ORIGINAL POST
I need a stiffer carbon graphite with a posterior rather than anterior calf
cuff. I need to control posterior knee thrust. The patient is a smaller
male.
I’d prefer non-custom as pt wants this before he takes a trip overseas.
Any suggestions? Thanks, Randy McFarland, CPO Fullerton, CA
RESPONSES
Have you tried using ProComp Carbon Composite material? Its a PP
Thermoplastic that has carbon fiber reinforcement. The carbon is extruded
with the plastic so its not a gluing process. I would suggest trying it out
if you haven’t at this point.
This company Ortho Active is in Canada. We had a rep. come show us their
carbon AFO’s. The Easy Walk Stable may be suitable…
http://www.orthoactive.com/index.php?option=com_content
&view=article&id=315%3Aorthobaltic-afos&catid=48&Itemid=53
Kinetic Research has a few semi-custom options with their “Build-To-Order”
designs. You can select the rigidity of the strut and footplate.
http://www.kineticresearch.com/forms.html
I’d go with an Allard Blue Rocker, post under the heel portion of the
footplate to induce more flexion and delay the extension moment, and then
teach the patient how to “lean into” the anterior shell to avoid the
hyperextension moment. This has been very successful on quite a few similar
situations.
How about the perosupport or peropro?
http://www.streifeneder-usa.com/en/products/orthotics-therapeutic-shoes/afo-
s/perosupport.tec
Kinetic Research can make a prefab but customized Classic Noodle with those
specs. Call 1-800-919-3668. I’ve used them a lot for things like this and
have never had one break.
I have used kinetic research ‘ s build to order option. Usually a quick
turnaround and you can really specify the options you want for shell and
rigidity. Wade and Darrell there are great.
Kinetic Research has the noodle AFO, which can be custom, OTS, or
customizable to measurements.
You might try the Dynamic Walk – I get it from Ortoped in Canada – it might
be Fillauer in the US. Is has a dorsi assist footplate and posterior calf
cuff and it is very low profile.
I have used kinetic research ‘ s build to order option. Usually a quick
turnaround and you can really specify the options you want for shell and
rigidity. Good luck!
Have you tried Fillauer/Centri dynamic walk?
For non-custom molded AFOs I prefer Matrix Type braces, which as you know
have an anterior shelf. I do not know of a posterior version that is strong
enough to help with posterior knee trust that is worth fitting. Swedish Knee
Cage?
I have been having Kinetic Research build semi-custom CG AFOs for some of
our kids. They call it a “Noodle.” You can choose the stiffness that you
want in the strut and the footplate. They say that “regular” is similar to a
Toe Off. I have only ordered “stiff”. The turnaround is quite quick.
Depending on the rest of the pathology, you may consider a fillauer dynamic
walk. With some patients I have seen this reduce knee extension by
encouraging DF and tibial progression. May be helpful for you but not
sure.
Kinetic Research makes custom to measurement AFOs and will add stiffness as
needed.
