Cosmetic effect of knee joint in a knee disarticulation prosthesis

Abstract

Abstract-Despite numerous advantages, knee disarticulations (KDs) are rarely performed because of the anticipated KD prosthesis fitting problems that include the positioning of the knee joint distally from the KD socket. This results in lengthening of the thigh and subsequent shortening of the shank. The objective of this study was to assess the cosmetic effect of the knee joint in a KD prosthesis by determining the extent of the lengthening of the thigh and the shortening of the shank. This lengthening and shortening were measured through an experimental setup using laser techniques. These measurements were made of 18 knee joints used in KD prostheses. Lengthening of the thigh varied between 23 and 92 mm, and shortening of the shank varied between 3 and 50 mm. The polycentric knees Medi KH6 and Medi KHF1 showed the least lengthening of the thigh, and the polycentric knees Teh Lin Prosthetic & Orthotic Co. Ltd Graph-Lite and Medi KP5 showed the least shortening of the shank.

Micromotion and Push‐Out Evaluation of an Additive Manufactured Implant for Above‐the‐Knee Amputees

“…10 Concerns have been raised about the cosmesis of through-knee amputation, as well as the perceived difficulties of prosthetic fitting. 11 Despite this, UK military surgeons supported amputation at this site based on the experience of the Defense Medical Rehabilitation Centre at Headley Court. 12 It was felt that superior results might be related to the ability of through-knee amputees being able to end bear 2 ; as such, the UK military consensus was that the distal femoral condyles should not be excised.…”

“…This is despite other evidence that while function is inferior to a trans‐tibial amputation, through‐knee amputation is associated with better results than above‐the‐knee amputations . Concerns have been raised about the cosmesis of through‐knee amputation, as well as the perceived difficulties of prosthetic fitting . Despite this, UK military surgeons supported amputation at this site based on the experience of the Defense Medical Rehabilitation Centre at Headley Court .…”

Knee disarticulation vs. transfemoral amputation after failed transtibial amputation: Surgical outcome and prosthetic fitting in patients with peripheral vascular disease

“…11 Another possible drawback is the fact that the prosthetic knee in a KD protrudes and gives a lengthening of the thigh that could be of cosmetic importance for the patient. 12…”

“…11 Another possible drawback is the fact that the prosthetic knee in a KD protrudes and gives a lengthening of the thigh that could be of cosmetic importance for the patient. 12 These circumstances in decision-making are perhaps even more difficult in the secondary setting when a reoperation needs to be done in an infected and/or poorly vascularized stump after a TTA. To our knowledge, no studies have compared TFA with KD as a reamputation level after a failed TTA in a dysvascular population.…”

Disarticulation of the knee: Analysis of an extended database on survival, wound healing, and ambulation

“…When combined with modern polycentric prosthetic joints, KD can offer improved walking stability in the geriatric population, enabling the performance of activities of daily living and thereby independence and a better quality of life. [11][12][13] The aim of this study was to analyze survival of the amputee patient, wound healing, and ambulation after KD with preservation of the femoral condyles in patients with peripheral arterial disease (PAD). Outcomes of this study may provide new insights in the determination of indication criteria for KD.…”