New Socket-Less Prosthesis concept facilitating comfortable and abrasion-free cycling after Van Nes rotationplasty.

BACKGROUND AND AIM: Current leg prostheses in rotationplasty typically feature a thigh cuff, which, in cycling, may cause perspiration problems and friction-related abrasions of the skin. The aim has been to develop a socket-less prosthetic device for persons with a rotationplasty to be able to engage in high-intensity cycling without contracting abrasions. TECHNIQUE: The new device (Socket-Less Rotationplasty Prosthesis for Cycling) features a standard cycling shoe on the rotationplasty foot, replacing the conventional socket and thigh cuff. A reinforced 12-layer carbon fibre frame bolted to the aforementioned shoe, replacing the standard tube, connects to a prosthetic foot and a second cycling shoe. Alignment of the Socket-Less Rotationplasty Prosthesis for Cycling is done both statically and dynamically. DISCUSSION: The Socket-Less Rotationplasty Prosthesis for Cycling is lightweight and more ventilated relative to conventional sockets. All components can be replaced easily. Most important, however, is that the current user now can cycle 135 km on end without skin abrasions. CLINICAL RELEVANCE: The Socket-Less Rotationplasty Prosthesis for Cycling concept enables patients with a leg rotationplasty to engage in high-intensity cycling without contracting skin problems, thereby facilitating clients' participation.

Functional added value of microprocessor-controlled knee joints in daily life performance of Medicare Functional Classification Level-2 amputees.

OBJECTIVE: To assess the effects of using a microprocessor-controlled prosthetic knee joint on the functional performance of activities of daily living in persons with an above-knee leg amputation. OBJECTIVE: To assess the effects of using a microprocessor-controlled prosthetic knee joint on the functional performance of activities of daily living in persons with an above-knee leg amputation. DESIGN: Randomised cross-over trial. SUBJECTS: Forty-one persons with unilateral above-knee or knee disarticulation limb loss, classified as Medicare Functional Classification Level-2 (MFCL-2). METHODS: Participants were measured in 3 conditions, i.e. using a mechanically controlled knee joint and two types of microprocessor-controlled prosthetic knee joints. Functional performance level was assessed using a test in which participants performed 17 simulated activities of daily living (Assessment of Daily Activity Performance in Transfemoral amputees test). Performance time was measured and self-perceived level of difficulty was scored on a visual analogue scale for each activity. RESULTS: High levels of within-group variability in functional performance obscured detection of any effects of using a microprocessor-controlled prosthetic knee joint. Data analysis after stratification of the participants into 3 subgroups, i.e. participants with a "low", "intermediate" and "high" functional mobility level, showed that the two higher functional subgroups performed significantly faster using microprocessor-controlled prosthetic knee joints. CONCLUSION: MFCL-2 amputees constitute a heterogeneous patient group with large variation in functional performance levels. A substantial part of this group seems to benefit from using a microprocessor-controlled prosthetic knee joint when performing activities of daily living.