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Microprocessor knees (MPKs) provide a perfect balance of situational stability and agility for patients. Imagine an old parking lot that slopes and is cluttered with potholes and speed bumps. The simple task of walking to a car across this ramshackle lot can be physically and mentally demanding for users of mechanical knees. Concentration is required for calculating the safest route to take and precise movement is needed to carefully maneuver over obstacles.
But navigating slopes and potholes doesn't have to be a demanding task for patients. Microprocessor knees adapt to the user's gait, so they can easily walk or run over uneven terrain.
What is a Microprocessor Knee?
There are two categories of prosthetic knees: mechanical control knees and microprocessor control knees.
Mechanical knees use friction, hydraulics, pneumatics or a locking mechanism to control the flexion and extension. Mechanical knees can be single axis or polycentric, and may be weight activated or other mechanical controls such as hydraulic or pneumatic. Mechanical knees may not be as responsive as microprocessor knees.
Microprocessor knees have a microprocessor that receives feedback from sensors and other parameters inside the knee joint and/or foot to adjust the knee flexion, extension, and speed to mimic the user's natural gait pattern. The knee's internal computer controls the mechanical mechanism, which can be single axis, pneumatic, or hydraulic. Microprocessor knees can also provide multiple specific user activity modes such as, Standing Support, Adjustable Flexion Locks, and Hiking, Basketball, and Golf modes.
The first commercially available microprocessor knee was Blatchford's Intelligent Prosthesis (IP) Knee, which activated during the swing phase. Several studies inspired by the IP knee discovered metabolic energy expenditure, oxygen rate, and cognitive demand were greatly reduced for users of the IP knee.
In , Ottobock introduced the first microprocessor knee with both swing and stance control: the C-Leg. The innovation improved ambulation on uneven terrain, stairs, and slopes.
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The IP and C-Leg led the way for more microprocessor-controlled knees to develop. Today, patients who use microprocessor knees can safely and easily navigate uneven terrain while expending less mental and physical energy.
For the industry, the microprocessor knees paved the way for better outcome measurements to justify the costs of orthotic and prosthetic care. The industry transitioned from gathering subjective patient-feedback to performing objective-based studies that measured how devices concretely transformed lives. These measurements help clinicians decide on who might benefit the most from certain interventions and identify improvements to the device.
Microprocessor Knee Justification
When considering the justification for prescribing a microprocessor-controlled knee to individuals with transfemoral amputation, it's important to review the patient's insurance coverage criteria carefully. Specific insurance providers may vary, but they generally require the following criteria to be met in order to justify medical necessity:
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