Rethinking The Knee

It is all up in the air now. Is Tru ready for a fully functioning knee or is it too soon? As is obvious from my last two posts Tru's knee has been giving him some problems and as a result some major bumps and bruises.

The knee component in Tru's prosthesis is meant to bend and spring back into place for his next step just like a natural knee. In order for it to work Tru has to walk with his leg under him and hit the ball of his foot just right to trigger the knee component. He does sometimes trigger it by accident which usually results in a tumble.

Well when Tru began walking with his prosthesis the knee component was locked and he had to swing his leg out to the side slightly in order take the next step. He adapted to that method very quickly. To him that method still works so why change things now? All he knows is that from time to time and without reason (to him) his knee now bends and he falls down and hurts himself.

His physical therapist, Lisa, was able to tighten the knee so that it is much more resistant. At the therapy session she loosens the knee is order to help Tru practice. And there lies another problem. In Tru's mind he can walk. Period. Therefore, he does not want Lisa to try to help him. When she tries to hold his leg/knee/hip to help him walk properly (to trigger the knee) he become very agitated and does all he can to get away from her. Perhaps another sign he is not ready for the knee.

Here are the problems:

He does not understand what triggers the knee.

Our explanations and attempts to demonstrate the knee result in frustration.

Not knowing what triggers the knee causes many falls. (Luckily he is getting better at catching himself rather than landing on his noggin!)


Tru has surpassed everyone expectations with his adapting to the prosthesis and walking. Because he adapted so quickly it was decided he was ready for the knee only 1.5 weeks after first receiving the prosthesis which is unheard of. [A side story - Lisa worked at a children's hospital in New York for 11 years. In that time she worked with many amputees. She told me that Tru is the youngest amputee patient she has worked with and by far the quickest to adapt to a prosthesis.]

Tru's physical therapist, orthopedic surgeon and prosthetist are a little stumped on what to do. Actually come to find out this topic (for children Tru's age) is up in the air throughout the medical field. Until recently the standard was to keep children's prosthetic knees locked until around age seven. Just recently they have changed the "rules" to add the knee whenever the child was ready.

Hmmmmm......

I have thought about it and thought about it some more. I do not want to take away any chance Tru has to progress. He is doing better with the falling and has learned when to slow down so that there is less of a chance of triggering the knee. I have also observed that lately there have been a few times when he unknowingly triggered the knee and he was able to right himself without falling. Progress!

We shall see what the medical professionals have to say...