POST-OP CARE · MICROPROCESSOR KNEES . MPK . RHEO vs C-leg - Actuator. Laminar Flow (Shear)...
Transcript of 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