did not have to disprove what Weyand claims is Pistorius’s biggest advantage — namely the ability to reposition his limbs more quickly. The Cheetah blades weigh about 5.4 pounds, compared to the approximately 12.6 pounds that a similar-sized runner’s leg weighs. He claims Pistorius’s “swing times” therefore are significantly faster than those of sprinters with legs. Shorter limb repositioning times theoretically decrease the time spent in the air and the force needed to push off and propel his body forward.

The lead researcher who challenged the IAAF, Hugh Herr, argues that Pistorius’s prostheses, without muscles, tendons, ligaments, and nerves, offer no advantage. He compares running on the Cheetahs, whose technology is 10-20 years old, to running on a mattress.

Pistorius contends that amputee sprinters on the same Cheetahs cannot approach his dominance in the 400 meters. He also points out that a few sprinters who suffered injuries requiring amputation never again matched their previous able-bodied times.

There is likely not an option that will satisfy everyone. If we allow amputee sprinters wearing Cheetahs to compete, should the sport allow prostheses with newer technology as well? Since the limbs are lighter, should the weight be equalized to match those of normal limbs? Right or wrong, the CAS might have opened a Pandora’s box of issues by allowing him to compete.

Pistorius and amputee sprinters like him have different running mechanics than able-bodied ones. With those differences come advantages and disadvantages. But even if they provided a competitive edge, would many athletes permanently sacrifice their healthy legs to race with carbon-fiber blades?

If Pistorius, nicknamed “Blade Runner,” beats 45.30 seconds for the third time June 9 in New York, he will become the first amputee track and field runner to qualify for the Summer Olympics. If he does earn the right to compete against able-bodied runners, it will be fascinating to see how the media and public regard him. Is Oscar Pistorius an inspiring role model, an athlete with an unfair competitive advantage, or both?

Dr. Geier is an orthopaedic surgeon and Director of MUSC Sports Medicine. For more on the scientific arguments mentioned here, go to Dr. Geier’s blog at drdavidgeier.com.