The gait patterns of patients following three-component, mobile-bearing total ankle arthroplasty more closely resembled normal gait when compared with the gait patterns of patients following arthrodesis. Dorsal motion in the sagittal plane was primarily responsible for the differences. Improvement in self-reported clinical outcome scores was similar for both groups. Further investigation is needed to determine why patients who have undergone total ankle arthroplasty do not use the plantar flexion motion in the terminal-stance phase and to explain the limited increase in power generation at toe-off after arthroplasty. Results obtained from this study may be used for future modifications of ankle prostheses and may add to clinicians' ability to inform patients of predicted functional outcomes prior to the treatment of end-stage ankle osteoarthritis.

This paper describes a new type of prosthetic knee joint mechanism that is intended to be cost-effective while providing high-level stance phase function to active individuals with a transfemoral amputation. Initial clinical testing suggests that the new knee joint may have some functional advantages over existing technologies in this category.

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The goal of this study was to investigate clinically relevant biomechanical conditions relating to the setup and alignment of knee-ankle-foot orthoses and the influence of these conditions on knee extension moments and orthotic stance control during gait. Knee moments were collected using an instrumented gait laboratory and concurrently a load transducer embedded at the knee-ankle-foot orthosis knee joint of four individuals with poliomyelitis. We found that knee extension moments were not typically produced in late stance-phase of gait. Adding a dorsiflexion stop at the orthotic ankle significantly decreased the knee flexion moments in late stance-phase, while slightly flexing the knee in stance-phase had a variable effect. The findings suggest that where users of orthoses have problems initiating swing-phase flexion with stance control orthoses, an ankle dorsiflexion stop may be used to enhance function. Furthermore, the use of stance control knee joints that lock while under flexion may contribute to more inconsistent unlocking of the stance control orthosis during gait.

Consumer socialization provides a new way to understand the developing role of youth as AT consumers and the YEP scale is emerging as a way to measure their product attitudes. When integrated with contemporary thinking about the assessment and selection of AT devices, providers and parents may be better able to incorporate the product perspectives of youth during this shared decision-making process. [Box: see text].

Higher external peak knee flexion moments during the stance phase suggest that greater demands for support and stability are placed on individuals and their assistive devices when negotiating real-life ground surfaces. Clinical relevance This study demonstrates that walking on irregular surfaces alters the loads placed on knee-ankle-foot orthoses and that the requirements for knee stabilization increase. This has important clinical implications on the design, prescription, and use of such devices given the structural and functional demands placed on them.