HKAFO

Hip-Knee-Ankle-Foot Orthosis (HKAFO) is a type of leg orthosis that stabilizes and aligns the hip, knee, ankle, and foot. It is worn to support the pelvis and lower limbs, control movement, and enable standing or ambulation for individuals with significant weakness, paralysis, deformities, or contractures resulting from neurological or musculoskeletal conditions. HKAFOs are typically prescribed when less extensive devices such as KAFOs or AFOs do not provide sufficient stability or control.

A typical HKAFO comprises several components: a pelvic band or girdle to anchor the device to the trunk, thigh and calf cuffs, and joints at the hip, knee, and ankle. The hip joints may be fixed or adjustable and may include abduction/adduction control. The knee joints often feature hinges with optional locking mechanisms for stability in stance and controlled flexion in swing. Ankle joints and footplates (or solid feet) complete the alignment, sometimes incorporating plantar/dorsiflexion control. Some designs use a reciprocating gait mechanism, linking the hips with cables to enable a more symmetric walking pattern.

Variants include solid HKAFOs and dynamic or reciprocating gait orthoses (RGO), which can facilitate a gait pattern that resembles normal locomotion. These devices are bulky and heavy and require extensive training and supervision to don, doff, and use safely. They are commonly used in pediatric populations and adults with spinal cord injuries, myopathies, spina bifida, or other conditions causing extensive lower-limb weakness.

Care and follow-up involve proper fitting, skin inspection, pressure management, and gradual wear schedules, with regular adjustments as the user grows or as conditions change.