A systematic review on design technology and application of polycentric prosthetic knee in amputee rehabilitation

The objective of this paper is to conduct a systematic review on design technology and clinical application of polycentric prosthetic knee joint in the rehabilitation of trans-femoral amputees. Relevant studies were identified using electronic database such as PubMed, EMBASE, SCOPUS and the Cochrane Controlled Trials Register (Rehabilitation and Related Therapies) up to February 2020. Screening of abstracts and application of inclusion and exclusion criteria were made. Design, modeling, material use, kinematic study, simulation technique and clinical application of polycentric knee models used in many developed and developing countries have been reviewed. Out of 516 potentially relevant studies, 43 articles were included. Specific variables on technical and clinical aspects were extracted and added to summary tables. The results reveal that polycentric knees have a variety of geometries but the methods for comparing their performances are rare. The data of structural analysis using different simulation techniques are validated with experimental results for determining model accuracy. Gait analysis using the polycentric knee components provides a valid tool to correlate with experimental results. There are well-designed studies on the technological development of polycentric knees, however, high-quality clinical researches are scarce. Conventional clinical knowledge had considerable gaps concerning the effects of polycentric knee and their mechanical characteristics on human functioning with a lower-limb prosthesis. Still, further research is needed to develop and implement standardized measures on prosthetic knee joints for their effective use, function, durability, and cost-effectiveness.