I am looking for suggestions for a patient recently refered to me. Patient
had total knee replacement four years ago. No problems until she fell last
summer when she fell and shattered her patella. It was fixed and was doing
fine until last Dec when she feel again and patella had to be removed.
Loss of patella results in reduced quad strength. Her problem is that if
she does not pay attention to how she is standing, her knee will trigger,
buckle anterior and she falls backwards. No M/L problems at all. Ankle
does have some laxity but normal ROM and funtion. She will need a total
knee on the other (rt) side sometime in the future.
Looking for suggestions. Have thought about: a) floor/ground reaction AFO
with free plantar flexion to hold the knee in extention, b) KO with
posterior offset knee joints, c) KO with some type of extension assist
(Tamarack dorsi assist joint used backwards; overcenter spring; Generation
II extension piece?), or d) KO with lock.
I want the woman to be able have as much knee freedom as possible when
walking. She is now using a knee immobilizer when she is up and a folding
walker (wheelchair for long distances) when she leave the house. Patient
is on disability leave but wants to return to work for two more years
before retiring fully.
The surgeon has two other similar cases that came from “St Elseswhere”, but
this one is his. Pateint is scheduled back end of next week.
What are your ideas? What have you tried and what kkind of success have
you had.
Thanks, Terry
PS: Less than Two months to the ISPO IX World Congress. Will you be there? TS
Terry Supan, CPO
Associate Professor
Director, Orthotic Prosthetic Services
SIU School of Medicine
PO Box 19230
Springfield, IL., USA, 62794-1420
phone: (217) 782-5682
fax: (217) 782-7323
E-mail:
