KO for obese patient

KO for obese patient

Jim Thelen

10/22/2009

I would like to seek advice from the list for bilateral custom KO's for
a 500+ lb female. She is diagnosed with OA but knee pain is elicited
mostly by full forced knee extension. She does not hyperextend.
Minimally ambulatory at this time due to size and knee pain. Ideal
orthosis would control genu varus and valgus as well as prevent full
extension.

Problems to consider are a large thigh and calf with respect to the knee
circumference (39proximal thigh, 25 calf, 6.5 ML), difficulty in
locating actual knee center, short medial thigh due to abdominal
overhang, difficulty in hip adduction with bilateral rigid ko's, + + +.
She is getting physical therapy land her goal is to be able to ambulate
more at home and possibly in the community without excessive pain.

I'm not stuck on a rigid brace if a neoprene device would be functional
for her. My best thoughts at this time is a ko with a lateral full
upright and medial joint that wraps to the lateral side just above and
below the knee to leave all the medial tissues free to conform. (Lennox
Hill??)

I would appreciate any other thoughts and comments about similar
successful fittings and the best sources for the ko's. She's on
medicare/medicaid.

Thanks

--
Jim Thelen, BOCO, CP, LPO
Trinidad Medical Consultants
<Email Address Redacted>
214-340-6200