For above knee amputees, the choice of knee joint for your leg prosthesis is critical for getting the best function from your prosthesis and the best match for your lifestyle. With improvements in prosthetic knee joint technology, the thinking of practitioners in the amputee rehabilitation field such as myself has had to change with regard to what knee to fit to whom and when.
When microprocessor controlled knee (MPK) joints first came on the market roughly 20 years ago, it was customary to fit these knees to the most active above knee amputees who had strong muscles and could demonstrate mastery of more conventional types of knee joint. In some obtuse way, these patients were seen as “more worthy” of the more advanced technology than their less able counterparts. We now realize that this is for want of a better word: garbage.
The MPK is actually of greater advantage to the less mobile amputee as it offers greater safety and therefore improved mobility. Indeed without this type of prosthetic knee joint, some of my clients would struggle to be prosthetic users at all. So in the “old” way of thinking they would be unable to “prove” themselves capable of handing an MPK by mastering a conventional knee joint at all.
Then there are those who have tried the MPK and found it too hard to walk with and so have gone back to their more conventional technology. The main reason for their “failure to convert” is invariably a lack of appropriate physical therapy gait training. The gait required to use the MPK knee is vastly different from the way in which you have to control a conventional knee joint. So much so that we now fit these knee joints routinely in an amputee’s primary prosthesis. This saves everyone from the frustration of prosthetic knee joints that do not offer enough safety AND mobility in the one unit. And additionally the frustration of having to retrain prosthetic knee control on top of outmoded technique.
I suppose the big message here is to make sure you have the correct prosthetic training to go with your type of prosthetic knee joint.
Until next time
Cathy …. The Amputee Coach
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