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Prosthetics&Orthotics > L6: Orthotics for Knee INstability > Flashcards

L6: Orthotics for Knee INstability Flashcards

1
Q

Prescribing/Recommending knee orthotics:

Understand these things:

A
  • knee mechanics, goals of pt*,
  • ***mechanical properties brace affords
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2
Q

Categories of knee orthoses→ based on desired goals, sx protocols, pt and PT

3 categories: ALL

A
  1. Rehab knee orthosis (RKO)
    1. dial lock, max restrict, protects sx site
  2. Functional knee orthosis (FKO)
    1. Return to Sport brace
  3. Prophylactic knee orthosis
    1. Just an FKO worn to prevent/limit injuries***
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3
Q

This knee orthosis has a dial lock, MAX restriction, protects sx site

A

RKO

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4
Q

This knee orthosis is a Return to Sport brace

A

FKO

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5
Q

This knee orthosis is just an FKO BUT worn prophylactically to prevent/limit injuries

A

PKO

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6
Q

Rehab Knee Orthosis (RKO)

used for/design

A
  • Post-op/early rehab
  • Controls excessive loading on healing tissues and controls knee motion***
  • Looooonger vs FKO/PKO for greater control/comfort
  • ***Dial lock one!!!
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7
Q

RKOs

More on design+Post-Sx progressions/protocols

A
  • Adjustable (dial lock)→ for free AROM incremental inc’s
  • Post-sx progression/protocols:
    • ACLs→ 0-90 free motion (NWB) 0-7 days (full EXT) PROM
    • In WB→ locked first 2-4wks or until good quad control and hold
    • AAROM→ 0-130 by 6wks
    • FULL AROM by 10-12wks
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8
Q

RKOs

Effective rehab braces have these qualities:

A
  • Adjustable→ for edema or atrophy, for standing/WB, MD protocols and sitting
  • Comfy, easy to don/doff
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9
Q

FKO brand to know

A

DonJoy

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10
Q

More dynamic brace vs RKO

A

FKO

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11
Q

FKOs

Features

A
  • Lt wt, rigid
  • Adj. velcro→ 4-point stabilizing force (same concept as 3-point)
  • Some polycentric→ mimic slide/glide, some w/ flex control OR ext assist
  • More dynamic vs RKO
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12
Q

Functional Knee Orthosis (FKO)

Components/Stabilizing forces broken down

*know where forces are located

A
  1. Posterior force over anterior prox. thigh
  2. Anterior force on distal posterior femur
  3. Posterior force @ prox. anterior tibia
  4. Anterior force @ midshaft of posterior tibia
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13
Q

FKOs

ACL insufficiency

A
  • Prevents forward translation of the tibia on femur (or posterior translation of femur on tib)
    • bc this is ACLs function!!!
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14
Q

FKOs

OA (esp Medial knee compartment)

aka Varus deformity corrected by valgus force brace

A
  • Valgus orthoses→ Dec pain by unloading knee jt during stance phase w/ adjustable tension straps crossing Lateral knee joint
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15
Q

FKOs

PTFJ dysf/pain

A
  • Neoprene sleeve over knee w/ opening over patella and “J” or semicircle buttress @ lateral patella
  • Goal→ guides patella in intracondylar groove
  • Design→ control undesirable, excessive lateral mvmt of patella
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16
Q

3 Conditions we talked about for use of FKO brace

A

ACLs

OA

PTFJ pain

17
Q

More FKO pics

A

ACL braces prevent anterior translation of tibia on femur

18
Q

PKO brace

P is for Prophylactic

SO when you see PKO brace also think…..

A

PREVENTATIVE!!!

19
Q

PKO BRACE

A
  • Prevent injury→ protect soft tissue restraints of knee
  • Worn by athletes exposed to lateral impacts (think about how brace set (medial protection)
  • NOT preferred for skill pos’s (RBs, WRs)
  • passive brace
20
Q

PKOs

Protection

A
  • Protects→ MEDIAL knee jt structures→ MCL, MM and internal knee ligs (ACL, PCL)
  • Research→ marginal benefits
    • no conclusive evidence for prevention injuries
    • too many variables to control**
21
Q

FKOs

Research for ACLs

A
  • incd afferent input to knee mm’s
  • slightly more energy expend.
  • impaired blood flow to distal thigh and leg straps→ more foot/ankle injuries
  • No diff in ant. tibial translation w/ hop test
  • Placebo, ACL brace, no brace→ no diff in mm function
22
Q

FKOs

Research for MCLs:

A
  • 1 study w/ sig reduction in MCL knee injuries
  • “more secure”
  • afferent input
23
Q

BASICALLY w/ these braces just know

RKO vs FKO vs PKO

A
  • RKO→ post-op, follows protocols, incremental adjustments, protects sx site
  • FKO→ ACL, OA, PTFJ pain/dysf
    • protects medial compartment knee, valgus force to accommodate varus deforms
  • PKO→ Preventative, just an FKO but worn to prevent injury

Prosthetics&Orthotics (19 decks)

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