You may have seen the special on ABC’s Primetime Thursday that showed injured soldiers coming home from Iraq and Afghanistan being fit with the computer controlled CLeg®. While many soldiers are receiving these high-tech prostheses, it is important to set guidelines for other potential candidates.

Walter Reed Army Medical Center recently hosted a forum sponsored by the American Academy of Orthotists and Prosthetists to establish clinical protocols and procedures for microprocessor (computer controlled) knees in the treatment of individuals with a transfemoral, or knee disarticulation amputation. Microprocessor knees work by sensing the angle of the knee, the speed of the knee, sensing the amount of body weight and sensing the amount of weight in the toe.

The c leg ® samples these criteria 50 times a second. Based upon that criteria it will then adjust the amount of resistance provided to the knee. It can do this virtually instantaneously, since it is sampling 50 times a second. The reason this is so beneficial is because the knee can change speeds when the amputee changes speeds. It will immediately lock if it senses the person is going to fall, and it provides maximum resistance so a person can walk foot over foot down a ramp or stairs. The knee essentially does the “thinking” for a person so he/she has the confidence to have a normal gait without worrying about whether or not the knee is going to buckle. In a conventional knee, the knee must go through one cycle before it can sense and then change the resistance it provides a person.

The C-Leg® is not an experimental product or a luxury, it does not just simply make these claims, it does provide a more stable gait which translates into more confidence, fewer falls, easier manipulation of stairs and uneven terrain, and less energy expenditure. It is however, very expensive. It is the only knee like it on the market.

The cleg, in my opinion, is the future of prosthetics. Here are the requirements set forth by the Veterans Administration Hospital for potential c leg wearers: You must have an adequate cardiovascular reserve to be able to walk at a higher speed. In other words, your cardiovascular reserve cannot be the reason you do not walk at a faster pace. You must have some aptitude to understand the higher level of technology. You must be able to walk at a baseline (normal) speed, and then be able to increase that speed to a faster than normal speed using a conventional knee. You must be able to walk greater distances than 400 yards on a daily basis for specific activities other than for home or basic community ambulating. You must demonstrate the need for regular ambulation on uneven terrain or for regular use on stairs. If you meet these requirements you are probably a candidate and could benefit from the C-Leg®.

- Jason Kahle, CPO, Westcoast Brace & Limb, Tampa, Florida