Lower-limb care has experienced a wealth of developments since I joined The O&P EDGE nearly 14 years ago. At the time, osseointegration (OI) was not yet approved in the United States, and I remember going to a session about the fabrication and fitting of the C-Brace shortly after its introduction where a patient model talked about the difference it made for him in working on his ranch. In this issue, we explore both these subjects, which have made significant strides in the intervening years.
Microprocessor technology had been steadily advancing in prosthetics since the 1990s, but orthotics lagged behind in this area until Ottobock introduced the first microprocessor KAFO (MKAFO), the C-Brace, in 2012. Since then, studies have shown that like microprocessor knees in prosthetics, MKAFOs improved users’ balance and decreased fall risk. Other manufacturers are now beginning to offer their own designs. But, despite the benefits and the establishment of an L-Code, commercial insurers remain reluctant to provide coverage for MKAFOs. “Getting Microprocessor KAFOs to the Right Patients” discusses which patients can most benefit from the technology and how clinicians can help overcome the hurdles to providing it to them.
Until a few years ago, it would have been unlikely that an O&P practitioner in the United States would encounter an OI patient in his or her practice, as most stateside patients who had undergone the procedure had to travel overseas for the surgery. Fast forward to today and after FDA approval, the procedure has rapidly gained momentum for people who have not been successful with socket-based prostheses. As interest grows, so does the need for understanding of protocols and specialized alignment techniques, which experts share in “O&P Providers Answer the Call for Optimal Care, More OI Education.”
Our final feature in this issue, “Hygiene and Its Implications in O&P Practice,” touches on a subject we may be more reluctant to discuss—that of patient hygiene, the way it impacts care, and how clinicians must confront their own reactions when it doesn’t mesh with their expected social norms.
Happy reading.
Andrea Spridgen
