Patellar tendon bearing orthosis--application as adjunctive treatment in healing of lower-limb tissue loss.

Abstract

To assess the efficacy of the patellar tendon bearing orthosis (PTBO) as adjunctive treatment of patients with significant lower-limb ischaemia and tissue loss complicated by neuropathy. Twelve consecutive patients (14 legs) with a variety of underlying conditions causing extensive lower limb tissue loss are described. Seven patients were diabetic. Six patients (seven legs) underwent vascular reconstruction procedures. Wound healing and amputation rate. Eight patients had ulcer healing within 5 months, one at 18 months (patient with alcoholic neuropathy who was poorly compliant with treatment), one stopped using the PTBO at 3 months and was converted to protective footwear with healing, one died of a myocardial infarct 1 month after the PTBO was fitted (the ulcer was showing signs of healing), and one has just had surgery and been fitted with a PTBO. Early results from this anecdotal series are encouraging and a prospective study to determine the application of the PTBO in patients with neuropathic and neuropathic/ischaemic tissue loss is planned.