Rehabilitation evaluation of the newly developed polymeric based passive polycentric knee joint

Functional outcomes and user preferences of individuals with transfemoral amputations using two types of knee joints in under-resourced settings

BACKGROUND

Information relating to prosthetic performance can inform clinical practice and improve patient outcomes in under-resourced countries.

OBJECTIVES

The main goal of this study was to compare functional outcomes and user preferences of individuals with transfemoral amputations using common types of knee joints in an under-resourced country.

STUDY DESIGN

Prospective, longitudinal, before and after trial.

METHODS

Twenty individuals with unilateral transfemoral amputations from a center in Cambodia transitioned from a commonly used single-axis manually locking knee International Committee of the Red Cross (ICRC) to a more advanced multiaxis knee joint with stance control All-Terrain Knee (ATK). Data were collected for the ICRC knee joint and the ATK immediately after fitting, after acclimation, and as part of a long-term follow-up. A timed walk test assessed walking distance and efficiency. Mobility and user-preferences were evaluated through questionnaires.

RESULTS

Distance during the timed walk test was significantly higher for the ATK compared with ICRC (P < 0.001), with functional gains retained at follow-up. No differences were found for gait efficiency and the mobility questionnaires. All participants, except one, preferred the ATK prosthesis. Benefits included greater knee stability and fewer perceived knee collapses; however, some disliked the appearance of the ATK.

CONCLUSIONS

The findings suggest positive outcomes with prosthetic services in under-resourced regions and the ICRC system, as well as the potential for improved functional outcomes with more advanced multiaxis knee components.

A systematic review on design technology and application of polycentric prosthetic knee in amputee rehabilitation

The objective of this paper is to conduct a systematic review on design technology and clinical application of polycentric prosthetic knee joint in the rehabilitation of trans-femoral amputees. Relevant studies were identified using electronic database such as PubMed, EMBASE, SCOPUS and the Cochrane Controlled Trials Register (Rehabilitation and Related Therapies) up to February 2020. Screening of abstracts and application of inclusion and exclusion criteria were made. Design, modeling, material use, kinematic study, simulation technique and clinical application of polycentric knee models used in many developed and developing countries have been reviewed. Out of 516 potentially relevant studies, 43 articles were included. Specific variables on technical and clinical aspects were extracted and added to summary tables. The results reveal that polycentric knees have a variety of geometries but the methods for comparing their performances are rare. The data of structural analysis using different simulation techniques are validated with experimental results for determining model accuracy. Gait analysis using the polycentric knee components provides a valid tool to correlate with experimental results. There are well-designed studies on the technological development of polycentric knees, however, high-quality clinical researches are scarce. Conventional clinical knowledge had considerable gaps concerning the effects of polycentric knee and their mechanical characteristics on human functioning with a lower-limb prosthesis. Still, further research is needed to develop and implement standardized measures on prosthetic knee joints for their effective use, function, durability, and cost-effectiveness.