PROTEOR FREEDOM PLIE 3 Notice D'utilisation page 11

D. Alignment
Careful attention to the alignment of the socket in relation to the Plié® 3 MPC Knee and the prosthetic foot is essential for a
successful user outcome. The prosthesis alignment should account for the range of motion (ROM), voluntary control, and
balance of individual users. Proper alignment and user voluntary control are essential to the optimal function of the prosthesis.
Prior to assembly of the prosthesis, the prosthetist should measure the patient's hip joint range of motion (ROM) on the
prosthetic side to determine if the user has a hip flexion contracture (Figure 1). If present, the user's hip flexion contracture
should be accommodated by attaching the socket to the prosthesis with an appropriate amount of flexion (Figure 2). Failure to
sufficiently accommodate a hip flexion contracture can compromise the patient's function during standing and ambulation
(Figures 3 and 4).
During standing, an unaccommodated hip flexion contracture may prevent the patient from standing straight, compromising
the patient's balance (Figure 5). Additionally, an unaccommodated hip flexion contracture can cause excessive lumbar lordosis,
compromising the structural integrity of the patient's spinal column (Figure 4).
During ambulation, an unaccommodated hip flexion contracture can cause an excessively asymmetrical gait pattern.
E. Bench Alignment
The Plié® 3 MPC Knee should be in a fully extended position during stance phase for level ground ambulation. An inherently
stable trochanter-knee-ankle (TKA) alignment is essential to a successful user outcome with the Plié MPC Knee. A plumbline
dropped from the trochanter reference point on the lateral socket should fall at or up to 5mm anterior to the knee joint axis
(Figure 5). Align the foot as recommended by the foot manufacturer.
An inherently unstable trochanter-knee-ankle (TKA) alignment can cause a rapid extension moment at the knee joint after mid
stance. The non-adjustable stance extension resistance could be insufficient to dampen the extension moment if the user does
not exert sufficient voluntary control and/or if the alignment recommendations are not implemented.
The recommended inherently stable alignment of the Plié 3 MPC Knee may differ from other knee joints. Consequently, if a
new socket is not fabricated for use with a Plié 3 MPC Knee, the socket attachment component may require re-lamination to
the socket to achieve the recommended alignment
F. Static Alignment
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Instruct the user to stand between parallel bars.
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With equal weight on each limb, adjust the height of the prosthesis as necessary.
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Ensure the trochanter-knee-ankle (TKA) alignment follows the recommendations of inherent stability.
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Instruct the user to sit in a chair. Adjust the height of the knee joint axis to match the contralateral limb as closely as
possible.
To prevent risk of injury to the user, perform the static alignment, dynamic alignment, and set-up between parallel bars.
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Ensure the transverse rotation of the knee and foot is appropriate.
G. Dynamic Alignment
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Instruct the user to take a lunge step with the prosthesis. The lunge motion will allow the user to feel the Stance Flexion
resistance and develop confidence. Repeat as necessary.
•
Instruct the user to carefully ambulate. Teach the user to flex the ipsilateral hip extensor muscles at initial contact to
stabilize the knee joint.
•
Train the user to load the prosthetic toe to initiate the swing phase transition.
•
Train the user to take steps of equal length.
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Adjust the alignment in the transverse, coronal and sagittal planes as necessary.
H. Plié Control 6
The Plié Control 6 software is required to program a Plié 3 MPC Knee. Download software from the following website to install
the program at https://www.pliesupport.com/download.
software should not be used by the patient.
Figure 1 Figure 2 Figure 3 Figure 4 Figure 5
This software is for use by prosthetists to program the knee. This