Reply to Kafo comp. for large person

Reply to Kafo comp. for large person

Thanks to all of you who responded. I have since learned that this person's
contracture's are long standing and are not expected to change. I have
discussed the issues with the patient and we have decided to use a Becker 1002 joint,
heavy duty drop lock with ball retainer, preflexed SS bars, plastic lower with
Tamarack free ankle, and a metal band thigh section.

Don McGovern CPO

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Original post>>> I am working with a fine mature male with a weight of 290
pounds.  He has had bilateral total knee replacements and has a knee flexion
contracture of about thirty degrees on one side.  He ambulates with a rolling
walker.  The knee with the contracture needs assist due to weakness and the doc
has ordered a KAFO with drop lock. The gentleman is vigorously attempting to
stretch the contracture.  It would seem reasonable to use a Step Lock type
joint, however the Step Lock can only tolerate 200 pounds. The question is:  what
type of joint would be sturdy enough while allowing the ROM to be altered
easily?

To those who recommended a KO, I am going with a KAFO for suspension. This
gentleman's thigh has the original inverted pyramid shape, which in my
experience would drive a KO down the leg.

 Responses:

In general most recommended Becker's 1006 and the OTS Step Lok. Both
companies reported their respective components are not rated for such a high weight,
but... they have seen their components on some very large persons.

Two of you recommended using an orthosis to first reduce the contracture
which is a good idea. I spoke with Rick Miller (see below) who motivated me to
contact the physician re: potential for an increase in ROM for the contracture.
The doc said it will not improve. The client was contacted and he agreed that
the ROM has not improved recently, and that the contracture is where it has
been for awhile.
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Call Becker for disc/dial locks o-bock has nothing comparible, the
flexion contracture should allow for easy swing through. ` There will
be quite a load on the knee joints so you better use steel to cover
your liabilities.  You have a really tough case as I have seen the
discs on the becker dial locks shear right off under these loads.
You could, i probably would also use the 3/4 x 1/4 ti or steel joints
and just edge bend them as needed. I would go with a traditional
metal kafo.  Please let me know what you decide. 

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We have developed a contracture reducing system for the elbow and have
successfully modified it for Knee applications.  It can be used as an
ambulatory system, however its best assist in the reduction of soft tissue
contractures.  If this is the approach you could eliminate his need for any
orthosis!  Check out our website at www.plor.net
My work email: &lt; <Email Address Redacted> &gt;
or call 888-281-5250 to discuss
Rick Miller, C.O.

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