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Prosthetic services

Above knee prosthetics

Prostheses concerning above knee prosthetics consist of a custom-made socket combined with a supportive frame, knee unit, pylon, and foot. Sometimes a suspension sleeve or harness may also be necessary.

The Prosthetic Knee System

Of all prosthetic components that are concerned with an above knee prosthetic, the knee system is arguably the most complex. It should provide:

  • Reliable support when standing,

  • Allow smooth, controlled motion when walking, and

  • Permit unrestricted movement when sitting, bending and kneeling.

Above knee prosthetic knees have evolved considerably over time, from the simple pendulum of the 1600s to those regulated by rubber bands and springs, pneumatic or hydraulic components. Nowadays, some knee units even have advanced motion control that is modulated through microprocessors.

For the trans femoral (including hip and knee disarticulation) amputee, successful function depends on:

  • The correct choice of knee relevant to age

  • Health

  • Activity levels and lifestyle

The latest technology or most advanced knee is not necessarily the best choice for everyone. For some amputees, safety and stability are more important than functional performance. Active amputees prefer a knee that will provide a higher level of function even if the knee requires greater control.

The Different Types of Prosthetic Knees

Since needs differ widely, there are various options to consider. What follows is a brief, yet informative description of the different types of prosthetic knees, including:

  • The New C-Leg®

  • Nabtesco Hybrid Knee

  • Rheo Knee®

  • Power knee)

  • Mauch Knee

  • Mauch Knee Plus

  • Total Knee 2100

  • 3R60 EBS Knee

  • 3R60Pro Knee

Anatomical SIT-Cast

Developed by Otto Bock, the latest innovation to be applied to the established SIT-Cast knee involves the new ramus containment socket (Anatomica). A trans femoral socket that encases the ischial tuberosity (also known as the ‘sit bone’ located in the buttocks) is fabricated using the Anatomical SIT-Cast device. This provides customized residual limb fitting for quality wearing and comfort.

The New C-Leg®

The new, improved C-Leg® gives the wearer confidence in the next step. Ultimately, confidence in a prosthetic device is of the utmost importance. In order to achieve this, Otto Bock have taken the best of the older version of the C-Leg® and created a device that:

  • Affords reliability and security in that the mechanical and electronic adjustments include improved swing phase control which enables the wearer to achieve a more natural gait pattern with an easier and smoother movement at the knee joint.

  • Enables improved stumble recovery which enables the wearer to achieve stability with the sound leg a lot quicker after a stumble.

  • Features an additional activity mode that allows for extra individualized movement patterns that can be selected by the wearer.

  • Provides the added benefit of adjustable damping behaviours when the battery is drained and improved splash protection of the knee joint.

  • Creates additional options for the wearer in that the IC60 Triton prosthetic foot has been approved for the C-Leg®.

  • Now has an increased weight limit of up to 136kgs.

Nabtesco Hybrid knee

As the name suggests, the Nabtesco Hybrid Knee is a new type of prosthetic knee joint. It utilizes a combination of a hydraulic damper and the unique Nabtesco MRS (Mechanism and Reaction Force Sensing) system to enable stance phase control and microprocessor-controlled pneumatic pressure for swing phase control, which enables the joint to respond flexibly to all kinds of movement and changes in cadence.

Many wearers of prosthetic limbs experience anxiety in that the knee might bend while the leg is upright or during heel strike when walking, or that the limb may be slow to come into motion during the swing phase. The Nabtesco Hybrid Knee alleviates this problem and is the most economical bionic knee available on the market. It is also the most preferred bionic knee among patients and medical aids alike.

Rheo Knee®

The redesigned Rheo Knee® by Ossur, is a smart prosthetic knee system that was developed following the introduction of Otto Bock’s C-Leg®. Made in Iceland, the Rheo Knee® follows the same computerized principles as the C-Leg®, but, uses different mechanical technology in that it contains a microprocessor that monitors the wearer’s walking style and type of ground being walked on. It also learns and remembers any changes to the wearer’s walking habits. The Rheo Knee® is incredibly responsive in that it completely frees the wearer from anxiety with respect to its performance.


  • The Rheo Knee® continuously recognises, learns and responds to individual walking styles and keeps pace with changes in speed, load and terrain.

  • Walking effort is reduced to a minimum and motion is much smoother and more natural.

  • Disturbances in the walking path are automatically recognised and stance support instantly activated to protect the user from a potential stumble and fall.

  • The Rheo Knee® system is highly efficient in that only a small, rechargeable battery that lasts up to 48 hours is required to ensure effective operation. In order to preserve battery life, the system can also be switched off when not in use.

Power Knee

Power Knee is the only prosthetic knee joint that is motor powered. It provides active motion and superior power stance stability to replace lost muscle function.


  • Power Knee enables powered extension when standing up, controlled resistance when descending and active flexion and extension during walking and facilitates symmetrical weight distribution and natural gait.

  • Users with a greater degree of functional loss as well as those who are highly active maintain that Power Knee goes a long way towards enabling them to go further by restoring their capacity for endurance.

  • It has been demonstrated that Power Knee significantly reduces rehabilitation time for new trans femoral amputees.

  • The PowerLogic Workbench software inherent in the Power Knee system enables prosthetists and physical therapists to provide patients with visual feedback during training and to log and report on user performance and prosthetic use)

Mauch® Knee

People who demand more out of life need a prosthetic knee that will keep pace with their aspirations. The Mauch® Knee is as versatile and efficient as its users.


  • The cylinder attachment delivers a lower tolerance environment.

  • State-of-the-art bearings contribute to smoother motion and increased durability.

  • Protected by rubber covers at the front as well as the back, the aluminium frame combines strength with an attractive design.

  • Extension stops added to the frame prevent hyper-extension thereby increasing the lifespan of the cylinder.

Total Knee® 2100 

Strong and durable, the Total Knee® 2100 is designed for general use by larger and more active adults.


  • Increased knee stability in early stance.

  • Adjustable stance flexion.

  • Natural, energy efficient gait.

  • Increased toe clearance during swing.

  • Reduces excessive heel rise and promotes knee extension.

  • 3-phase hydraulic swing control accommodates changes in walking speed.

  • Low build height is useful for long limbs or knee disarticulation.

3R60 EBS Knee

EBS’ stands for ‘Ergonomically Balanced Stride’. The patented, unique construction of the 3R60 EBS Knee Joint, which has proven itself over and again, has been further improved and upgraded to the new generation 3R60 Knee Joint.


  • The 3R60 EBS Knee is significantly closer to the physiological gait pattern.

  • With optimized swing phase hydraulics, the 3R60 EBS Knee is smaller and lighter.

  • The 3R60 EBS Knee is suitable for all amputation levels as well as mobility levels 2 and 3

Prosthetic services

From surgery to rehabilitation to the fitting of your prosthesis – The journey: part 2 – Learning about prosthetic limbs and their technicalities

Modern prosthetics work so effectively nowadays and look so convincing that often, you may not be able to detect that one is being worn.  Those with prosthetic legs can often walk, run and even swim as though they were using natural limbs.   Nowadays, prosthetic technologies are available that enable the wearer of prosthetic arm and hands to have individual control of all five fingers.

Prosthetic limbs rank high among the world’s greatest inventions and provide a great boosting in terms of optimism and independence – key factors in dramatically improving quality of life.

What do prosthetics involve?

Prosthetics, also known as artificial limbs, are an artificially constructed substitute for a limb that could have been lost through either a congenital condition which is present at birth, illness, wartime injury or accident.

A cosmesis has little function and is worn for prosthetic reasons

A type of prosthetic known as a cosmesis is designed purely for cosmetic reasons and has little or no function.  Artificial hands often fall into this category.

Other prosthetics are highly functional and have little or no cosmetic value, which artificial legs designed to be covered by trousers are a typical example and are often little more than metal rods and wires.

Types of prostheses

Any part of the body, from the ear or nose to the finger or toe could be replaced by a prosthesis in theory.  However, in practice there are four common types of prosthetic limbs that are designed to replace either a partial or complete loss of an arm or leg.

  • A below the knee, also known as a BK or transtibial prosthetic consists of a prosthetic lower leg which is attached to an intact upper leg.
  • An above the knee, also known as a AK or tranfemoral prosthetic consists of a prosthetic lower and upper leg which includes a prosthetic knee,
  • A below the elbow, also known as a BE or transradial prosthetic consists of a prosthetic forearm.
  • An above the elbow, also known as a transhunmeral prosthetic consists of a prosthetic lower and upper arm which includes a prosthetic elbow.
  • Above the knee (AK, transfemoral): A prosthetic lower and upper leg, including a prosthetic knee.
  • Below the elbow (BE, transradial): A prosthetic forearm.
  • Above the elbow (AE, transhumeral): A prosthetic lower and upper arm, including a prosthetic elbow.

At Roger Wolfson and Associates we firmly believe that the more you know about what goes on behind the scenes with prosthetics, the better equipped you will be to get the best out of your new limb.  Give Roger a call on (011) 640 7198 and send an email to

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Prosthetic services

From surgery to rehabilitation to the fitting of your prosthesis – the journey: part 1

The aim of this two-part article is to offer a concise overview of your journey towards your ultimate goal of a successful prosthetic outcome – that is, to restore your mobility.

So that you can lead an active and normal life, your therapy team, which includes doctors, therapists your prosthetist and not to mention you and your loved ones, will all band together to help you achieve independence.

An average indication is that the rehabilitation process can take anything from two to six months.  The length of time this process takes can vary considerably taking various factors into account such as how well your prosthesis fits and your own levels of motivation.

The information that follows outlines a number of helpful suggestions to aid your rehabilitation and recovery.  However, it should be borne in mind that the instructions you receive from those on your rehabilitation team should take priority since it is those individuals who are best qualified to evaluate your individual situation.

Whether you have recently found out about your amputation or have known for a length of time, it is important to always remember that you are not alone.  Your physicians are there to offer support, answer your questions and find you the solutions that will work best for you.

Pre-surgical examinations and discussions

If you are to undergo a planned amputation surgical procedure, you will be examined several times in great detail prior to surgery.  Your doctors will explain what takes place during surgery and what will take place after the operation has been performed.

In the case of a traumatic accident, such conversations will happen post-surgery.

You have the opportunity to ask any questions that are important to you during these discussions and it is a good idea to note down anything that you may wish to ask your doctor prior to these discussions.  Always remember that it is the task of the physician to clearly explain things clearly.

Preparation in advance

Talk to your prosthetist about the types of prostheses available and what is best suited to you

It is of critical importance that you talk to your prosthetist about the types of prostheses available and what is best suited to you in terms of your lifestyle needs.


If at all possible, it is a good idea to begin therapy exercises that you will use after the amputation surgery before your surgery takes place.  This will enable you to strengthen your muscles in advance.  It is also a good idea to practice moving properly from the bed to the wheelchair.  This advance preparation can make the time after the operation a lot easier on you.  Of course, your medical team are there to guide when it comes to the exercises most suitable for you.

Counselling and psychological support

Undergoing an amputation represents a big change in your life and it is always helpful to seek counselling and psychological support which can greatly assist you in working through any issues or fears you may have, while taking the weight off of yourself as well as your friends and family.

Engaging with other amputees

We strongly recommend that you engaging with other amputees who have also undergone amputation surgery.  Others will offer their opinions and advice and will be able to share tips on everything to do with using your new prosthesis.

At Roger Wolfson and Associates we are here to answer your questions and put you in touch with those that offer support in numerous ways.  Call us on (011) 640 7198 or drop Roger a mail at

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Articles/Case Studies

3 important questions you should ask prior to undergoing a lower limb amputation

Statistics show that for every 1000 people in South Africa there are approximately 1.5 amputees.

The main reasons behind why and how amputations occur include:

  • Vascular disease which covers diabetes and peripheral arterial diseases
  • Cancer
  • Trauma

In this article we address three important questions you should consider prior to undergoing a lower limb amputation which can be either below the knee (trans tibial) or above the knee (trans femoral).


  • At one point should I consult with a prosthetist?


To ensure optimal prosthetic outcomes, it is critical that you consult with a prosthetist prior to undergoing surgery.

The process begins with an overall evaluation of your mobility and lifestyle expectations as well as an analysis of the various details involved in your condition as well as the nature of the upcoming surgery.

A number of surgeons see this process as invaluable especially in determining whether certain surgical techniques should be used that could enhance desired outcomes post-surgery.

Detailed knowledge and understanding of the specifics involved in your situation greatly assist the prosthetist to fabricate and fit a prosthetic that will work best for you.


  • How do I prepare for the initial prosthesis fitting


The time it takes before a prosthesis can be worn varies from person to person, and can also depend upon the nature of the surgery as well as your own unique circumstances and can even be influenced by surgical techniques such as Immediate Post-Prosthesis (IPOP).

Your surgeon, your prosthetist and your physical therapist all play very important roles in your rehabilitation. Your residual limb is bandaged and treated immediately post-surgery in order for your surgical wound to effectively heal. It is crucial that you follow the recommendations of all professionals involved in your recovery.

Taking the appropriate time to heal and wear compression stockings to decrease the swelling are both key factors in preparing you for your initial prosthesis fitting.


  • What takes place during physical therapy in the prosthesis fitting process?


Post-operative physical therapy ensures that you retain the function of your residual limb and prepare the area for your temporary and then your definitive prosthesis. Physical therapy is important in maintaining and expanding mobility and activity levels during the prosthesis fitting process.


Maintaining a positive mental attitude is vital to successful recovery

The role of maintaining a positive mental attitude cannot be underestimated in successful recovery and it is not uncommon for a patient to discover that they have greater mobility once accustomed to a new prosthesis as opposed to living with an unhealthy limb prior to surgery.


If you would like to know more about what to do prior to undergoing surgery for an amputation or need to ask Roger a question call us on (011) 640 7198 or drop us an email at





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