KOs and KAFOs Flashcards

Question

Indications for Locked Knee

Answer 1

Upper extremity and trunk too weak or unstable to balance over the hip Patient needs to lean back behind the knee joint to stabilize the hip Hip and knee flexion contractures Plantarflexion contracture Bilateral lower extremity paralysis

Answer 2

1. Ischial Ring (Thomas Ring) 2. Ischial Containment Brim 3. Quadrilateral Brim 4. Patten Bottom with Ischial Brim

Answer 3

2 inch metal ring covered with leather and padding Advantage- cool with small surface area Disadvantage- small surface area provides limited support and creates high pressure on ischium

Answer 4

Custom molded or prefabricated shell contains ischium Advantages- good rotation control and axial loading due to skeletal contours Disadvantages- difficult to fit

Answer 5

Quadrilateral shape allow for the ischium to sit on the posterior ledge of brim Advantages- easier to fit than ischial containment and good rotation control Disadvantages- can be difficult to maintain ischial contact and prevent slipping off posterior ledge (Especially with hip flexion contractures)

Answer 6

Foot floats in between uprights and above metal foot plate Advantage- 100% unloading of the leg as foot does not contact ground Disadvantage - cumbersome, raises the affected side

Answer 7

Off set free knee joint Ankle in plantarflexion with maximum rigidity

Answer 8

Off set knee with lock Free knee with lock

Answer 9

Off-set free knee joint Knee lock unnecessary in pure Genu recurvatum Knee lock may be needed if G Recurvatum is associated with extensor weakness Ankle in neutral or DF to prevent knee extension moment

Answer 10

Adjustable to correct contracture

Answer 11

Use of lock optional, dependent on severity of problem and associated deficits

Answer 12

Use of knee lock optional, dependent on severity of the problem and associated deficits

Answer 13

Function Full flexion, 0 degree extension stop Advantage Full range of knee motion Disadvantage Cannot be locked

Answer 14

2 axes move center of rotation closer to anatomical knee axis Advantage Better Knee motion Bulky

Answer 15

Function Free knee joint-inherently stable due to extension moment with joint position posterior to weight line of body Advantage Inherently stable for mild knee problems, good for hyperextension control Disadvantage Can't guarantee knee staying extended all the time

Answer 16

Free knee joint-inherently stable due to extension moment with joint position posterior to weight line of body Advantage Inherently stable for mild knee problems, good for hyperextension control Disadvantage Can't guarantee knee staying extended all the time

Answer 17

Adjustable dial to change knee joint flexion/extension angles Locking options available Advantage Ability to adjust knee angle after brace is made, good for knee flexion contracture Disadvantage Rachet teeth in dial can wear out faster than regular knee joints, especially after multiple adjsutments

Answer 18

Rings around knee joint drop down automatically with gravity, but must be manually lifted to unlock Advantages Strong Simple Disadvantages Requires 2 hands to unlock (not for hemiplegia) Unlocking hard for spastic clients Must have full knee extension range to work

Answer 19

Cable attached to each side of drop lock allows the locks to be lifted at the same time One hand can operate locks Not as bulky as spring loaded bail lock Difficult to unlock if leg does not have full extension Must grab cable through trousers

Answer 20

Automatic spring loaded lock, disengaged by manually lifting a rigid metal bar posterior to the knee Advantage Easy to open, unilateral or bilateral AKFO use Can open by leaning against wheelchair No bending at hip to unlock Disadvantages Bulky underneath trousers If bilateral KAFOs, bails can catch each other Wears faster than drop locks

Answer 21

Isolated quad weakness Incomplete spinal cord injury Polio/post-polio CVA Peripheral Paresis/Paralysis Nerve Inflammation Neurological Failures Myopathies MS or similar diseases Must be able to initiate swing thru Must have fair or better hip flexor strength

Answer 22

Knee flexion contracture > 10 degrees Central Paralysis Hip flexion contracture Hip muscular involvement Poor Balance/Coordination Weight-bearing orthosis Uncorrectable Genu Varum/Valgum > 10 degrees Significant cognitive impairment

Answer 23

Usually for isolated quad weakness Most joints lock on initial contact with unlocking at terminal stance when dorsiflexion occurs in conjunction with extension moments at the knee Most joints require hip extensor control in order to neutralize forces across the orthotic joint

Answer 24

Ottobock Free Walk Horton Technology Inc Stance Control Horton Technology Inc Smart Knee Filauer Swing Phase Lock System Becaker Orthopedic UTX Swing KAFO Becaker ORthopedic E-Knee (Broader application, patients with higher level of disability) Ultraflex Systems Inc. Ultra Safe Step (Stroke Patients)

Answer 25

Motion controlled with KO having good purchase of proximal and distal to knee with sufficient lever arms and contact through soft tissue to stabilize the knee Generation II Don Joy

Answer 26

Pain can be relieved with infrapatellar strap to apply pressure at tibial tuberosity Reduce motion and control tracking of patella as knee flexes and extends Patellar stabilization knee sleeve also worn to decreased symptoms caused by patellofemoral conditions

Answer 27

Medial or lateral compartment pain managed in KAFO or possibly Ko Applies varus or valgus force depending upon diseased compartment Suspension of KO not always possible

Answer 28

Commonly controlled with neoprene or elastic knee sleeve having cut out for patella, sewn in buttresses that maintain patella in normal tracking position