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Prosthetic services

Through knee prosthetics

Introduction to Through Knee Amputations

Roger Wolfson and Associates is a certified provider of prosthetic sockets designed to cater for the needs of through knee amputees.

A through knee amputation, also referred to as the ‘Buchler Technique’, is a highly suitable surgical option where it pertains to a successful prosthetic outcome. With the correct prosthetic fitting, the suspensions as well as the weight-bearing components of the anatomy are utilised.

Why consider a through knee amputation as opposed to an above knee amputation?

  • A through knee amputation is a disarticulation amputation; hence, the knee joint has been separated from the femur. Unlike the above knee amputation, where a great deal of leg weight is distributed through the ischial tuberosity area (the buttocks); in the case of a through knee amputation, the weight of the leg is distributed around the femoral condyles (the bottom of the stump, comprising the left-over knee joint), which makes the rehabilitation and walking process far more comfortable than would be the case with an above knee amputation.
  • The femoral condyles or bottom of the stump comprising the left-over knee joint, are more bulbous (larger) than the other parts of the amputated leg, which allows for a perfect suspension system for the prosthesis.
  • Longer length of the residual stump as a result of a through knee amputation enables greater control over the prosthesis than would be the case with an above knee amputation.

Achieving the best results

Where circumstances allow, Roger Wolfson and Associates will advise and guide the surgeon performing an amputation to choose the most advantageous surgical procedure involved in the amputation to ensure the best outcome for the patient and their subsequent use of prosthetics. In order to maximize all opportunities wherever possible, Roger Wolfson and Associates maintains regular contact with orthopedic and general surgeons and acts in an advisory capacity to assist in achieving the best results.

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Prosthetic services

Does your prosthesis hurt? Are you walking with difficulty?

While various levels of amputations are carried out, by far, the most common involve:

  • Below knee (trans tibial)
  • Above knee (trans femoral)

No matter the amputation level, there is a great deal your dedicated prosthetist can do to diagnose and employ the right measures in order to alleviate any painful conditions associated with prosthetic use.

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Prosthetic services

From amputation to prosthesis in three weeks

From post-op to crutches within five days and walking comfortably with a prosthesis in as little as three weeks! The idea of walking with crutches within five days post-op and being able to walk with a prosthesis in as little as three weeks after undergoing an amputation sounds like science fiction – but it is not. It is just up to clever engineering on behalf of Roger Wolfson and a desire to get walking again.

Yet, it is even more surprising to learn that the technique used in creating a prosthesis designed to do just that has been around for many years.

Why surgeons should regularly use the services of a prosthetist when performing an amputation

Should a surgeon perform the amputation procedure in consultation with a prosthetist that is familiar with the Immediate Post-Operative Prosthesis (IPOP) technique, the results can be extremely beneficial to the well-being of the patient, and result in considerable cost savings to both patients and funding sponsors alike.

A scientific paper pertaining to this very topic was presented at an Orthopaedic Surgeons Congress that took place in South Africa recently. However, despite the fact that the Chairman of the Congress raised the burning question as to why, in fact, surgeons don’t regularly consult with a prosthetist around the surgical procedure, the fact still remains that as things currently stand, the number of surgeons that use the services of a prosthetist nevertheless remains fewer than desired.

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Prosthetic services

Measuring Residual Limb

When is the residual limb ready for measurement?

How long does it take before for the residual limb is ready for measurement?

Once the initial measurements have been taken a number of test fittings are carried out.   This is vital for the comfort of the patient. I like to compare the making of a prosthesis to the making of a wedding dress. For a young future bride the making of a wedding dress is of vital importance and she wants to have it fitting absolutely perfectly.

The more fittings the dressmaker is prepared to do for her, the happier she will be as she wants the outcome to be perfect. If the dressmaker’s worth her salt and has pride in her work she will be happy to do the extra fittings even though they are not in the initial cost.

We will do as much as it takes to make sure that the outcome of the prosthesis will give the patient comfort, mobility and confidence. If the patient is a trans femoral (above knee amputee)the process of measuring and fitting for the first walking prosthesis takes between three and five days.

If the amputee is a trans tibial (below the knee amputee) the first walking prosthesis can be anything from one hour to 2 days once both the patient and the prosthetist are happy with the fit. When the final prosthesis is made the time frame should not be longer than three weeks before the finished prosthesis is fitted.

During this process the amputee goes for an extensive exercise program which is carried out by an experienced physiotherapy team.

The Rehabilitation exercise program is optional and it depends on the economic situation of the patient usually the medical aid will pay for this service as they have already invested money in the prosthesis and they would like the amputee to make full use of the prosthesis. Even though the exercise sessions are long and hard my patients report to me that they are a lot of fun. Actually I find them fun because I join in some times especially the dance class.

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