A new biomechanical method for determination of static prosthetic alignment S. Standing posture and static alignment of 18 experienced trans-tibial prosthetic users with good walking ability were determined and compared with 20 healthy persons. The individual load line was defined by means of the new Otto Bock alignment system "L. The sagittal standing posture of trans-tibial amputees and non-amputees differs. Normally only a prosthesis worn by the trans-tibial amputee and dynamically aligned over an extended period of time satisfies biomechanical rules of alignment. In contrast, prostheses aligned during one session in the traditional subjective manner seem to lack any recognizable biomechanical systematics.
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Here are the resposes I received. Thanks to all that responded. More responses would be appreciated for further insight. We find it to be more dynamic thansimply using a plumb bob although the plumb bob has its uses too as alow cost and effective tool to estimate the line of gravity. We havefound use of the LASAR posture device effective in demonstrating tostudents the alignment of the lower limb joints in relation to changesin stance phase.
We are getting the sales pitch and currently considering this purchase too. L modular prosthesis in the lateral plane. Every L. Due to this introduction, it is really important the load line location with respect to the joint centers always on the lateral plane such as knee or ankle joint for a transfemoral prosthesis. LASAR traces the real objective load line on the prosthetic limb of your patient so that you can verify and eventually adjust the device alignment 4 screws modules according to the joints manuals.
If you are using a hydraulic knee with a unit that controls both stance and swing phase and, by means of LASAR posture, discover the load line passes in front of the knee center patient is standing , the joint will not work correctly. This stretches the hydraulic rod and in a short period could damage the knee frame.
All the time you observe hyper extension during stance the hyd. In this case a cheaper joint could be fitted i. Remind that an excessive extension torque during stance involves excessive contact forces between stump and socket. I saw several prostheses fitted with C-leg too working in this way! LASAR is a good and simple method to avoid that. There is a limit to this method: if a bad mistake has been done to locate the proximal connector i.
In this case you should use an alignment device to correct the problem and LASAR for the feedback, in order to evaluate the functional response. Finally there are some cases you are adjusting to find a right alignment i. This means your patient usually this happens with amputees used to walk with no stance control knees, so that they do want to feel the device in full extension for their safety is extending the hip muscles.
Only your experience or a gait analysis lab can help you in this case. In this case also a gait analysis lab is needed for feedback. Biggest waste of money I have ever made! We were aligning C-legs without it for the first couple.
It was taking a lot of trial and error to dial in the positioning a-p of the socket for optimal alignment. When ours arrived, I was aligning a knee disarticulation, and had already gunked and broken loose the socket a couple of times. Put him on the lasar, showed how much needed shifting, and it worked out great.
It really has helped for C-leg aligning.
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