Amputee Treatment Center Forum

OPINIONS REGARDING PROSTHETICS => In my opinion => Topic started by: Sharkattack on March 03, 2008, 01:41:40 AM

Title: Knees
Post by: Sharkattack on March 03, 2008, 01:41:40 AM
 I'm so glad I found this place. I'm a fairly new AK amputee and I'm about to get my leg here in the near future but I know nothing about knees.  I think Tigercat has a great Idea about posting what people have used and like, since I know absolutely nothing about knees other than the few things I've seen people say.  I was told the C-Leg is what I should get but I would really like to know what other people have used and what they like best before I make that kind of decision. Is it true that a leg might cost me up to 100,000 dollars? if so I would really like to make the right decision the first time and who better to help me make that decision than people who have used these things. OK I guess I'll just do this

Q--- What knees have people used and which ones do you like best?
Title: Re: Knees
Post by: Oneblueleg on March 03, 2008, 05:46:17 AM
Tigertatt's going to hate me for this but hey, I can take it.
This really is not the best way to find out about knees. It may help to ask people's opinions, but everyone is an individual, has different needs, different restrictions and requirements. What is ideal for one will quite possibly be anything but ideal for another. Just because I like something, won't necessarily have any bearing on what will be right for you.
You are about to go on a voyage of discovery and the best place to start if you don't trust your prosthetist and care team when they prescribe something for you, is to find some literature on the subject of knees. They are many and varied, too much to include here, stabilizing, free knees, pneumatic control, hydraulic, combinations of both, four bar/multilink mechanisms, electronically controlled etc. etc.
Good luck in your quest. I honestly believe that my experience is not valid to you without understanding our differences/similarities, so I won't bother you with them.
Title: Re: Knees
Post by: pegleg jack on March 03, 2008, 10:27:26 AM
sharkattack, i am not a AKA, But have talked to a lot of army vets and if you are highly active, they say stay away from it for it does not hold up that good, got ithis infromation when iwas at the VA hospital in Temple, TEXAS having my ears checked out, most of them preferred the RHEO KNEE, and said that it was holding up better for them,

I am a bilaterial BKA my self  and am just passing on what i was told while talking to a couple of bilaterial AKA'S that wear there getting some medical work done.

P.S. That was the C-LEG that we were talking about.
Title: Re: Knees
Post by: pyourke on March 03, 2008, 07:17:43 PM
Hi sharkattack
Recognizing Oneblueleg's proviso, I can only speak to myself. I'm a BAK and have been so for 34 years. I haven't tried a C leg and don't think that it would be appropriate for a 64 year old amputee. I've used two types of knee units. First a pneumatic unit that was very basic and not very good, but that was 34 years ago. After my first two sets, that I had made at the same time (one for black and one for brown shoes!) I got my first Mauch knee units with variable speed, stance control and stumble recovery. Being a bilateral AK, the stumble recovery was the best thing that I'd ever experienced. As most amputees, let alone bilateral amputees, falling can be a common problem. The stumble recovery has saved me too many times to count. I likely have only 1 or 2 actual falls a year and that is from my canes slipping on ice, water or some slippery surface. I have requested this knee every time. If I was starting over again, I think that I'd be tempted to try C Legs, but the cost would likely not be affordable. In Canada, C Legs can cost $60,000. ea, vs the $10,000. that my carbon fibre / titanium endoskeletal / with 4 way ankles & Greisinger feet cost per leg. Fortunately our government health plan covered 52% of the legs I chose. I've only talked to a couple of people with C Legs and they seem to have more problems with repairs than I do. Actually, I seldom require repairs. The last set required some re lamination on the fibreglas sockets towards the end of their life. I've had 3 or 4 sets of Mauch knees and never had a problem with any of them.
Title: Re: Knees
Post by: jmoore on March 03, 2008, 09:21:31 PM
hi sharkattack like obl said each person has different needs with there socket, knee and feet, and ankle i like my toque adapter  some people do not. i started with a 3r60 knee it worked great for me on flat ground but i live on a mountain so it did not suit my needs when i tried to walk down my hill so i worked my butt off for the VA to get my c-leg i love it i can do what i want in it, i use a mas socket i feel it is part of my body but i like a tight fitting socket to me it feels more me when my mas gets lose i hate it and have to have it tighten up. to me  the problem is that these company's only let you try these knees for a couple hours and your suppose to make a decision in that short a mount of time i feel they should have loaners so you can try them for a week and i am talking about the micro processor knees especially when you are about to spend 30 to 50 grand on a knee well good luck sorry for the long answer
Title: Re: Knees
Post by: herb on March 03, 2008, 10:33:01 PM
Hi Sharkattack - I have used the c-leg for a little over 5 years and have been very happy with it. It cost $40k with a new socket. It has been extremely dependable and I have used it very hard. i can pick up 100 pounds and walk with safety. I live on a farm and do hard physical work every day. I plan to replace my c-leg with an agility knee leg within the year. I learned to walk with the mauch knee which I also thought was great. I still use a leg with the mauch knee when I expect to get wet. The mauch knee cost less than half as much. Herb
Title: Re: Knees
Post by: King Rocky on March 07, 2008, 06:25:29 AM
Well, I'm an above knee amputee and used the 3R60 for 20 months ... and it didn't help me.  I'm not even sure why OttoBock keeps manufacturing those!  Sorry, but I paid a lot of money (when insurance doesn't cover that in India) ... and it's useless.  I developed a walking pattern which affected my good knee, as it wouldn't give me any stance control -- though they claim it does! 
I now have a 3R80 (which is cheaper than a 3R60) ... and it does what the C-Leg does?  Only difference, C-Leg is micro chip controlled, whereas 3R80 is Pneumatic / Mechanical.   So, it's not real-time adjustments ... but it does support the body weight and I can descend stairs by just holding on to the railings like a normal person (well, sort of!).

C-Leg, I know is quite expensive - it costs nearly 42.5K$US in India with a new socket.  But I am told the recurring maintenance cost (after the 1st 2 years) is about 2kUS$ or close to that ... which is costly.
I even know of someone who was stranded at the airport in S'pore once because the microprocessor failed and his knee was locked.
Now, that's a possibility with a C-Leg ... mechanical joints don't do that instantly - it's a gradual process.
I have heard good things about Rheo Knee and Mauch ... no complaints from any of the users.  I believe Rheo knee also helps one to ascend stairs like a normal person, rather than dragging with the good leg up first ..

King Rocky
aka Jan '06
Title: Re: Knees
Post by: herb on March 07, 2008, 10:56:40 AM
Hi Rocky - I have used my c-leg for 5.5 years and have not spent one penny on it. One time when I was traveling the airline lost my luggage for a week and I could not charge it. i wasn't stranded when the battery died. It is just a little harder to walk on it. It is designed to fail in a safe mode. Even if the knee locked up, you could still walk on it like walking on a pegleg. I use the second mode on my c-leg to put it in the locked stance which helps me when I am working on steep hills and do not want the knee to bend. Herb
Title: Re: Knees
Post by: King Rocky on March 12, 2008, 06:14:37 AM
Sure Herb ... but it's just that when you pay so much upfront, you expect it to work like the way you describe it. 
But having heard people struggling with it ... makes me think twice.
Not that I have the money and I want to get it right away ... but surely, in the future ... would love to have one. 
I understand what you mean by walking 'pegleg'.
Again, once you are used to the comfort of walking freely, you don't want to be doing that --- but in an emergency, anything goes I guess!

Did you say you walk on steep hills?  Is that difficult?  Do you have to drag with your good leg up first?  How about descending down the steep hill?

King Rocky
Title: Re: Knees
Post by: herb on March 13, 2008, 03:44:20 PM
Hi King Rocky - I live in New Hampshire in the white mountain area. I walk on steep hills every day. The c- leg is no help going up the hills but it is a big help going downhill. You can ride down on the hydraulics.  Going up a moderate hill you can lead with your prosthetic leg but the steeper the hill, the more difficult that is. Herb
Title: Re: Knees
Post by: herb on March 13, 2008, 03:53:45 PM
Hi Teo - One of the prosthetists that works on my legs uses the Plie knee.He is very happy with it and walks very well on it. The first time I saw him walking, I did not immediately notice that he was wearing a prosthesis because he was walking so naturally.  He previously used the c-leg and now prefers the Plie knee. He especially likes that he can get it wet when he goes boating. It is also cheaper than the c-leg. I am eager to get one, but will wait till my c-leg dies. Herb
Title: Re: Knees
Post by: Jeff Jester on March 14, 2008, 10:59:23 AM
I believe one should use a hydraulic knee first -  Catech - Mauch - etc. One reason is to check the if it would be viable to use a processing knee. Example myself, I have never had a hydraulic knee that lasted really more then a year with out developing problems. In the 13+ years as an AKA, I have used 6 legs with hydraulic knees and have replaced or had repaired the hydraulic cylinders in these legs a total of 15 times. The last leg I had made 2 years ago (Endolite Catech) I had them include two extra cylinders as spares of which I have now installed the second spare one in to it. I always have two legs that I wear alternatively. One with a foam cover to protect my pants and one without to wear with shorts. Being highly mobile and active is the reason for the wear on these cylinders. I took a count of stairs I go up and down on an average day at work and it was around 2000 steps daily. Therefore with this kind of wear and tear it would make no sense for me to invest in a processor knee, and the fact that I live in a third world country where it is an extreme logistical problem to get something sent away for repairs. I found that most these knees are quite good for walking and have probably only fallen a dozen times in all this time with alcohol to blame for probably half of that. Oh and by the way Rocky, I have had one knee lock in the straight position for what ever reason so it can happen. I was up country and had to walk with a stiff leg for two days until I reached home. By the way I am not complaining as I have always been happy with the way my legs have fitted and worked. That's my two cents on that.
Regards Jeff
Title: Re: Knees
Post by: Robogirl on March 14, 2008, 11:49:41 AM

I am currently wearing the Plie' knee and love it.  Before that I had a C-leg for almost six years.    I'd recommend either one of them.  Which one is right for you is a personal decision.  It's best to get all the info you can on what the knees do, figure out which ones meet your needs, and then try them out if you can.    In my experience, for maximum stability, and if you want a leg that you can lock in one position (something important to bikers, rollerbladers), then the C-leg is a good choice.  I happen to prefer the Plie' knee as I feel it is less controlling, and allows for a smoother and more natural gait, is lighter, AND water resistant while still providing stance and stumble recovery.  And there are other microprocessors on the market that I can't comment on because I haven't tried them, but I'd urge you to check them out as well.  It's really important to figure out which one is best for your lifestyle.  Just because your prosthetist or someone on this forum prefers or has "heard" that one is better than another doesn't mean it's the best for you.  Don't get caught up in the hype that some people create about what is the "best" knee on the market right now.  Actually, the "best" thing is that there are more choices now, and a better chance to find something that suits you.

If an amputee is fit with a microprocessor knee from the beginning they have less fear of falling and can learn to utilitize and trust the stance and stumble control features.  I lost my leg at a young age and learned all kinds of bad habits and "tricks" to keep me from falling, but as a result developed a horrible gait.  It wasn't until I started walking on a microprocessor knee and didn't have to think about every step I took that I was able to concentrate on my gait and correct it.  Also, a note - the C-leg will not ever lock stiff, it goes into a safe mode where it is harder to bend, but you can still walk and sit down.   :)

 I haven't ever blown out hydraulic cylinders, but I have heard that the Mauch has been redesigned to address that problem.  Apparently when people were running (or climbing hundreds of stairs on a daily basis, as in Jeff's case) there was no "stop" to protect the cylinder.  I know a guy (a runner) who used to have to replace his every few months because of that problem, and he has had no trouble since the redesign last year.   

Hope I've been of some help to you!

Title: Re: Knees
Post by: King Rocky on March 19, 2008, 04:47:30 AM
By the way, how much does the Plie' or the Agility knee cost?  And what is the life-span?  Any warranties?
Title: Re: Knees
Post by: Robogirl on March 29, 2008, 10:04:50 AM
Hi, Rocky

I don't know what it's lifespan is, since it's a new product.  I guess that's one of the things to consider when choosing.  But, I do know that Freedom provides a 3 year warranty with regular "check ups", and will send you a loaner.  As far as exact cost, you'd have to ask your CP, but it is less than the C-leg.

Hopefully once there are more out in the field, some prosthetists will be able to buy one for their office that patients can trial and make an educated decision.  Or maybe Freedom will bring test knees out to the prosthetic offices so patients can try them (I did that with the Rheo knee). 

Title: Re: Knees
Post by: Myffanwy on June 05, 2008, 05:02:28 AM
Hi: Is there a particular foot that works best with the Plie knee?  I'm considering getting one of these knees, but have never used microprocessor technology...or anything even close to this level of sophistication!  But I've been falling a lot (RAK for 50+ years) and my prosthetist thinks it will be safer.

So the Plie needs servicing every six months, is that right?  And can it be used with a cosmetic cover?

Thanks!  Myffanwy   :)
Title: Re: Knees
Post by: pegleg jack on June 05, 2008, 08:27:43 AM
this is old PEGLEG, putting a dasher on the knee, you may want to check and make sure if you use a differant foot than what they manufacture the warranty my not be any good. I know OTTO BAUK is that way on thiere C-leg.
Title: Re: Knees
Post by: Robogirl on June 05, 2008, 10:21:39 AM
Hi, Myffany

You can wear any foot you want with the Plie' knee, but I wear the Freedom Runway (adjustable heel foot).  It's the most natural walking foot I've worn with a good amount of energy. But everyone is different, so I would encourage you to try a few different ones. As for warranty servicing, I believe it's once a year now (12 and 24 months), and they send you a loaner. 
Title: Re: Knees
Post by: pegleg jack on June 05, 2008, 03:26:01 PM
Robogirl, thanks for the update on that knee, did want some one to get it and thier foot and find out that the warranty was no gook.
Title: Re: Knees
Post by: pegleg jack on June 05, 2008, 05:45:55 PM
Hey there sounds like you need to take a baseball bat with you the next time that you have an appointment and do a little attitude adjustment, sounds like this guy is a complete moron when it comes to making sockets, keep after him and make him do it right.
Title: Re: Knees
Post by: Robogirl on June 09, 2008, 01:22:23 PM
Hi, Myffany

I swear I saw another response from you asking me about wearing the Plie' with a cosmetic cover, but my computer went down and now that I'm back online it seems to have disappeared!  ???    Anyway, yes, I wear mine with a full foam cosmetic cover.  It's actually easier to cover than my C-leg was. 

You might talk to your prosthetist about a conference for practitioners that is being held in Canada in a couple weeks.  Freedom Innnovations, who makes the knee, will be there.  I'm sorry I can't give you more info, I just heard that in passing from a sales rep who was in my prosthetist's office since he is attending it. 

I've been on the knee probably longer than anyone, since I beta tested it before it was released.  It's going on 2 years now, and I still love it!  Let me know if you have any more questions.
Title: Re: Knees
Post by: Myffanwy on June 10, 2008, 04:21:32 AM
Thanks, Robogirl.  Um, yeah, I did have another're sharp for noticing it missing.  Thought I said something I shouldn't...maybe deleted too late. 

However, I really appreciate your info re: the Plie.  I am probably moving over to another prosthetist first though: having trouble with socket fitting, but I think I've figured out who to go to, and now it's start over time and the knee will have to wait for the time being.  Gotta get that socket right first!   :)
Title: Re: Knees
Post by: chrysochloridae on June 11, 2008, 07:18:01 PM
Try the Endolite KX06, its an awesome knee thats won loads of design awards, and it has a 3 year warranty on the housing and cylinder!