pneumatic vs hydralic knee

[cyclerider]

I am a new amputee and getting my first leg. The insurance company will only pay for a basic leg with a pneumatic knee. I was hoping for a hydraulic knee. I am 51 and work as a nurse. I have fears that I won't be able to walk with a lesser quality leg. Should I try to come up with the $13,000 difference? I'm new to all of this and I have no idea what to do. I need input from experienced AKA's about what to do.

[allenuk]

Hello cyclerider (actually, fellow-cyclerider).

I'm in the UK, where life is different (i.e. free, mainly), and I'm only BKA, so no direct knowledge of AKA problems.

All I can say is that having spent the past 6 years around the fitting room at my local orthopaedic hospital, I've seen AKAs using all sorts of legs, from C-legs (VERY expensive if you had to pay for them) down to fairly 'basic' models. But the point is, that all the amps I've met could WALK, most of them pretty well, with whatever AKA leg they had.

If it's anything like BKA experience, then for the first 6+ months whatever leg you get will be a pain in the bum - then with adjustments, replacements, etc., plus your brain getting used to the new way of living (pretty important part of the process, that is), it will settle down.

My gut feeling is NOT to pay too much at present, mainly because of this prolonged settling-in period, but hopefully AKAs on the site will be able to give you better feedback.


Allen.

[oneblueleg]

Hi cyclerider,
Short answer, NO... not yet…. if ever maybe…
Don't pay the money out... many people are very happy with a pneumatic knee. There are different schools of thought, so take all the advice and make your own mind up.
To summarise, I see it like this:
Some say get the best knee you can from the outset. This doesn't mean the most expensive, this means the best knee for you. This will be decided by your Consultant or Prosthetist. Unfortunately this may (will) be based upon price, but when you get the prescription, ask some questions about what the professional would choose based upon your clinical need, not money. Only then will you have any valuable information.
Your condition, age, size, weight, pre-existing conditions, type of activity you intend indulging in etc. can all have an effect on what would suit you.
Often these people will suggest a hydraulic unit as it will encourage the natural use of your residual musculature, this is good thinking in my view as anything that builds muscle, and therefore support, is good.
Some of the very expensive microprocessor knees may even discourage this muscle development.
The other school of thought is to have a 'lower spec' knee at the outset until everything settles down. As a new amputee you are called a primary patient and may be treated differently as a result by these prescribers. Having said that... who's to say they are wrong?!
A pneumatic knee can be a lot safer, especially for a primary amputee. They can swing freer and be more accommodating to a poor fitting socket.
All this aside, the fit of your socket is the one and only thing of importance if you had to list the elements that go to make up a good limb build. If you had a socket that fitted like a glove, that didn't hurt and felt a real part of you, you could walk on a broomstick with a rubber bung on the end.
If you had a Otto Bock Genium that cost $60k and your socket wasn't comfortable, you will walk like an old man and suffer a miserable life.... and owe plenty of money!

So I would say take all the advice you can find, but don’t think that any one person knows it all. There are too many variables to make general statements about which knee is best. And it certainly isn’t as simple as comparing pneumatic to hydraulic knees.
Also, don’t forget other important elements of your limb build, including the foot and ankle, not to mention the type of suspension used (the way in which the limb is secured to the body).

Good luck with whatever you get. Most importantly, build a good relationship with your Prosthetist, he/she will turn out to be one of the most important people in your life!

[cyclerider]

Thanks for the input. Things are so confusing right now. i just want to walk again and have the least amount of problems. I appreciate the opinions of those who have gone before me.

[ann-]

Hi Cyclerider

Like Allen am not an above knee amputee, but over the years have known a number of a/ks who do walk and get along very well. I know nothing about 'knees' so can't recommend, but would support what the others have said to you and would think the most important thing is getting the fit of the socket correct, along with good alignment. In the first few year or so you will be shrinking down size quite rapidly and have many changes so if it was me, I wouldn't be paying out unnecessary money to begin with before you really know what you are going to need longer term.

I notice nowadays that a lot of emphasis is put on certain 'kits' but whatever type of prosthesis or components you get the leg doesn't walk for you, you will have to put the input also, altho there is no doubt that certain components can help some people longer term.
Good luck with everything, it will all become more normal and less confusing as time goes by.

[stinker373]

I would imagine you belong to a union, so they should be able to help you with information. Sounds to me like they are trying to get away cheap. So demand to try other knees and be sure ur doctors papers are filled accordingly.

[Deleted]

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