Client Case Study – Knee Instability and Foot Drop

Every now and then we see a client that presents with significant difficulty, whether it be a congenital or acquired condition. The results can be extraordinary when the client is fit with a device that assists in decreasing pain or increasing mobility. We decided to conduct a case study on one of our clients who came to our office with an acquired condition that required a high level of attention to detail, see the outcome below.
This patient was seen in our clinic due to a previous trauma that caused instability of the lateral collateral ligament (LCL) and posterior cruciate ligament (PCL). The trauma at the knee also damaged the nerve responsible for lifting the toes up, resulting in a drop foot.
A hybrid knee ankle foot orthosis (KAFO) was fabricated to mimic the PCL, support the LCL and assist in picking up the foot. The knee section is a custom PCL brace made by Ossur that was altered to allow for a streamlined attachment to the custom AFO. The custom AFO was made at Niagara P&O and is completely made from carbon fiber.
Outcome:
The patient displayed significant changes to his gait.  A reduction in plantarflexion allowed for adequate foot clearance through swing.  Reductions in external rotation of the knee,varus of the knee, knee flexion angle at midswing, and lateral trunk lean became less evident when wearing the orthosis. With these changes, we expect the patient’s energy conservation to have improved significantly as well.

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