I have a patient who is 70 years old, 5’3″ tall, and weighs 165 pounds. She has had numerous knee surgeries to treat her osteoarthritis since the mid-seventies. She now has a total knee prosthesis, which is intact and secure, and her ROM is within functional limits. However, she has a positive laxity of all ligaments, extension strength of 3-, functional flexion strength, and an extension lag of 35 due to a patella tendon rupture. Upon weight bearing, the patient exhibits moderate genu valgum and hyperextension. She ambulates reasonably well with a cane, but reports that knee pain becomes unbearable after walking short distances.
Her orthopedist has recommended a knee arthroplasty, but she refuses further surgery. He has asked me to evaluate her for an orthosis that will be “functional and lightweight”. I think that a custom molded knee orthosis with carbon graphite reinforced laminated cuffs, a lateral extension-assist knee joint, and a hinged overlapped medial knee joint would best suite her needs; but I would appreciate any suggestions from members of this listserv.
Paul W. Guimond C.O.
