post-op care · microprocessor knees . mpk . rheo vs c-leg - actuator. laminar flow (shear)...

POST-OP CARE

Methods of compression Ace wrap • Most appropriate immediately

post-op • Not preferred for long-term use • Inconsistent results • Requires training to don properly Shrinker • Donned ~ 2 days- 1 week post-op,

per surgeon • Most common • Cloth tube • May be reflected for graded

compression

Gel Liner • Superior graded compression • Can be used in conjunction with

shrinker • Improved hygiene • Transitions to prosthesis as

suspension • Accommodates fleshy limb • Less traumatic to don

Rigid dressing • Immediate post-op (by surgeon) • Aids in protection of limb and

contracture prevention

IPOP: Immediate Post-Operative Prosthesis

Advantages

• Eliminates contracture potential

• Reduces time to fitting of preparatory prosthesis

• Restricted use on vascular or diabetic patient due to skin abrasion and inability to monitor the residual limb

Disadvantages • Poor control • Poor gait potential • Client perception of prosthetic usage

Would you use a liner with this?

YES - Limb Healed in liner using wet to dry

PROSTHETIC HIGHLIGHTS

Prosthetic Design

Patient’s pre-amputation lifestyle • Best predictor of outcome

• In some cases amputation improves function

Co-morbidities Patient goals

• Vocational

• Avocational

Residual limb shape/ Skin condition

Socket fit determines potential outcome

Challenges faced with a poor socket fit: • Disadvantaged to achieve goals

• Increased risk of falls

• Unable to develop confidence

• Componentry cannot be used to full potential due

to lack of control

• Increased risk of damage to skin and joints

• Increased energy expenditure

• Poor gait mechanics

• Pain

• Inability to progress patient in physical therapy

AK Socket: Ischial Containment

• Creates ‘boney lock’ • Provides stability side to side • Prevents lateral gapping • Ensures socket moves with body

Ischial Containment No lschial Contianment

Fitting Process diagnostic test socket (dts)

• Best outcomes • Allows for custom socket

adjustments • Comfort • Function • Control

• Capture Alignment • Walk on componetry

• Evaluate suspension

ALIGNMENT

Suspension Options

Sealing Sleeve and Liner

Pin Locking Liner (right) __________ Seal-in Liner (below)

MICROPROCESSOR KNEES

MPK

RHEO vs C-leg - Actuator

Turbulent fluid flow Laminar Flow (Shear)

RHEO KNEE C-Leg

RHEO MR Fluid Actuator Velocity Independent

Minimizes ‘Drag’ at high speeds

Default free

Hydraulic Unit Velocity Dependent

Increases ‘Drag’ at high speeds

Default locked

How Does Rheo Work? • Magnetorheologic fluid

• Magnetic charge changes

the fluid viscosity

• Microprocessor, gyroscope, and actuator determine appropriate fluid viscosity