High activity knee responses
Pinkston, Brian
Description
Collection
Title:
High activity knee responses
Creator:
Pinkston, Brian
Date:
10/6/2006
Text:
This is the original post followed be responses. Thanks to everyone for
your attention on this matter, This listserve is a great resource for
the profession, may everyone treat it with the respect it deserves.
Brian Pinkston C.P.
Hello everyone: I have a 27yo male Transfemoral amputee with a long
residual limb who is very active and wants to be able to run extended
distances ie 3 to 5 miles. This patient states that he has tried to do
this with other prosthetic knee's but that all of them seem to slow with
knee extension. Does anyone out there have any good experience with a
knee that will satisfy this patient's needs.
That is the distances I typically run and I run on the Muach S only
unit. Part of your patients problem may be nothing more than technique.
Ensure he is spending ample time (loading) on the prosthetic side.
Brad Halling CP
had a tech of mine as a t/k who ran in the paraolympics in
1996...atlanta 100m i and he used the O/B hydraulic 4 bar knee....less
than 16 secs was his time...set really free both on hydraulics and
friction and he found lots of other competitors using the same
setup.....we added an extension elastic band to the shin and socket to
assist with extension( crude but effective)
hope this of help
laurence hughes
S/R P&O UK
First of all there is to say that there is no such thing as a knee unit
tested for running. So far there is no testing procedure to guarantee
correct functioning. No manufacturer provides such knee and the risk is
completely on the side of the patient. Please inform the patient about
the risks and maybe let him sign a form so You don't end up in jail in
case there might be any wrong.
Nevertheless patients run anyway. What you are looking for is obviously
a knee unit approved for K4 with a high activity frame, a very stable
axis construction, a strong extension assist and maybe some adjustable
stance flexion to dampen the heel impact. I have some experience with
those patients from my time in the prototyping and from my experience as
a CPO I would try the following combination:
Foot: Freedom Renegade (lightweight, shock absorbing heel, very high
energy return)
Knee: medi OH6 (strong knee extension assist, adjustable stance flexion,
adjustable 3-way hydraulic, high activity knee frame with needle bearing
axis good for K4 up to 300 lbs) Of course I tend to recommend my
product, but I can only tell You something about products I am
experienced with. An alternative would be the Ossur Total Knee 2100, but
I think the extension is not as fast.
A hint: All major manufacturers give a satisfaction guarantee - so you
can try all and send those back who don't work for the patient.
Best Regards
Hello Brian. I have been working with an active knee disarticulation
runner and he competes in 5K, 10K, and someday hopes to run a marathon.
He is 6 feet tall and weighs around 185 lbs. He has broken every knee
that he has ever run on...whether it's due to overheated hydraulic
fluid, excessive stance extension moments, or just poor product design.
He is currently running on a new and improved Mauch XG Knee, and he
reports that it is holding up so far. His current foot setup is the
Freedom running blade.
As a knee disartic, he prefers a polycentric knee over the single axis
knee for toe clearance when running and knee clearance when sitting.
This may or may not be an issue depending on how long your long AK
patient is.
My experience with running knees is that they are just not built to
last...and I don't know if this is due to design constraints or market
forces. The problem with my patient is that he will blow out the
bushings or hydraulics within a few weeks. He ran on the T2100 Total
Knee for a while and he posted some good times and he liked the action
of the knee. However, we were sending it back so often for repairs that
he tired of the hassle. He has also run on the Mauch Gaitmaster Loaner
Knee and reported fair results.
The Otto Bock 3R45/3R55 may also be worth considering. And rumor has it
that Ossur has got someone running on a Rheo Knee.
Good Luck...and please post your results on the listserve!
Charles McIntyre, CPO
Certified Orthotist Prosthetist
Thorsten Spiekerkoetter
He could try a strait pylon and circumduct then not have to worry about
what the knee's doing. There's a lot of up-down motion with the running
feet, so clearing the toe in swing is not as bad in running as in
walking.
Zach Harvey, CPO
Prosthetics Sales Manager
medi USA
Try a single or poly centric knee with low extension assistance. They
are just sraight mechanical knees. Pneumatics with resistance on low may
also work. Simplier the better because you need low resistance
Brian,
I have a patient wearing a Mauch XG Frame and S&S cylinder. We asked
that the cylinder be sent to albion to have the lever flipped up (free
swing mode) and that does him great. It sounds like a swing only knee
but there is a difference for him. My patient is PFFD and Symes on the
other side and all of his knees slowed him down. Try it but be
persistant with ossur that you have the SNS done that way. no matter
what they say it does feel more free upon extension.. The other knee
would be the symbiotechs XT9. I have not used it but it has pneumatic
with spring extension assist and hydraulic stance control that is
adjustable. I am getting ready to order it for another patient. It is
totaly water proof and good warranty.
Good luck!
Will Graybeal, CP
Try the Endolite Mercury--HA. If you have any questions you can contact
Chuck from Bremmer Brace #904-354-2508. He is a technician and has been
running on this leg with success. He has blown through several other
Knees in the past.
Good Luck,
Matt Doering
Endolite--Florida
813-817-0229
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (813) 281-0300.
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If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
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OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
your attention on this matter, This listserve is a great resource for
the profession, may everyone treat it with the respect it deserves.
Brian Pinkston C.P.
Hello everyone: I have a 27yo male Transfemoral amputee with a long
residual limb who is very active and wants to be able to run extended
distances ie 3 to 5 miles. This patient states that he has tried to do
this with other prosthetic knee's but that all of them seem to slow with
knee extension. Does anyone out there have any good experience with a
knee that will satisfy this patient's needs.
That is the distances I typically run and I run on the Muach S only
unit. Part of your patients problem may be nothing more than technique.
Ensure he is spending ample time (loading) on the prosthetic side.
Brad Halling CP
had a tech of mine as a t/k who ran in the paraolympics in
1996...atlanta 100m i and he used the O/B hydraulic 4 bar knee....less
than 16 secs was his time...set really free both on hydraulics and
friction and he found lots of other competitors using the same
setup.....we added an extension elastic band to the shin and socket to
assist with extension( crude but effective)
hope this of help
laurence hughes
S/R P&O UK
First of all there is to say that there is no such thing as a knee unit
tested for running. So far there is no testing procedure to guarantee
correct functioning. No manufacturer provides such knee and the risk is
completely on the side of the patient. Please inform the patient about
the risks and maybe let him sign a form so You don't end up in jail in
case there might be any wrong.
Nevertheless patients run anyway. What you are looking for is obviously
a knee unit approved for K4 with a high activity frame, a very stable
axis construction, a strong extension assist and maybe some adjustable
stance flexion to dampen the heel impact. I have some experience with
those patients from my time in the prototyping and from my experience as
a CPO I would try the following combination:
Foot: Freedom Renegade (lightweight, shock absorbing heel, very high
energy return)
Knee: medi OH6 (strong knee extension assist, adjustable stance flexion,
adjustable 3-way hydraulic, high activity knee frame with needle bearing
axis good for K4 up to 300 lbs) Of course I tend to recommend my
product, but I can only tell You something about products I am
experienced with. An alternative would be the Ossur Total Knee 2100, but
I think the extension is not as fast.
A hint: All major manufacturers give a satisfaction guarantee - so you
can try all and send those back who don't work for the patient.
Best Regards
Hello Brian. I have been working with an active knee disarticulation
runner and he competes in 5K, 10K, and someday hopes to run a marathon.
He is 6 feet tall and weighs around 185 lbs. He has broken every knee
that he has ever run on...whether it's due to overheated hydraulic
fluid, excessive stance extension moments, or just poor product design.
He is currently running on a new and improved Mauch XG Knee, and he
reports that it is holding up so far. His current foot setup is the
Freedom running blade.
As a knee disartic, he prefers a polycentric knee over the single axis
knee for toe clearance when running and knee clearance when sitting.
This may or may not be an issue depending on how long your long AK
patient is.
My experience with running knees is that they are just not built to
last...and I don't know if this is due to design constraints or market
forces. The problem with my patient is that he will blow out the
bushings or hydraulics within a few weeks. He ran on the T2100 Total
Knee for a while and he posted some good times and he liked the action
of the knee. However, we were sending it back so often for repairs that
he tired of the hassle. He has also run on the Mauch Gaitmaster Loaner
Knee and reported fair results.
The Otto Bock 3R45/3R55 may also be worth considering. And rumor has it
that Ossur has got someone running on a Rheo Knee.
Good Luck...and please post your results on the listserve!
Charles McIntyre, CPO
Certified Orthotist Prosthetist
Thorsten Spiekerkoetter
He could try a strait pylon and circumduct then not have to worry about
what the knee's doing. There's a lot of up-down motion with the running
feet, so clearing the toe in swing is not as bad in running as in
walking.
Zach Harvey, CPO
Prosthetics Sales Manager
medi USA
Try a single or poly centric knee with low extension assistance. They
are just sraight mechanical knees. Pneumatics with resistance on low may
also work. Simplier the better because you need low resistance
Brian,
I have a patient wearing a Mauch XG Frame and S&S cylinder. We asked
that the cylinder be sent to albion to have the lever flipped up (free
swing mode) and that does him great. It sounds like a swing only knee
but there is a difference for him. My patient is PFFD and Symes on the
other side and all of his knees slowed him down. Try it but be
persistant with ossur that you have the SNS done that way. no matter
what they say it does feel more free upon extension.. The other knee
would be the symbiotechs XT9. I have not used it but it has pneumatic
with spring extension assist and hydraulic stance control that is
adjustable. I am getting ready to order it for another patient. It is
totaly water proof and good warranty.
Good luck!
Will Graybeal, CP
Try the Endolite Mercury--HA. If you have any questions you can contact
Chuck from Bremmer Brace #904-354-2508. He is a technician and has been
running on this leg with success. He has blown through several other
Knees in the past.
Good Luck,
Matt Doering
Endolite--Florida
813-817-0229
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients. If you are not the intended recipient, (or authorized to receive for the recipient) you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please destroy all copies of this communication and any attachments and contact the sender by reply e-mail or telephone (813) 281-0300.
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Pinkston, Brian, “High activity knee responses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/227445.
