“What do you want to do that you can’t do now?” and “How does your current prosthesis limit your activities?” are good questions to start with, Cale said.
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Your answer to that question may be “nothing” or “not at all.” That’s the case with Leslie, clinical and regulatory affairs manager for Ottobock. Her activity level has not changed since first getting her C-Leg Microprocessor Prosthetic Knee, so she is planning to stick with that product at her next replacement.
But many times over the almost 40 years Leslie has worn a prosthetic leg, she has experienced the impact that new technology can make. When she went from a hydraulic knee into the C-Leg eight years ago, it changed her life. “Almost right away, walking was amazing and effortless,” she said. “For the first time, I could walk down steps foot over foot.
“Even if you stick with the same technology, it will be an adjustment, because every prosthetic system is custom,” she continued. Also, the product you’re using may have undergone an upgrade that could be an improvement for you. It’s worth talking to your prosthetist about this.
At 66 years of age, Don, who has the C-Leg, is considering how much longer he wants to continue to play tennis. “That’s the sport that beats up the leg the most,” he said. He would like to be able to go up stairs step over step, so he is looking at the Genium Bionic Prosthetic System.
Rob got the Genium above-knee prosthesis last year. “Now I can walk up and down hills step-over-step, even at an angle,” he said. “It’s great for getting on and off planes. And I can tackle the big hill in my yard with the lawn mower.”
In addition to looking at what the leg would enable you to do, it’s important to consider the limitations imposed by the knee you are considering, Cale said. There may be limitations to how the knee performs on stairs, hills, uneven terrain and ramps, for example.
Consider asking your prosthetist for names of people they work with who have the product you are considering so you can talk with them in person. “Although privacy laws limit distribution of specific patient information, most reputable clinics will have established relationships with amputees who would be willing to meet with you to provide a realistic, first-hand account of what to expect, ” Cale said.
In addition, manufacturers such as Ottobock have patients who help train others and are available to speak with people considering their products, Leslie said.
But there’s nothing like a test drive to help you know for sure if something is for you. “If you have an opportunity to do a trial fitting with a specific product, do it, especially if you are going to a new technology,” Leslie said. Ottobock allows patients to try their products in the prosthetist’s office.
Wide variation exists among insurance plans regarding coverage of prosthetic devices, Cale said. However, in general, insurance companies will consider coverage for a new prosthetic knee if:
“The typical lifespan of a prosthetic component is three to five years,” he said. “I’ve seen knees last 15 years, and I’ve seen them last two years. It depends on how active the person is and the environment where the prosthetic is most often used.”
How do you know if your knee needs replacing? See your prosthetist regularly and discuss with him or her any of the following signs of wear:
If you begin tripping or falling repeatedly and that had not been the case before, see your prosthetist immediately.
Whatever your reason for needing a new prosthetic knee, be prepared for the fact that you may need to be persistent to get insurance coverage. One of the most important things you can do is to enlist your prosthetist’s help in educating your physician about what to include in their documentation, which is the basis for any coverage decision.
“A primary care doctor may have only one patient with limb loss in a population of 2,000 patients, so we can’t assume they know what documentation the insurance companies need,” Leslie said.
Don’t let fear of denial keep you from asking for what you need. “In my experience, if you have all the necessary documentation and all the details are taken care of, it dramatically increases the likelihood you will get reimbursement,” Cale said. “Every patient deserves the opportunity to investigate the full range of what’s available based on their functional abilities.”
According to their experiences, amputees often have unique, very individual needs. So typically, the problem for an artificial knee designer is to capture as many of the essential features in a design that will produce an artificial leg with the ‘best’ technology available, that is, either created (like the patented VGK microkinetic processor technology) or that is traditionally ‘proven’ by known technologies.
There are significant qualitative differences, in the feel of different kind of knee joints, since knee joints in an artificial limb for trans-femoral amputees can give very different experiences. In an ideal world, the best way an amputee could find out what works for them, is to try out a variety of alternative based technologies. The feel of the knee may range from a crude hinge to something that many amputees, who have tried out the VGK, have spontaneously called: “A Very Good Knee joint, one that feels very close to one’s own leg”
(In other words, do you fear that the knee will collapse if you are not careful?)
Ask yourself:
Do I need to make a special effort to keep it from collapsing?
Do I struggle to walk-and-talk?
Does my knee joint give way when it is not fully straight if I walk downslope?
IF YOU ANSWER ‘YES’ TO ANY OF THESE QUESTIONS, read on, the VGK may offer you something useful.
Ask yourself:
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Can I keep up with other people walking?
Does my leg feel nice in swinging through?
Can I push my leg forward through grass?
IF YOU ANSWER ‘NO’ TO ANY OF THESE QUESTIONS, read on, there could be something better.
Ask yourself:
Do I kind of jump over my false leg to make it look like as if I do?
Does the knee kind of lock up or collapse if I try?
Does my knee make me scared to try in the first place?
IF YOU ANSWER ‘YES’ TO ANY OF THESE QUESTIONS, then you may not have tasted the pleasure of controlled stairs descent.
Ask yourself:
Does my knee sometimes shoot if I try?
Does my knee get stuck solid if I attempt?
Does the knee fail me when it gets hot?
IF YOU ANSWER ‘YES’ TO ANY OF THESE QUESTIONS, then you may not yet have a knee that ‘does the job’. Since the VGK-Go! is designed to do this very well. The VGK-Go! could have some answers for you. We believe the Very Good Knee offers solutions. It’s a knee joint with that naturally adaptive response, created by the patented use of fluid-flow reactive to the needs of the immediate movement
If you think so, measure, whilst sitting, from the end of stump to end of knee cap of the other leg, and if you measure more than 20 cm (8″) then you may have a short stump.
Ask yourself:
Does my artificial limb feel heavy and far away?
Do I find it hard to control my prosthesis?
Even though I have a light foot, is it hard to swing the prosthesis?
IF YOU ANSWER ‘YES’ TO ANY OF THESE QUESTIONS, then may be the VGK-S is worth looking into, since it designed to address the special problems associated with a short femur.
A: The VGK has been designed to be compatible with any foot. However, if a high heeled shoe is not accommodated for in the alignment of the foot, the joint stays in stance stability if the toe of the foot does not receive enough load due to the high heel. The VGK has been seen to be compatible with fluid controlled ankle devices with energy storing feet. It is important to avoid a very soft a forefoot, as this hinders a proper forefoot loading.
It has been found that an energy storing foot both helps in further easing release into swing, and to help propel the shin into swing.
A: False, NOT just another hydraulic joint! A VGK uses polykinetic control technology. Technology is the art of solving problems efficiently. In fact, the polykinetic technology replaces the electrical sensors and on board computing, Polykinetic processing controls for variations in forces applied to the limb and variations in viscosity, and at the same time delivers state of the art functionalities!
A: A VGK has been designed to withstand water and even shallow immersion (waist deep). If you need to get the joint wet on a regular basis, please contact Orthomobility or your CPO so that a suitable service program can be arranged. However, a VGK is NOT suitable for scuba diving or other such deep water activities deeper than 5 meter, for the risk of drowning: naturally the VGK is less than buoyant and like any other metal knee joint would not help to keep an individual afloat.
A. The VGK has been developed by a Dutch CPO/MEng with extensive specialist experience in the UK NHS. Eighteen years of clinical and design experience supports the construction and fine detail of the VGK. The VGK is available through your CPO, who can contact us direct for advice regarding ordering. Alternatively you can contact us direct if you have other questions.
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