Dear Colleagues,
I have an interesting case of an AK amputee who is an excellent walker and
has been an amputee since the 1950’s.He was originally on a suction socket,
I changed him to a lanyard and then changed him to a Ossur Seal-in liner.
He was originally on the Hydracadence knee. Since that time he has been on
an OHC 4 bar knee, an Ossur Total Knee, a DAW IC controlled knee and Otto
Bock C-leg , an Ossur Mauch SNS knee, and currently on an adaptive knee.
The Otto Bock C-leg was dialed in by Otto Bock professionals, and the
Adaptive dialed in by an expert as well.
He walks well up and down ramps and can walk down stairs but finds it more
of a “trick” than something he find useful.
He rejected the OB because he could not adjust the heel height…. By the
way , this man walks on a treadmill everyday at 3mi per hour.
I put him on the Endolite Adaptive because I could put an adjustable foot on
it which he liked. Interestingly enough, he thought the Adaptive was more
stable for him. He has a long residuum and obviously has good control.
Despite his outward excellent gait, and his preference for the Adaptive with
an adjustable heel height,
he feels he prefers the hydracadence because of the active dorsiflexion.
This makes me think that theories or facts about increased toe clearance
with 4 bar knees, and improved toe clearance with the timimg of IC
controlled single axis knees, may still be less of a consequence than the
dorsiflexion provided by a hydracadence type knee.
As I said, he is an excellent walker. If he feels he needs/wants/appreciates
dorsiflexion, this is significant to me.
I will be putting him on a hydracadence type knee. However, I have known for
sometime that Proteor (in France) manufactures an improved lighter weight
hydracadence knee with improved and presumably more reliable hydraulics, a
carbon fiber frame,
an integrated pylon that can be cut to length and the ability to use any
foot that doesn’t have a pyramid.
In the USA, DAW is the distributor. I look forward to using / learning
about it. Wondered if anyone else has used it.
Mark Benveniste RN BS CP
MEDVA Medical Center
Houston, TX
USA
