Most lower limb amputees know this problem: Finding the right prosthetic knee is not an easy task. For most of us it means working out the right compromise between our day to day needs, our spare time interests and our ambitions for the next couple of years on the one hand and our health insurance plan and financial means on the other hand. This in itself is already rather complex. Things get even more complicated if we take into account that even the best of knees can only unfold its full potential if mounted under a well-fitting socket, combined with a good foot that suits our activity level.

So much for the theory. But what does this actually mean in practice? Well, there are several ways to go about dealing with this challenge. And there are significant differences depending on the country you live in and the health service that applies to you. So…

If you are new to the amputee life, finding the right right knee (and foot and socket) for you more often than not means relying on others to make the - hopefully - right decisions. Depending on the country you live in, the most likely scenario is that after the amputation you are referred to a prosthetist. He or she will assess you and your situation, both in terms of your physical conditions and need as well as your life style and aspirations as an amputee. He or she will then walk you through the options you have, explain the pros and cons of various prosthetic knees, outline the cost implications and what is or is not covered through your national health service or insurance plan. In many you then have to make a decision about how you want to proceed. Sometimes there might be the additional opportunity to try out some of the knees/feet that are most likely to suit your needs before making the final decision. But this is not a given and depends a lot on the country you live in and the service providers you work with. If you have this opportunity make sure you use it. There is nothing like first-hand experience. And be aware that once you made the decision - and in many cases the immense investment - and settled on one prosthesis or another you are stuck with it for the next five to seven years.

More experienced amputees often have a much better idea of what they need. Often they can draw on plenty of first-hand experience in a variety of situation. Many have used different models over the years and learned to appreciate the pros and cons of various knees and feet. Based on this knowledge, they can make an informed decision about the next prosthesis they would like to get, which features it should have and which features they are happy to live without. Many people who have been amputees for a longer period of time are in regular exchange with others who suffered limb loss. They are active on forums, in discussion groups and have had contact with support groups and charities. But even then, engaging in in-depth discussions with your prosthetist is an essential part of the process of choosing the right prosthetic knee. And hopefully - as mentioned above - you have the opportunity to trial your favored knee-foot-combination before making your final decision.  

Why do I think that an in-depth discussion with an experienced prosthetist is essential? Or even better with a team consisting of a prosthetist and a physiotherapist with years of experience with amputees? Well, I think despite all the information you get from your exchange with other amputees, from the internet and from other sources, they are still your most important partner in this process helping you to navigate an increasingly complex landscape.

For many of us, the temptation is high to go for the most advanced microprocessor knee, if we can afford it. But there is more to making this decision than aiming for the newest top-of-the-range product. Will this knee work with the foot you have in mind? How long will the battery last with one charge? And how important is to you to be able to be away from the next charging option for extended periods of time? Can you change setting by yourself or do you have to go to a prosthetist every time this needs to be done? If that is the case, how far are you away from the next prosthetist? What about reliability; i.e. a knee might be great when it works. But your prosthetist will know if it is prone to failure. He or she will be able to tell you details about service and maintenance, warrantee issues, potential cost implications if the needs to be repaired and the like. Often your prosthetist/physiotherapist can draw on an immense wealth of experiences from other users and is more than willing to share. In some cases they might be able to directly connect you to them. So, having the opportunity to engage in in-depth discussions with your prosthetist and even better also with a physiotherapist is a key when looking for a new knee prosthesis.