Orthotic Knee Control - Replies
Mark Raabe
Description
Collection
Title:
Orthotic Knee Control - Replies
Creator:
Mark Raabe
Date:
4/14/2010
Text:
Thank you to those who replied, all replies listed below.
Obviously my preference would have been a KAFO set up with lateral upright.
Client is reluctant though.
Looks like the Basko/Fillauer SPL joint will be our first choice.
Otto Bock E-Mag free joint is not rated by the patient due to battery
reliance.
Have attached the paper mentioned by the last reply; very interesting, well
worth the read.
Hi All,
Have 37yo female patient with history of osteosarcoma with subsequent KOTZ
knee prosthesis.
Recent fall and subsequent fracture has resulting in patella removal.
Patient has experienced an increase in falls since.
We are investigating the possibility of stance control technology with a
custom Knee Orthosis.
The patient is reluctant to go with a KAFO set up.
The BASKO knee and the E-MAG Active are two alternatives identified so far.
Has anyone had experience with either of these systems and if so what
recommendations could be made.
Mechanical extension knee systems are also of interest however a natural
swing phase is desired.
Gas/Pneumatic/Spring extension systems that have been used effectively with
a cosmetic outcome?
Would appreciate your feedback, will circulate replies.
Thanking you in advance
Mark Raabe, CPO-AOPA
MISPO, MAOPA
OrthoSynergy Pty Ltd
P: 612 9522 2990
F: 612 9522 2116
E: <mailto:<Email Address Redacted>> <Email Address Redacted>
Contact Gary bedard at Becker. He is really an expert on this stuff and
although he works for Becker, he respects all that is out there.
I have done KOs for knee flexion control only before and it was total
failure. not enough lever arm and suspension.
Here's my suggestion to you: don't go full blown KAFO. do KO with lateral
strut and footplate. it is much less weight/bulk, self suspends, footplate
can be fashioned very low profile. Normally, I use Townsend for those. You
can do whatever, as Townsend will not put non-company hinges on their
product. Townsend also has extension assist hinge. But no, they do not have
computerized or gravity/mechanical stance control knee joints. Fillauer
does.
How about the OAK swing phase KO from Fillauer?
Sounds like she damaged the Quads. A KAFO would be best. All stance control
knee joints are heavy and suspension is difficult.
Hi Mark,
Obviously, you have done your research on SCO's. I have considerable
experience with the Basko design known as the SPL. This joint is one that
works well for a KO or KAFO design. The joint has a 'Functional Unit' that
incorporates a simplistic pendulum design that works whether the foot is on
the floor or not. Thus lending itself for a SCO KO. Here in the states, we
have constraints relative to coding reimbursement that must utilize a KAFO
design. Unfortunately, there is no mechanical extension assist built in
however there is a 'Flexion Limiter' that controls excessive heel rise
during ambulation although, it is possible to use only the single sidebar
design as long as there is no instability in the ML plane.
I have utilized an inverted Y strap similar to that utilized in prosthetics
for short residuum's. Albeit not very cosmetic, it certainly functions well
as an extension assist mechanism. It sounds from your patient presentation,
that the Basko SPL would work well.
All the Best!
I've used a townsend custom ko with ext assist bands on an elderly quad
deficit pt and it worked great.
We are starting testing of a prototype for a new hydraulic stance control
orthosis knee joint that uses angular velocity control (i.e., threshold is
set such that the knee flexion resistance engages when the user's knee
flexion angular velocity exceeds the threshold, such as during a knee
collapse event). This should work in a knee brace, since ground contact
information is not needed for knee control (although we have only evaluated
this on KAFO's so far). If you continue to have problems with your case
after trying some of the existing options, we may be able to try this.
I am attaching a paper on the initial tests . although we have moved onto
another design approach for the mechanism that seems to work better.
Obviously my preference would have been a KAFO set up with lateral upright.
Client is reluctant though.
Looks like the Basko/Fillauer SPL joint will be our first choice.
Otto Bock E-Mag free joint is not rated by the patient due to battery
reliance.
Have attached the paper mentioned by the last reply; very interesting, well
worth the read.
Hi All,
Have 37yo female patient with history of osteosarcoma with subsequent KOTZ
knee prosthesis.
Recent fall and subsequent fracture has resulting in patella removal.
Patient has experienced an increase in falls since.
We are investigating the possibility of stance control technology with a
custom Knee Orthosis.
The patient is reluctant to go with a KAFO set up.
The BASKO knee and the E-MAG Active are two alternatives identified so far.
Has anyone had experience with either of these systems and if so what
recommendations could be made.
Mechanical extension knee systems are also of interest however a natural
swing phase is desired.
Gas/Pneumatic/Spring extension systems that have been used effectively with
a cosmetic outcome?
Would appreciate your feedback, will circulate replies.
Thanking you in advance
Mark Raabe, CPO-AOPA
MISPO, MAOPA
OrthoSynergy Pty Ltd
P: 612 9522 2990
F: 612 9522 2116
E: <mailto:<Email Address Redacted>> <Email Address Redacted>
Contact Gary bedard at Becker. He is really an expert on this stuff and
although he works for Becker, he respects all that is out there.
I have done KOs for knee flexion control only before and it was total
failure. not enough lever arm and suspension.
Here's my suggestion to you: don't go full blown KAFO. do KO with lateral
strut and footplate. it is much less weight/bulk, self suspends, footplate
can be fashioned very low profile. Normally, I use Townsend for those. You
can do whatever, as Townsend will not put non-company hinges on their
product. Townsend also has extension assist hinge. But no, they do not have
computerized or gravity/mechanical stance control knee joints. Fillauer
does.
How about the OAK swing phase KO from Fillauer?
Sounds like she damaged the Quads. A KAFO would be best. All stance control
knee joints are heavy and suspension is difficult.
Hi Mark,
Obviously, you have done your research on SCO's. I have considerable
experience with the Basko design known as the SPL. This joint is one that
works well for a KO or KAFO design. The joint has a 'Functional Unit' that
incorporates a simplistic pendulum design that works whether the foot is on
the floor or not. Thus lending itself for a SCO KO. Here in the states, we
have constraints relative to coding reimbursement that must utilize a KAFO
design. Unfortunately, there is no mechanical extension assist built in
however there is a 'Flexion Limiter' that controls excessive heel rise
during ambulation although, it is possible to use only the single sidebar
design as long as there is no instability in the ML plane.
I have utilized an inverted Y strap similar to that utilized in prosthetics
for short residuum's. Albeit not very cosmetic, it certainly functions well
as an extension assist mechanism. It sounds from your patient presentation,
that the Basko SPL would work well.
All the Best!
I've used a townsend custom ko with ext assist bands on an elderly quad
deficit pt and it worked great.
We are starting testing of a prototype for a new hydraulic stance control
orthosis knee joint that uses angular velocity control (i.e., threshold is
set such that the knee flexion resistance engages when the user's knee
flexion angular velocity exceeds the threshold, such as during a knee
collapse event). This should work in a knee brace, since ground contact
information is not needed for knee control (although we have only evaluated
this on KAFO's so far). If you continue to have problems with your case
after trying some of the existing options, we may be able to try this.
I am attaching a paper on the initial tests . although we have moved onto
another design approach for the mechanism that seems to work better.
Citation
Mark Raabe, “Orthotic Knee Control - Replies,” Digital Resource Foundation for Orthotics and Prosthetics, accessed December 25, 2024, https://library.drfop.org/items/show/231393.
