Posted on 12th December 2017
Since the NHS England Clinical Commissioning Policy for microprocessor controlled knees came into place it has meant MPK’s can be prescribed to patients at specialist rehabilitation centres giving Prosthetists the opportunity to prescribe amputees with the best solutions the market has to offer.
So far, in all of the NHS limb centres across England combined, over 200 qualifying amputees have been assessed for a micro-processor controlled knee joint. With all of these patients having been vetted against the commissioning policy, the number of patients that have rejected the chance to transfer onto this life-changing equipment has been very low.
Access to microprocessor-controlled knees continues to be hugely beneficial to those suffering with above knee, knee disarticulation and hip disarticulation amputations, particularly what are referred to as K3 walkers. These are patients that are able to walk outside at a range of walking speeds and traverse obstacles. These users face both the potential of injury caused by falls and long term health issues associated with uneven weight distribution caused by lack of confidence with their current devices. Use of the old systems available on the NHS meant amputees often struggled to even stand still comfortably as their knees have limited stability. A lack of trust in their prosthetic limb often means that the user will shift 80% of their weight on to the none-amputated limb. This has a detrimental effect on other joints. Users of microprocessor-controlled knees also therefore benefit from stability on different terrains, slopes and steps, as well as being able to walk more naturally and efficiently at either single or varying speeds.
One of the leading examples of such a knee joint would be Blatchford’s Orion 3. This knee adapts hydraulic resistance in real time, providing the wearer with support when moving in any environment or standing still. For example, while standing still, the Orion 3 will lock allowing the issue of uneven weight bearing mentioned above to be significantly reduced. Along with this, it also has stumble recovery technology, ensuring that the knee remains stable should the user trip or falter. This further reduces the risk of amputees falling or injuring themselves when walking or changing environments, and is another feature that provides users with the confidence and stability needed to move without fear. Such benefits not only make a huge difference to patient safety and quality of life; they also reduce the lifelong care needs of amputees. Prevention of falls was one of the key drivers for the NHS in creating this new policy – reducing the chances of acute injuries – but effective stabilisation can also cut the knock-on medical problems often experienced by amputees with conventional prosthesis and joints, such as lower-back pain, arthritis and hip replacements. If patients wearing microprocessor-controlled limbs are less likely to injure themselves thanks to the advanced technology, this has the potential to reduce costs and waiting times at clinics. If fewer amputees have to visit GPs or hospital wards due to prosthetic issues or injuries, NHS time and money can be spent on other areas.
The decision to make microprocessor knees more readily available to NHS patients in much larger numbers will act as a catalyst to accelerate the development of even more advanced technologies to improve patients’ lives further. Already the larger volume of users having access to the technology has encouraged Blatchford to offer hydraulic ankle technology into the clinical offering at no extra cost.
The use of hydraulics in the ankle provides proven benefits to the wearer including efficient roll-over, for optimal alignment, greater clearance of the toe during swing-phase extension and reduced socket pressure. Hydraulic foot technology such as Blatchford’s Echelon foot which self-aligns to terrain and remains dorsiflexed for swing provides a smooth, safe and natural walking experience for the user. When you combine both hydraulic foot and knee technologies together across the two joints the outcomes are further improved. In fact, such is the effect of the foot that many users notice the improvements from the foot more during their daily lives than the microprocessor knee – it’s almost as though the effect at the foot is felt on every step whereas the knee acts like a silent guardian quietly monitoring and keeping the user safe at all times.
Previously, the technology was only accessible to a small market, hindering developer’s potential to grow and expand whilst also limiting the amount of user feedback and supporting research evidences available. Now that the treatment will be available on the Health Service, the amount of people who have access to these devices has become far broader. This will provide a much larger user group whose experiences and feedback can help to steer further future technological advances in this area.
It’s refreshing to see that NHS patients will now have access to advanced microprocessor technology that is already widely available in other countries. In a world where technology continues to improve the lives of patients, it is a positive step to see NHS England harnessing what the market has to offer to benefit amputees, as well as investing in preventative measures to reduce the need for future treatments. This is a positive step forward for patients, the Health Service and the industry alike, that stands to only get better as the technology is developed further now it has at last become accessible.
For more information on Orion3 and free Orion3 training courses click here.