Novel Surgical Procedures & High-Level Prosthetic Devices

Question 1

what are the possible complications of femoral lengthening after TFA?

Answer 1

infection
slowed bone healing
pin migration

Question 2

what improvements are seen after femoral lengthening after TFA?

Answer 2

gait
lower energy consumption
patient satisfaction
prosthetic use

Question 3

femoral lengthening commonly lengthens the femur from ____ to ____ cm

Answer 3

15.5 cm to 21 cm

Question 4

what are advantages to osseointegration?

Answer 4

removed socket-residual limb interface
improved function
improved quality of life

Question 5

what are disadvantages of osseointegration?

Answer 5

risk of infection/irritation
risk for revised amputation in case of falls with fracture

Question 6

what happens during an ewing amputation?

Answer 6

agonist-antagonist myoneural interface (AMIs) are created by linking muscle pairs within the residual limb (connects agonist and antagonist muscles)

Question 7

what is the purpose of an ewing amputation?

Answer 7

aimed to provide proprioceptive feedback and better control of prosthetic device
– embodiment –> feels more connected with their foot

Question 8

who were intrepid dynamic exoskeletal orthosis (IDEO) originally developed for?

Answer 8

service members with severe lower limb trauma (fractures, nerve injury, arthritis, ankle fusion)

Question 9

what kind of material is the IDEO?

Answer 9

custom carbon fiber AFO

Question 10

what does the IDEO improve?

Answer 10

pain
general LE function
high-level function

Question 11

in order for a patient to qualify to use an IDEO, what must they accomplish first?
– why?

Answer 11

adopt non-rearfoot running foot strike (there are rearfoot, midfoot, and forefoot patterns for running)
– decreases stride length to keep foot under themselves

Question 12

running specific feet:
– C shaped is for ____ and has ____ mount
– J shaped is for ____ and has _____ mount

Answer 12

– endurance ; inferior
– sprints ; posterior

Question 13

what is the bench alignment for a C shaped foot?

Answer 13

M-L = middle
1-2” of foot in front of weight line to make contact with ground

Question 14

what is the bench alignment for a J shaped foot?

Question 15

what is the static alignment for a running foot?
– _____ 3-5 deg
– _____ 5-7 deg
– load line _____ from toe point of contact
– vertical deflection _______

Answer 15

– ER
– PF
– 1-2 inches
– 1-2 inches

Question 16

true or false. the running foot is 1-2 inches shorter than unaffected due to vertical deflection

Answer 16

false - 1-2 inches longer

Question 17

what is the dynamic alignment of a running foot?
– forefoot strike with ____
– deflection of the foot with _____
– _____ step length
– max hip ext at ____
– max hip flx at _____
– _______ kinematics
– ______ of knee flexion for:

Answer 17

– knee slightly flexed
– return of energy
– equal
– toe off
– terminal swing
– symmetrical
– 90 deg ; foot clearance

Question 18

ossur total knee and ottobock 35S0 Sport knee are both specific to _____-

Answer 18

running

Question 19

what is one pro to choosing a running prosthetic without a knee?

Answer 19

increased stability –> no knee to buckle, no fwd flex

Question 20

how is foot clearance accomplished in a running prosthetic without a knee?

Answer 20

circumduction

Question 21

when do patients typically choose to use a running prosthetic without a knee?

Answer 21

for long distances

Question 22

what secondary MSK complication would you be worried about in running prosthetics without a knee?

Answer 22

bursitis or tendonitis – a lot of work on the abductors

Question 23

running prosthetics without a knee can be challenging to use on _____

Answer 23

uneven terrains and slopes

Question 24

what are considerations for a prostheses user performing weight lifting?

Answer 24

consider weight capacity of foot
limited DF ROM

Question 25

what are considerations for a prostheses user performing cycling?

Answer 25

consider feasibility of clipping in/out (don’t wear shoe while cycling)
free knee appropriate
safety/balance