title: Patellar tendon bearing orthosis--application as adjunctive treatment in healing of lower-limb tissue loss.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Wound healing and amputation rate.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Walsgrave NHS Trust Hospital, Coventry, U.K.
authors.forename: H S
authors.initials: HS
authors.lastname: Khaira
authors.forename: T
authors.initials: T
authors.lastname: Coddington
authors.forename: A
authors.initials: A
authors.lastname: Drew
authors.forename: P N
authors.initials: PN
authors.lastname: Roberts
authors.forename: C H
authors.initials: CH
authors.lastname: Imray
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D017719:Diabetic Foot / Q000534:rehabilitation; D005260:Female; D005528:Foot / Q000601:surgery; D016523:Foot Ulcer / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D014945:Wound Healing