Efficacy of a Knee Walker for Foot and Ankle Patients: Comparative Study with an Axillary Crutch

CATEGORY: Ankle, Orthosis, rehabilitation INTRODUCTION/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. Recently, knee walker was introduced, which minimized these weaknesses and yielded favorable results in some clinics. To the best of our knowledge, there have been no previous original article comparing the clinical results of the knee walker and axillary crutch in foot and ankle patients who require nonweightbearing. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. METHODS: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing 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. Jin Bae He Wheel Chair X 01 (JBH Medical Apparatus, Nanjing, China) was used for the knee walker and standard axillary crutch was used. 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.