Knee Disartic
Joan Cestaro, CPO
Description
Collection
Title:
Knee Disartic
Creator:
Joan Cestaro, CPO
Date:
6/5/2020
Text:
Dear List,
Would love suggestions or advice, please. Have a very unique case of a
traumatic knee disartic with an implanted internal metal rod from the
femoral head to about 2” from the distal end of the femur. It appears that ½
of the femoral condyles were shaven off and the other half make a flare at
the end, which is apparently one way to do a KD surgically. According to my
research, any remaining flare of the condyles allows for some weight
bearing. And she does have strong end bearing. The patella remains. In the
initial Xrays from a year ago and according the record, the patella is
sutured in place. However, during my exam, it appears that perhaps the
patella migrated and is sitting distal to the femur. I didn’t feel the
femoral flare distally, I’m pretty sure I was feeling the patella centered
distally. The residual limb length is minimally longer than knee center. I
have new Xrays ordered. A very challenging case indeed on a very strong,
otherwise healthy young lady who is quite anxious to walk without crutches.
I doubt a surgical revision is possible considering the multiple healed
femoral fractures and rod, so I’m pretty sure I need to fit it as is. I’ve
expressed the challenges and prepared her for the cosmetic issues. There are
so many things to consider in regards to suspension, limited options for
knees, insurance will be limiting. I am happy for any suggestions, thoughts,
advice, things to consider. Positive, helpful responses only, please.
Joan Cestaro CP
Would love suggestions or advice, please. Have a very unique case of a
traumatic knee disartic with an implanted internal metal rod from the
femoral head to about 2” from the distal end of the femur. It appears that ½
of the femoral condyles were shaven off and the other half make a flare at
the end, which is apparently one way to do a KD surgically. According to my
research, any remaining flare of the condyles allows for some weight
bearing. And she does have strong end bearing. The patella remains. In the
initial Xrays from a year ago and according the record, the patella is
sutured in place. However, during my exam, it appears that perhaps the
patella migrated and is sitting distal to the femur. I didn’t feel the
femoral flare distally, I’m pretty sure I was feeling the patella centered
distally. The residual limb length is minimally longer than knee center. I
have new Xrays ordered. A very challenging case indeed on a very strong,
otherwise healthy young lady who is quite anxious to walk without crutches.
I doubt a surgical revision is possible considering the multiple healed
femoral fractures and rod, so I’m pretty sure I need to fit it as is. I’ve
expressed the challenges and prepared her for the cosmetic issues. There are
so many things to consider in regards to suspension, limited options for
knees, insurance will be limiting. I am happy for any suggestions, thoughts,
advice, things to consider. Positive, helpful responses only, please.
Joan Cestaro CP
Citation
Joan Cestaro, CPO, “Knee Disartic,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/255002.
