Responses: Dynamic assist knee joints

Responses: Dynamic assist knee joints

zach harvey

9/15/2004

Thanks to all who responded. Your ideas helped me to decide what to do with some challenging legs I'm working with. I'm needing to accomodate Bilateral knee flexion contractures of 40 degrees and I'm wanting to get some energy return from a knee extension assist later in stance phase. After consulting with the psysiatrist, I learned that the contractures would not be reduced until the child is full grown- that way he would not need to undergo surgery twice. That presents a dilema, especially with the lack of quadricept strength. In addition to the responses listed below, ideas I got from other collegues included using the step lock joints, the Becker polycentric with scott cam lock and extension assist, laminating the thigh cuffs to the BK sockets, and attaching anterior thigh cuffs with neoprine posterior straps. If anyone is curious what I ended up doing, contact me later and hopefully, because of your help, I will have come up with a good result...

Original question: Dear list,
I have a 9 year old Bilateral Congenital BK I'm
working with. He presents with knee flexion
contractures of about 40 degrees and he lacks knee
extension but has fair knee flexion. Hip ROM and MMT
are normal. He currently wears sockets with thigh
cuffs attached with dial locks permanently fixed in
flexion. He walks without crutches and it looks as if
he were climbing up a steep hill just walking on flat
ground. He circumducts and laterally leans. I plan
to fit him with dynamic response feet and new sockets
and thigh cuffs.

My question is: Does anyone have experience using a
extension assist knee joint of some kind in a similar
situation? I'm thinking that if he could get some
spring back out of loading the thigh cuffs, it would
help propel him forward. Thanks for your ideas, Zach
Harvey, CPO

Responses:

sounds like a great idea. Will you use a Scott style knee extension

joint

(tube rubber to pull him into extension)?