How Salisbury VA’s Personalized Prosthetic Care Builds Veterans’ Confidence
Reading Time: 5 minutes
___
Summary:
-
Salisbury VA tested a Quattro microprocessor knee on veterans at the K2-to-K3 transition.
-
Toe-load calibration made the knee a weaker fit for lower-impact users, per the VA lab chief.
-
Manufacturer’s remote diagnostics found similar patterns in knees nationwide.
-
Fix could help K2 and K3 users across VA, which reports over 4,000 microprocessor users.
-
Navy veteran David Graham says he’s more confident in his Quattro knee than his previous one.
___
Across the Department of Veterans Affairs (VA), prosthetics teams continually explore ways to help veterans with limb loss become more active. A recent case at the W.G. (Bill) Hefner Salisbury VA Medical Center illustrates what that looks like in practice and could eventually benefit thousands of others across the country.
As stated by the National Institutes of Health (NIH), clinicians rate the mobility of lower-limb prosthesis users on Medicare’s K-level scale, formally known as the Functional Classification Level. The higher the number, the more active the person: K0 means a prosthesis isn’t appropriate, while K4 indicates high-impact activity, up to Paralympic level.
Cody Reimers, who leads the prosthetic and orthotic lab at Salisbury, and his team set out to determine whether a Quattro microprocessor knee (MPK), usually reserved for people at the K4 and K3 levels, could also suit patients at the upper end of K2 or the lower end of K3. The VA says recently published research prompted the idea.
When the data failed to match the fit
Two of the veterans the team fitted sat precisely at the boundary between K3 and K2. While walking normally, the knee didn’t respond as expected. The behavior repeated often enough that Reimers and his colleagues asked the manufacturer, PROTEOR, to take a look.
PROTEOR moved quickly. A clinical specialist traveled to Salisbury within a day, and the veterans were given a temporary replacement knee the same day.
Reimers said the manufacturer pinpointed two settings, the knee’s calibration approach and its preset toe-load threshold, as the reason this model isn’t the best match for lower-impact users. He explained that the knee defaults to a stance mode. When the wearer’s toe-load doesn’t reach that threshold, the knee’s stumble-recovery feature engages to help prevent a fall.
A local fix with national reach
Reimers next asked the company to look at how other veterans with similar mobility levels were doing with the same Quattro knee. Engineers reviewed the devices remotely and saw the same pattern, linked to the same toe-load setting.
According to the VA, over 4,000 veterans nationwide use microprocessor-controlled prosthetic components. Once it is corrected, K3 and K2 users at VA sites across the country may find it easier to be more active.
Reimers pointed to the case as a reason to build close working relationships with device makers and other suppliers, so VA’s patients remain a top priority.
A routine adjustment for two patients turned into a chance to improve care across the VA. The case indicates that careful attention to even a handful of patients can pay off for veterans well beyond one clinic. Reimers described it as a lesson for VA staff and vendors alike and said this type of collaboration improves the overall quality of care.
What it means for one veteran
Navy veteran David Graham, a Salisbury VA patient who wears a Quattro MPK, can describe the difference in everyday terms.
Graham has lived with above-knee limb loss for close to six years, so he knows how much a prosthesis shapes a normal day. Until he came to Salisbury VA’s Prosthetic and Sensory Aids Service, his previous prosthetic knee left him uneasy, and he feared it could give way at any moment. By his account, the old knee might buckle under him, while the Quattro hasn’t.
The change is less noticeable in distance covered than in routine moments: getting up, heading to the bathroom, grabbing a snack, or taking a walk. Graham says those activities feel easier now, and he has more confidence in this leg than in the last one he wore.
Prioritizing follow-up care
At VA, the prosthetic fitting is only the starting point. Later visits allow the team to continue fine-tuning the device to the person wearing it, so it keeps working for them over the long term.
Reimers outlined how his team stays in touch: patients return after a week or two, then again at one month and three months, and subsequently twice a year if everything is progressing well. Every veteran leaves with the next visit already booked, so nobody gets lost between appointments.
Reimers considers this kind of follow-up to be a major benefit of getting prosthetic care at VA. His team isn’t rushed, he said, which matters for patients with complicated needs like Graham’s, since a visit can run past 30 minutes when that’s what it takes to get a good result.
For Graham, that confidence rests on the care behind it: he says he trusts Reimers, who manages his prosthesis. A good fit, advanced technology, and a steady follow-up have done more than improve his prosthetic knee. They have restored his confidence as he walks.
Between appointments, prosthetic socks and gel pads can help with everyday socket fit, while prosthetic cleansers support daily skin care. However, for ongoing fit or alignment issues, consulting your prosthetist is always the best choice.
Related Reading:
The Knee That Thinks Ahead: Inside QUATTRO 2’s Real-Time Adaptive Technology
Medicare and Prosthetic Limbs: Coverage for Amputees Explained
The NYC Lab Helping Veterans Thrive After Limb Loss
Study Says Powered Lower-Limb Prostheses Promote Better Overall Health
