Friday, March 29, 2024

prosthetic knees!!

Schafer, Kristin

Hi All,
Clinical question…I have a 56 y. o. male with an AK amputation which
occurred last December. He was a very active outdoorsman who enjoyed
camping, hunting, fishing and skidoo-ing. He has been wearing an Otto Bock
3R20 polycentric knee joint with an OWW single axis foot. The socket is a
sock fit with Otto Bock transfemoral suspension belt. He is very comfortable
in the socket with a 3 ply fit. We recently tried a Mauch SNS unit with
Entegra knee frame, and a College Park foot. Our objective was to give him
improved stance stabilty, the ability to lock the knee joint, (or unlock it
for cycling), greater ROM at the ankle for the uneven ground situations, and
to, generally, improve the efficiency of his gait pattern. He loves the
options of locking the knee and feels the swing phase of walking to be more
effortless, meaning he does not feel he has to really swing his leg out to
achieve full extension prior to weight bearing. He feels that the unit
itself does this for him. However, he used to be able to walk 1-2 miles/ day
for exercise, with fatigue of the sound side being the only limiter. He says
now, with the new knee and foot, he gets far too tired too quickly on the
prosthetic side, and his sound side feels fine. He feels the system itself
is too heavy.
Questions: 1. Is there a lighter weight knee available with the same
functionality as the Mauch SNS?
2. Does he have to “get used” to the new system and build up more
endurance?
3. Is there something else I should look at to improve this system
to make it feel more lightweight for him?
4. Would a liner and pin do this? I think his shrinking has almost
plateaud (for now!) and we have talked about this option.
5. What would you do?
Please enlighten me!!!
Still learning in Northern Ontario….
Thanks in advance,
Kristin Schafer, CP, CP(c)

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