Lecture 13: Novel Surgeries

Question 1

describe femoral lengthening after TFA

Answer 1

may need to be done in combo with skin and tissue expanders

complications: infection, slowed bone healing, pin migration

benefits: improvements in gait, lower energy consumption, improved pt satisfaction, and prosthetic use

Question 2

advantages and disadvantages of osseointegration

Answer 2

advantages
- removed socket residual limb interface
- improved function
- improved QOL

disadvantages
- risk infection/irritation
- risk of revised amputation in cases of falls/fx

Question 3

what is an Ewing amputation

Answer 3

during sx, Agonist-antagonist Myoneural Interface (AMIs) are created by linking mm pairs within the residual limb

aimed to provide proprioceptive feedback and better control of prosthetic device

“embodiment”

Question 4

describe an IDEO device

Answer 4

intrepid dynamic exoskeletal orthosis

designed for service members with severe LE trauma (i.e. fx + nn injury, arthritis, ankle fusion)

custo, carbon fiber AFO

improves pain, general LE function, high level function

must adopt non-rear foot running foot strike

Question 5

what are the different types of running specific feet and what are their purposes

Answer 5

C shaped = designed for endurance

J shaped = designed for sprint

don’t stick to labels as much as initially; now more pt preference; both can work for endurance or sprint if needed

can have a posterior or inferior mount

Question 6

describe static alignment

Answer 6

foot ER 3-5 deg

foot PF 5-7 deg

load line 1-2 in from toe point of contact

vertical deflection between 1-2 in

Question 7

describe dynamic alignment

Answer 7

forefoot strike with knee slightly flexed

deflection of foot with return of energy

equal step length

max hip extension at toe off

has hop flexion at terminal swing

symmetrical kinematics

90 degrees of knee flexion is ideal

Question 8

types of knee for running

Answer 8

generally mechanical and not microprocessor

i.e. ossuary total knee or ottobock 35S0 sport knee

Question 9

describe running without a prosthetic knee

Answer 9

increased stability

circumduction for foot clearance

typically chosen for long distances

challenging on uneven terrains and slopes

may be harder for unilateral amputee

Question 10

describe weight lifting with a prosthetic and things to keep in mind

Answer 10

must consider weight capacity of the foot

limited DF ROM available

knee disarticulation = uneven joint centers

Question 11

cycling considerations with prosthetic

Answer 11

consider feasibility of clipping in/out

free knee is appropriate

keep in mind safety and balance