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

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POST-OP CARE

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Page 1: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

POST-OP CARE

Page 2: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

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

Page 3: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

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

Page 4: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

Would you use a liner with this?

Page 5: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

YES - Limb Healed in liner using wet to dry

Page 6: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

PROSTHETIC HIGHLIGHTS

Page 7: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

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

Page 8: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

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

Page 10: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

Fitting Process diagnostic test socket (dts)

• Best outcomes • Allows for custom socket

adjustments • Comfort • Function • Control

• Capture Alignment • Walk on componetry

• Evaluate suspension

Page 11: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

ALIGNMENT

Page 12: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

Suspension Options

Sealing Sleeve and Liner

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

Page 13: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

MICROPROCESSOR KNEES

Page 14: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

MPK

Page 15: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

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

Page 16: POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear) Turbulent fluid flow . RHEO KNEE. C-Leg. RHEO MR Fluid Actuator . Velocity Independent

How Does Rheo Work? • Magnetorheologic fluid

• Magnetic charge changes

the fluid viscosity

• Microprocessor, gyroscope, and actuator determine appropriate fluid viscosity