We have a 12yo male with arthrogryposis that utilizes bilateral KAFO’s for ambulation. He has bilateral knee flexion contractures of 40 degrees. He is all boy and VERY active. The result is frequent broken bars and joints themselves. The amount of torque placed on the KAFO knee joints has elongated and broken the drop lock rings. MOC requests motion at the knee so that her son can sit on a chair and have his knees bent rather than extended. The patient has limited function of his hands but can operate the drop locks and ball retainers.
We currently have the boy in ¼” copoly AFO sections and 3/16″ copoly thigh sections. The bars are ¼ x 5/8 aluminum with drop locks and ball retainers. The bars had the flexion added to them by the manufacturer. We suggested going to a “gutter splint” design but MOC is dead set on motion at the knees.
Here is a list of questions for this forum:
1. Has anyone used an adjustable strut behind the knees (attaching to the bars) that reduced the torque on the metal knee joints?
2. What type of KAFO design did you use to treat a patient with arthrogryposis? Similar activity level and knee flexion contractures.
3. Stainless vs titanium bars??? We want to keep the KAFO’s relatively light but still durable.
4. Any ideas on reducing the torque on knee joint of the KAFO’s?
Thanks in advance for any and all replies.
Philip T. Lis C.P.O.
Prosthetic & Orthotic Director
Pediatric Orthotic & Prosthetic Services – POPS Southeast
950 West Faris Rd.
Greenville, SC 29605
Tel: (864) 255-7951
Fax: (864) 255-8751
E-mail: [email protected]
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