Reply summary: Non-slip coatings

Reply summary: Non-slip coatings

Ted Trower

10/26/2009

I recieved a large number of replies to this question and clearly it
is a common problem. What I had in mind was smoe material that could
be applied like a bead of silicone to the existing lining, but I may
look into some of the other options. Most interesting to me was the
idea of leaving the thigh section somewhat looser to allow the
relative slippage to occur without loosening the suspension on the calf.

Thank you to all who replied!


---------------------------------

My original question was
I have a very large gentleman who has been wearing a Generation II
adj KO for OA in his left knee. He has been experiencing
difficulties keeping the orthosis in place regardless of using an
undersleeve etc. He is applying the orthosis correctly.

I would like to try to increase the coefficient of friction between
the leg. Has anyone had success applying a high friction coating of
some type and what did you use? What about some sort of gel sheet to
re-line the interior of the orthosis?

 ===========================================================================

Try a piece of gel sleeve you've cut off from a prosthesis. Apply
about a 5-6 inch portion to the calf. Works wonderfully. Kevin

---------------------------------
Years ago when I was in England, CTI had an off the shelf KO that
came with a thigh sleeve. You would have the patient apply a thick
neoprene thigh sleeve, and then you would remove the regular padding
from the proximal shell of the KO. The Velcro on the frame of the
brace would attach to the thigh sleeve. This worked well for the
rugby and racquetball patients. I still use this concept on a lot of
rigid framed KO's when suspension is an issue. It works well.

I hope this helps.

---------------------------------
have used both gel line sections and neoprene

---------------------------------
This has worked for me, albeit it is a pain in the neck. Remove the
padding from the orthosis. Have the patient don a thin neoprene
under-sleeve and then carefully don the orthosis. The velcro that
holds the padding in place will grab the nylon cover of the neoprene
sleeve and will keep the orthosis in place

---------------------------------
Have you tried using a gel type undersleeve? Trying to line the
orthosis may prove to be a bear. If a stock doesn't fit go with a custom made.
There is always going to be movement between skin and orthosis, so be
careful in use of high friction coatings, they may cause blisters.
I have had success using a gel sleeve and then using velcro, hook on
sleeve and pile on orthosis. Patient uses thin plastic sheet (I use
X-ray film) as barrier while adjusting orthosis.
I have also used a supracondylar wedge on an adjustable strap
attached to lateral side of orthosis and designed to pull wedge tight.
Also used a pad on adjustable strap that exerts pressure just below
popliteal area, essentially downward migration of orthosis being
stopped by calf.
Success and comfort depends on patient's shape and
tolerance. Sometimes I've reverted to using all three on one patient.
A sure-fire solution, but not usually acceptable to patient, is to
attach KO to either a single-upright metal or to a plastic
spoon-type shoe insert upright.

---------------------------------
Try silicone on the strap pad. Some other orthosis will have the silicone
dots or squiggles on the strap pads to increase the friction and help
maintain proper strap alignment while preventing migration.

---------------------------------
GII used to provide an alternative liner which they called shark
skin. I used it in the past with a great deal of success, but it
has been a while.

---------------------------------
I'm not sure if it's what you'd be looking for but I've used Dycem
for prostheses in the past. It's very thin and adds a much higher
coefficient of friction although it may be tough to adhere. PEL may carry it.

---------------------------------
've used alpha or other types of gel liner material (the excess cut
off from a prosthetic patient's liner BEFORE it went on them) and
sewed it to straps of KOs to increase friction. It usually works great.


---------------------------------
Never tried it but how about a 3MM Alpha liner glued to KO with gel
against the skin?


---------------------------------
I 've found that, he G II(unloader one) liners are gel coated and
work well you could replace the with those some legs seem only to
respond to an waist belt or afo extension.
---------------------------------
I have used 1/8 neoprene, sticky side out, with good success but one
key thing - only use it on the tibial section and let the thigh
section slide. Also make sure he isn't tightening the thigh too much
because if it can't slide up and down slightly during flex/ext it
will force the whole device down. It's counterintuitive to most
patients so they tighten the top instead of the popliteal strap.
---------------------------------
This problem exists for anyone. Silicone coated liners do help. If
everything fails apply Tincture of benzoin before applying the brace.
The surgeons use it to adhere stirrie strips. It works well.
---------------------------------




Ted A. Trower C.P.O., FAAOP
A-S-C Orthotics & Prosthetics
Jackson, Michigan, USA

www.amputee.com

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