Academy Meeting in San Diego
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This year's Academy Annual Meeting was very well attended and featured an almost overwhelming series of concurrent scientific and business related presentations, in addition to the traditional table-top exhibits, which filled rooms on two different levels. The field has grown to the point that it is now impossible for any one person to attend all of the scientific sessions and nearly impossible to visit every exhibitor!
Stance Control Orthosis Interest Continues
There was really no "major buzz" this year, but the number of exhibitors continues to grow and the technical choices increase each year. Certainly Stance Control Orthoses [SCOs] continue to generate keen interest as more and more successfully fittings are being reported nationwide. For example, Hortons Technology has Qualified over 500 Certified Orthotists nationwide to use their Stance Control Orthotic Knee Joints [SCOKJ®], so this technology is now available in almost every state in the Union.
The Academy sponsored an afternoon Symposium featuring all currently available SCOs, and the room was full of interested orthotists. Each of the manufacturers presented a brief overview of their particular approach to SCOs, and then participated in a panel discussion. It was clear from the questions the audience asked that more and more orthotists are interested in understanding the key differences between the advanced knee joints that have recently become available.
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The Academy is hosting an Advanced Training Seminar in Chicago from September 18-20th to meet this need. At the end of the three-day course, attendees will have completed the training programs for all of the mechanical SCOs presently available, as well as Becker's innovative electronic SCO. The finale to this ATS will be an interactive session between the participants and the lecturers creating a matrix summarizing the indications, contraindications, advantages, and disadvantages of each of the advanced knee joints. Additional information will be posted at www.oandp.org.
Low Temperature Thermoplastic Casting Cones
One of the niftiest new products I saw in the exhibit hall was the ClearForm ™ casting cones. Over the decades, I have often used low temp plastics to cast pediatric patients, particular infants with transradial absences, because the material hardens faster than plaster and the resulting "cast" can be quickly trimmed with scissors to serve as an preliminary test socket.
Replacement Arts Designs has taken this idea one step further by creating pre-shaped cones from low temp plastic. The material softens at 150 degrees Fahrenheit, using either warm water or an oven. [An old 42 cup coffee maker makes an excellent hydrocollator.]
The inside of the cone is lubricated with petroleum jelly prior to immersion in the hot water, with additional lubrication applied to the patient's residual limb. Within a minute or two, the cone turns clear and can be slid onto the residuum and hand molded. Local areas can be hardened with a spritz of cold water, or with a small fan.
Once the cone is cloudy, it can be removed and allowed to cool fully. It can then be filled with plaster of Paris to make a positive model, or trimmed and used as a static test socket. Optionally, the cones can be sanitized with a spray disinfectant and used over and over again. For additional information, go to www.duplicone.com.
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New Vertical Shock Dynamic Response Foot
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Upstart company Freedom Innovations debuted a very clever approach to creating a shock absorbing dynamic response foot at the Academy meeting. Functionally similar to the Ohio Willow Wood "Pathfinder", the "Renegade" includes an anterior spring keel, sole plate, and posterior shock module. Unlike the "Pathfinder", which uses an air spring, the "Renegade" uses a carbon fiber spring to absorb shock, much like the OSSUR "Re-Flex" that originated this category of ankle-foot systems.
I was concerned that this design might not perform as well on slopes and declines as alternative VS-DR feet, but I spoke with several amputees including one bilateral gentleman who all assured me that my fears were unfounded. I saw a number of amputees try the "Renegade" in San Diego, and their responses were uniformly enthusiastic. Most were able to walk and run on it readily, and reported a good combination of comfort and dynamic response.
Like the other FI feet, the "Renegade" seems to be slightly softer than alternatives during normal walking, yet stiffer and more propulsive at higher cadences. The patients I spoke with all liked this performance characteristic compared to other high performance foot systems they had tried.
New Dynamic Response Foot with Adjustable Heel Height
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OSSUR debuted the "Elation", which looks like an improved version of the Total Ankle that they acquired from John Stonecipher a few years ago, now integrated with a nice-looking carbon fiber dynamic response foot. Since the demise of the MasterStep, this combination of an articulated ankle with adjustable heel height and a dynamic response keel has not been available in the United States.
Although it is limited to low and moderate impact levels, the "Elation" looks like a good addition to our armamentarium, and it should fill a need for many of the patients who want to vary their heel height without the hassle of changing feet.