Computerized Lower Limb Prostheses

Policy issue:Amputation is a life-changing event. VHA takes a special interest in the veteran amputee and is interested in making available to eligible veterans prosthetic devices that are beneficial. C-LEG® (Otto Bock Orthopedic Industry, Inc.: Germany; Minneapolis, MN)is a microprocessor controlled lower limb prosthesis that became commercially available in the US in 1999.

In 2000, the VHA Prosthetics and Sensory Aids Service Strategic Healthcare Group, which dispenses prosthetic devices in VHA, requested information on the benefits of C- LEG® to assist in developing prescription guidelines for use.

Assessment:VATAP produced a systematic review of microprocessor-controlled lower limb prostheses.

Computerized Lower Limb Prostheses, March 2000

Current status:Prescription guidelines are available to assist in provision of these devices in VHA.

VHA Prosthetic and Sensory Aids Service Strategic Healthcare Group's Prescribing Guidelines for Computerized Lower Extremity Prosthesis.

VA Rehabilitation Research and Development Service (RR&D) is evaluating the benefit of microprocessor controlled prostheses such as C-LEG® in the veteran population. Read about RR&D's solicitation of research proposals for the evaluation of clinical efficacy of major limb prostheses for veteran amputees: SOLICITATION OF APPLICATIONS FOR TECHNOLOGY ASSESSMENT OF MAJOR LIMB PROSTHETICS (March 2004): http://www.vard.org/rehab.htm *

Related information:

• Veterans Health Initiative: Traumatic amputation http://www1.va.gov/vhi/page.cfm?pg=10

• VHA Prosthetics and Sensory Aids Service Strategic Healthcare Group (Intranet only)http://vaww1.va.gov/prosthetics/
  

• VHA Center of Excellence for Limb Loss Prevention and Engineering:http://www.seattlerehabresearch.org/ *

• Read about VHA Preservation-Amputation Care and Treatment (PACT) program which uses preventive care measures to reduce the incidence of complications due to diabetic foot ulcers and amputations: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=86

• Diabetes information on-line: http://www.amputee-online.com/amputee/diabetes.html *

• See VATAP Report on Clinical Predictors in Lower Limb Amputation

Adams Elizabeth. Chair of and presenter at a preconference workshop: "Guidance for the Rational Diffusion of Health Care Technologies in the Presence of Low Quality Data" at the International Society for Technology Assessment in Health Care Annual Meeting, Canmore, Alberta, Canada, June, 2003.

Workshop includes information on:

• C-LEG: Computerized lower limb prostheses.


• Positron Emission Tomography: Evidence based medicine vs. Advocacy based medicine.