Tuesday, September 10, 2024

Knee valgus-more replies

mollypitcher

thanks for the many replies. Your information has been very helpful in making a decision. Molly Pitcher CPO
Below are a few more replies regarding my question about a KAFO for knee valgus for an 88 year old woman:

>The GII brace system is a little rough on the frail skin and bones of the ederly.Have you thought about the Bledsoe thruster 2 brace with stirrup attachment.I have found that that brace system is a little more forgiving than the GII.I am not a fan of off-the-shelf bracing in this situation,but you might be able to hold the knee ina more stable setting.
>We seem to be seeing more of these(varus/valgus knee) cases. Often I find
that the KO works but suspension is a major problem. I have used the Gen II
KAFO with moderate success as this does help supension problem. The
negatives I see w/GenII are 1.their turn around time and 2.single upright
sometimes not enough Rotation(and consequently ML)control. Another
FAb=Flex Tech (DeRoyal owned) who does some Very nice KO&KAFO work for me.
They are also very accomadating. They do primarily carbon shells so I have
done several “hybrid” kafo’s where Flex Tech does the correcting KO, I fit
this, and then make a poly AFO porting to attach to the KO. The person to
talk to @Flex Tech=Joe and the Ph.#=800-681-3539 or(CA)949-650-3052.
>I am doing a G2 right now for a 87 year old short lite gal right now.
Ko did not work and G@ is making over. 3/16 thick poly pro with
corrogations in the plastic and tam ankle. Brought the polypro up to
the mtp prox and dist for better control.
Otherwise use Kinetic Research and do a short steel bar wrappeed in
carbon. they do a great job and did one for me for a gal with 40
degrees of valgum and 30 degrees of recurvatum with no ankle
joint(solid ankle) and pretib shell for 1 1/2 lbs out of prepreg.
Got her to 10 and 10 as she was flexible as a noodle. Prior to
bracing wqas one of ther ugliest LE I have seen.
>I am doing a G2 right now for a 87 year old short lite gal right now.
Ko did not work and G@ is making over. 3/16 thick poly pro with
corrogations in the plastic and tam ankle. Brought the polypro up to
the mtp prox and dist for better control.
Otherwise use Kinetic Research and do a short steel bar wrappeed in
carbon. they do a great job and did one for me for a gal with 40
degrees of valgum and 30 degrees of recurvatum with no ankle
joint(solid ankle) and pretib shell for 1 1/2 lbs out of prepreg.
Got her to 10 and 10 as she was flexible as a noodle. Prior to
bracing wqas one of ther ugliest LE I have seen.
>I’ve had one such patient years ago that I made a lateral upright KAFO
for. It was poly with minimal shells attached to a shoe with free
motion ankle and knee. I believe I also used a diagonal medial strap.
The KAFO worked very well. I’d be surprised if a GII would have worked
for her.
>I’ve used the GII KAFO once on a patient with severe valgus and also drop foot. It worked fine although the fabrication of the AFO portion could have been nicer.
>My two cents, We do a lot of Blounts Varus braces on pediatrics, and we also
use the same principle on our geriatrics as you are describing, KAFO with
single upright and a pull strap, if you want to get fancy use a polycentric
joint, if you have G2 fabricate this you will be forever miserable, fab it yourself
and save the bucks.

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