There are many prosthetic leg options to choose from, and the best fit will be dictated by an individual’s level of injury, physical factors, complications, as well as their lifestyle and vocational or recreational goals.
Every amputation is different, and it is critical that persons who have sustained an amputation work with a certified prosthetist and physiotherapist to determine which kind of prosthesis will be the best option for them.
In this article, we will highlight prosthetic leg options and physiotherapy for through-knee or above knee amputation.
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Prosthetic legs allow an individual who has sustained an amputation to walk with a more normal and energy efficient gait pattern and will often allow them to walk without the need for assistive devices such as crutches or walkers. In addition to enabling a more normal gait pattern, they allow the user to accommodate for sitting/standing, stairs/ramps as well as uneven terrain and different walking speeds.
A prosthetic leg includes several components including the socket, which is molded to the individual’s residual limb, the suspension system, which is how the prosthesis stays attached to the individual, and the prosthetic leg itself, which includes different options for knee and ankle joints.
Individuals can be fitted for a prosthesis once the wound from the amputation is stable and well-healed, which can be within a few weeks after the surgery. This may be delayed if they have complications related to the amputation.
After an above-knee or through-knee amputation, the residual limb shrinks, as the individual loses muscle mass in their thigh. Users will need to be fitted for multiple sockets over time to accommodate for the decreasing size of their residual limb.
Amputation refers to the removal of a limb due to injury, disease, or surgery. It can be utilized as a surgical procedure to manage discomfort or a disease condition in the affected limb. Individuals can also undergo traumatic amputations resulting from motor vehicle accidents or workplace accidents.
There are several complications related to amputation such as infection, phantom limb pain (residual limb pain), slow wound healing, vascular issues and necrosis, neuromas, edema, and skin breakdown. Phantom pain is a common occurrence after an amputation and is perceived in the limb that has been removed from the body. It is typically characterized as a sharp or burning pain that occurs due to a miscommunication of nerve signals from the brain to the spinal cord.
Prosthetic knees allow a person who has sustained an amputation at or above the knee to regain use of the knee and ankle joints and participate more easily in their daily activities.
Prosthetic knees are divided into two categories, mechanical or computerized. Mechanical knees are further divided into single-axis, multi-axis, and polycentric knees. Each prosthesis has its own unique features which are chosen based on the user’s requirements.
This is the simplest type of prosthetic knee joint that allows for rotation around a single axis during flexion and extension of the knee. Individuals who use this type of knee require good muscle strength, as this type of prosthesis can be difficult to control. These are sometimes recommended when there are limited economic resources, as it is the most cost-effective option.
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Unlike a single-axis knee, a polycentric knee allows multiple points of rotation around several axes. Polycentric joints can have either 4 or 7 bars, meaning that you can either have 4 points of rotation or 7 points of rotation. This type of joint provides good stability when there is involuntary flexion during the heel strike phase of walking because the center of rotation is located more proximally and posterior when the knee is fully extended. This knee is typically recommended for active people, or people who are more likely to walk independently, without a gait aid.
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This type of joint locks while the user is weight-bearing on it. They will need to manually disengage the lock to be able to sit down.
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This knee provides a constant friction force while weight is on the limb. This helps to prevent it from buckling when standing on that leg, while still allowing it to swing freely when unweighted.
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Pneumatic/hydraulic components (pistons with cylinders containing air or fluid) can be added to either single-axis or polycentric mechanical knees, as well as computerized knees. This is to help increase mobility and control with the leg and allow the user to vary speeds. When walking faster it will limit the air flow and fluid to reduce the flexion of the knee to allow a faster walking pace. The opposite will happen with a slower gait. Typically, hydraulic knees work well for more active individuals.
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Mechanism and Indications
These knees have microprocessors to allow feedback from within the knee or foot joint. Information from the sensors adjusts the range and speed of knee flexion and extension, according to the user’s requirements. Knee extension is powered, and resistance is provided through knee flexion, allowing the individual to more easily get in and out of a sitting position, and navigate stairs using a reciprocal gait pattern. It also allows for a symmetrical weight distribution and a natural gait pattern.
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The nature of rehabilitation after a leg amputation at or above the knee will depend on the client’s goals and physical presentation but will often include:
When an individual has undergone an amputation at or above the knee, learning to use a prosthetic leg is often a crucial step in the rehabilitation process. A well-fitting prosthesis can help individuals regain mobility and return to their daily activities. This allows the freedom and independence to get back to doing the activities that are important to them.
Evolve Prosthetics & Orthotics in Las Vegas offers the best solutions to meet our clients’ needs when it comes to knee prosthetics. We will work hard to find the best prosthetic knee solution for you and ensure it fits correctly.
Many factors influence the type of knee prosthesis you might need, including amputation, age, and activity level. We can even help with knee disarticulation, which is a rare case when the amputation happens at the knee joint itself, rather than the femur. We offer many options in our Las Vegas prosthetics clinic.
This option is the most basic type of hinged prosthetic knee. The advantages of these knees are that they are simple to use and durable. They are also typically lighter than their counterparts. Single axis knees can be used with a manual lock or constant friction control.
A manual locking knee is the most stable option. It provides an automatic locking option with the ability for you to unlock it manually. This may be a great choice for unstable patients or those who need to gain more strength before trying a different type of prosthetic knee. Manual locking knees are also suitable for those who frequently walk on rough terrain and are more active.
Weight-activated stance-control knees work by locking the joint while weight is placed on the prosthesis. It bends as the load is shifted. Many times this is the first prosthetic prescribed for a patient. It’s also commonly used by older or less active patients and those who need to regain muscle strength.
These types of prosthetics offer four or seven axes of rotation, with four being the most common. This level of versatility offers stability while also providing more range of motion. You can comfortably sit down with a bent knee with this prosthesis, which is not always the case with other types. Polycentric knees can be heavier, though, and do not yield as easily on ramps or stairs.
These knees control motion via pistons filled with either air (pneumatic) or fluid (hydraulic). The purpose of these types of knees is to control flexion when walking at different paces. They store energy and release it as needed. These are great options for very active individuals. They can also be combined with computerized or microprocessor knees.
Microprocessor knees are also known as computerized knees. They combine the best of modern technology, including software, batteries, sensors, and a hydraulic or pneumatic system. The sensors gather information and make adjustments based on different environments and your needs.
Microprocessor prosthetics are state-of-the-art and offer the most versatility of all the options available. They can, however, be heavier, more fragile, and more expensive than other types of knee prostheses.
You can trust Evolve Prosthetics & Orthotics to help you find and fit the right knee prosthetic for you. We are conveniently located in the Las Vegas metro area. Contact us today for an appointment or stop by our clinic. We would love to assist you in finding and customizing the prosthesis you need.
The company is the world’s best Single Axis Prosthetic Knee Joint supplier. We are your one-stop shop for all needs. Our staff are highly-specialized and will help you find the product you need.