Portal de Periódicos da CAPES

Alignment of the above-knee prosthesis/1

1979; Lippincott Williams & Wilkins; Volume: 3; Issue: 3 Linguagem: Inglês

10.3109/03093647909103097

1746-1553

J. Foort,

Total Knee Arthroplasty Outcomes

1. A long prosthesis forces drop of the pelvis on the normal side, can cause crotch pressure and distal femoral pressure leading to discomfort, can reduce voluntary control, may force the amputee to walk with an abducted stump hip for stance phase and to swing the leg outward for toe clearance in swing phase or to compensate by rising up on the sound foot to clear the prosthetic foot. 2. A short prosthesis may shorten stride, increase listing over the prosthesis in stance phase, enhance prospects for a narrow, walking base and increase the ease of balancing o ver the prosthesis in stance phase. 3. Moving the foot forward relative to the stump increases prosthetic stride length. 4. Moving the foot posteriorly relative to the stump does the reverse. 5. Displacing the foot medially has variable effects which may include walking with a narrow base, moving the foot laterally by hip abduction of the stump for relief of pain and increased voluntary control. Stump length and strength is a strong mediator in what choice the amputee makes as he tries to get comfort, save energy and maintain a cosmetic gait. 6. Displacing the foot laterally may lead to the amputee adducting the stump to reduce the width of the walking base, or force him to lean over the prosthesis during stance phase an it, or lift his body over the prosthesis by means of a strong lateral impulse from the sound leg as the prosthesis becomes weight-bearing with the torso erect. 7. Increasing downward inclination of the prosthetic toe shortens stride on the normal side. 8. Tilting the toe upward on the prosthetic side lengthens stride on the normal side. 9. Knee axis stability is increased for a larger percentage of the stance phase on the prosthesis when the prosthetic toe is inclined — downward or when the prosthetic foot is moved forward with respect to the stump. 10. Toe-in and toe-out have comparable effects to moving the foot inward or outward except that the effects are lessened or reversed at heel contact, tending toward the effects indicated as the step advances. 12. Inversion-eversion changes are basically for cosmetic effects.