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previous land-transports, besides the irresponsibility of people who drive them without
being able to do so, contribute to injuries, particularly in lower limbs. Finally, the third
and today more important cause for amputations are vascular diseases, especially from
diabetes. This last cause is the main reason for amputations in most countries
nowadays and has been growing steadily over the last years (Limb loss in the United
States, 2006; Peripheral arterial disease (PAD) and limb loss, 2006).
Additionally, to have a complete picture regarding the theme of lower limb
amputees, it should be mentioned that when one refers to a lower limb amputation, it
could be of two kinds: transtibial (below-knee or simply B/K) or transfemoral
(above-knee or just A/K). The treatment of the first one, in order to recover a normal
gait, is easier than with the second one. In an A/K amputation, the patient has lost the
knee and he counts with a remaining limb join in his hip to control whichever be the
prosthetic device that he uses to face walking again.
A lot has been done from last century until the present, in order to develop a
prosthetic technology that allows transfemoral patients to recover a natural gait. In
this sense, the present work aims to show the different scientific research lines that
have been developed during this period to solve this problem, instead of making a
review of the different knee prostheses designed up to now, which has been done
already (Michael, 1999; Radcliffe, 1977).
This paper is pided in three sections: Introduction, Review, and Conclusions. In
Introduction, the theme of the lower limb amputee disability and its growing number is
presented. Likewise, the transtibial amputation is differentiated from the transfemoral
amputation, and the aim of this work is presented regarding the last one. In Review, the
different parts of a complete prosthesis for an A/K amputee are mentioned, as well as the
relevance of the knee prosthesis upon the others. Later, this section is pided in three
subsections: Prostheses design, Performance assessment, and Control strategies. Each
subsection refers to a scientific research line identified by us, regarding the development of
knee prostheses. Therefore, every subsection deals with a particular research line,
describing its evolution through the published material found in the area. Finally, in
Conclusions, a summary of the research lines described in the previous section is
presented, as well as an insight intowhat advances could be expected in the development
of prosthetic technology in the near future, based on the trends in the field today.
Review
The human gait is an activity that the brain controls practically unconsciously, but at
the same time, it is a very complex activity given the biomechanics associated. These
facts involve a tremendous complexity that explains why the challenge of prosthetictechnology remains the same, because until now, it has not been possible to replace a
limb in human body, with an artificial device which performs the same way the
original one would do.
Given the complexity of the problem approached in general terms, regarding A/K
lower limb amputations, the main concern is to develop a prosthetic technology, to give
back to the A/K amputee the possibility of having a natural walk. But even with this
simple purpose, the problem involves so many aspects that, in terms of scientific
research, it is split in different lines of study. In other words, the sides of this problem
are many, and it has been necessary the contribution from different areas of knowledge
to approach it, even in a limited way.
A complete prosthesis for a transfemoral amputee is composed by: a socket, a knee
prosthesis, an ankle-foot prosthesis and a link between the laters, but the part that has