Journal List > J Korean Foot Ankle Soc > v.22(3) > 1101924

Song, Kang, Kim, Heo, Won, Jung, and Chung: Efficacy of a Knee Walker for Foot and Ankle Patients: Comparative Study with an Axillary Crutch

Abstract

Purpose

An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch.

Materials and Methods

A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a non-weightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0∼100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated.

Results

The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p<0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch.

Conclusion

Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.

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Figure 1.
The image of knee walker.
jkfas-22-100f1.tif
Figure 2.
The images of male using knee walker are shown. (A) Oblique image. (B) Lateral Image.
jkfas-22-100f2.tif
Table 1.
Demographics Data of the Study (n=62)
General information Value
Injured foot and ankle (n)
Right 22
Left 40
Mean age (yr) 36.5 (17∼61)
Age group (n)
10∼20 yr 6
20∼30 yr 20
30∼40 yr 20
40∼50 yr 10
50∼60 yr 4
60∼70 yr 2
Sex (male:female) (n) 42:20
Mean body mass index (kg/m2) 24.6
Mean duration of use (wk)
Knee walker 5.2 (4∼10)
Axillary crutch 2.4 (1∼4)

Values are presented as number only, mean (range), or mean only.

Table 2.
Cases of Knee Walker (n=62)
Cases No. of patients
Lateral ankle instability 16
Ankle fracture 14
Achilles tendon rupture 12
Distal tibia shaft fracture 4
Calcaneus fracture 4
Pilon fracture 3
Acute ankle sprain 3
Metatarsal bone fracture 2
Osteochondral lesion of talus 2
Prehallux 1
Lisfranc injury 1
Table 3.
Clinical Outcomes of Knee Walker and Axillary Crutch
  Knee Walker (n=62) Axillary Crutch (n=62)
VAS satisfaction score 88 .8 (45∼100) 27.5 (10∼45)
Complication 10 (16.1) 56 (90.3)
Fall down 0 (0) 2 (3.2)
Preference of orthosis 58 (93.5) 4 (6.5)

Values are presented as mean (range) or number (%). VAS: visual analogue scale.

Ipsilateral knee pain (n=6), ipsilateral thigh pain (n=2), collision of contralateral foot with wheel (n=2).

Axillary and wrist pain (n=32), axillary pain (n=14), wrist pain (n=10).

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