NHS funding for Microprocessor Knees

In December 2016 NHS England approved funding for the use of microprocessor knees (MPKs) for patients with the Clinical Commissioning Policy on Microprocessor controlled prosthetic knees.

Patients that meet the criteria set forth by NHS England (see FAQ below), will be allowed to try out two separate microprocessor knees, to allow for optimal fit. The details of the selection process is outlined in the Clinical Commissioning Policy, but we recommend patients contact their local prosthetic centre to ask about funding and suitability. You may also reach out to our Össur Experts if that suits you better.

Download the Clinical Commissioning Policy

A real possibility of a life changing benefit

This means that NHS England has acknowledged that there is evidence to consider supporting microprocessor limbs, devices which can offer life changing benefits to patients and ensuring they can live a life without limitations, as the main focus of the funding is to improve walking and balance by aiding walking movements in real time which reduces falls and accidents caused by a lack of stability that can be experienced with other prosthetic limbs.

Does Ossur offer knees which are eligible for funding?

Össur has been at the forefront of designing the next generation of prosthetic limbs, [bionic], two of which are among the most advanced products on the market and eligible for the NHS Funding.

What can Microprocessor Knees offer?

The technology of MPKs has advanced significantly in the last few years. Referred to as any artificial knee joint which includes a battery-powered, built-in, programmable computer they are designed to constantly monitor the activities of the patient including:

  • Easy walking between parallel bars in rehab to smooth walking on real world terrain
  • Continuously controlling swing and stance phase based on real time gait data
  • Automatic cycling recognition from range of motion training on a stationary bike to riding your bike in the great outdoors
  • From stepping over manmade objects in rehab to avoiding real world obstacles
  • From stepping over manmade objects in rehab to avoiding real world obstacles
  • From varying speed up to a light jog in rehab to running in a variety of everyday situations

What are my next steps?

In the first instance you should contact your local prosthetic centre to ask about funding and your suitability. All patients will undertake the pathway as outlined on page 21 of the NHS Clinical Commissioning Policy (link provided above).

  1. Selection: Suitability of the patient in relation to the criteria set within the policy, with an assessment performed by a multidisciplinary rehabilitation team
  2. Prioritisation: Patients will be assessed in relation to their clinical need due to budgetary constraints
  3. Full clinical assessment: A complete physical examination combined with assessments of your medical and activity history and current status
  4. Goal setting: This refers to the outlining of SMART objectives
  5. Trial: Once you have been accepted a trial will be arranged, allowing you to trial two separate units so that you are able to compare prior to making a decision on which is most suited for you

Following this process a number of outcome measures will be assessed as to the overall and continued suitability of the MPK.

Need more information?

FAQ's

Am I eligible for the funding?

Prior to funding being released the NHS stipulates that patients must meet a specific criteria considering your amputation level, activity level and mobility level.

Amputation level

  • Unilateral Trans-femoral
  • Hip disarticulation
  • Knee disarticulation
  • Knee disarticulation

Activity level

  • K3: The patient is able to walk with a free mechanical knee and has the ability or potential for ambulation with variable cadence and traverse environmental barriers as a community ambulator.

Mobility level

  • SIGAM D or above: a patient is able to walk more than 50 yards on level ground

In addition to these criteria patients to demonstrate a number of actions including:

  • Commitment to prosthetic rehabilitation through active participation with the therapy team
  • Adequate strength and balance to be able to activate the knee unit
  • Requirement of MPK as the main day to day prosthesis

For further information on the criteria and to understand more about what the patient must be able to demonstrate to be considered for funding please refer to page 19 of the NHS Clinical Commissioning Policy (link provided above).

How do I apply for funding?

The MPK funding initiative is only available for NHS England centres presently. If you live in Scotland, Wales or Ireland then please speak with your local clinic on the availability of microprocessor knees.In the first instance you should contact your local prosthetic centre to ask about funding and your suitability. All patients will undertake the pathway as outlined on page 21 of the NHS Clinical Commissioning Policy (link provided above).

This includes:

  • Selection: Suitability of the patient in relation to the criteria set within the policy, with an assessment performed by a multidisciplinary rehabilitation team
  • Prioritisation: Patients will be assessed in relation to their clinical need due to budgetary constraints
  • Full clinical assessment: A complete physical examination combined with assessments of your medical and activity history and current status
  • Goal setting: This refers to the outlining of SMART objectives
  • Trial: Once you have been accepted a trial will be arranged, allowing you to trial two separate units so that you are able to compare prior to making a decision on which is most suited for you

Following this process a number of outcome measures will be assessed as to the overall and continued suitability of the MPK.

What is Microprocessor Knees funding?

In December 2016 NHS England approved funding for the use of microprocessor knees (MPKs) for patients with the Clinical Commissioning Policy on Microprocessor controlled prosthetic knees.

NHS England found that following a review that there was evidence to consider supporting the routine commissioning of microprocessor limbs, devices which can offer life changing benefits to patients and ensuring they can live a life without limitations. The main focus of the funding is to improve walking and balance by aiding walking movements in real time which reduces falls and accidents caused by a lack of stability that can be experienced with other prosthetic limbs. The overall goal of the funding is to improve the level of services available to patients with limb loss in England.

What is a microprocessor knee?

An artificial knee joint which includes a battery-powered, built-in, programmable computer that continuously controls both swing and stance phase based on real time data of the user’s gait.

What are the causes of amputation of the knee?

A prosthetic knee joint is part of a lower leg walking ‘prosthesis’ – sometimes known as an artificial leg or limb. It is used by people who have lost a leg at or above the knee. The loss of this part of the leg is commonly a result of problems with the blood vessels in the leg (‘vascular disease’). These problems may happen with or without diabetes.

Other causes of limb loss include:

  • Severe injuries caused through an accidents (‘traumatic injuries’)
  • Treatment of ‘malignant’ disease – usually related to cancer
  • Infections
  • Complications of muscle and bone illness (‘musculoskeletal’)
  • Limb deformities from birth (called ‘congenital’).

What is a SIGAM Mobility Grade?

The SIGAM (Special Interest Group in Amputee Medicine) scale is a simple yet fully validated scale of Disability Mobility Grades. It measures function of lower limb amputees fitted with a functional or cosmetic prosthesis in terms of mobility. It was developed from the Harold Wood/Stanmore Mobility Grades to improve accuracy of grade allocation. It includes a benchmark distance of 50 meters and uses a questionnaire and algorithm with grades from A (non-limb user) to F (normal or near normal walking).

What are K Activity Levels?

A 5-level functional classification system related to the functional abilities of patients with lower-limb loss. It ranges from K0 (no mobility) to K4 (High activity, with high impact stress on the prosthesis).

Do I need to visit an NHS England clinic first?

Yes. The MPK policy states that in the first instance you should speak with your NHS England prosthetic centre to be considered for selection, from which you will follow the pathway as outlined on page 21 of the NHS Clinical Commissioning Policy (link provided above).

Is the MPK funding only available to those living in England?

Unfortunately yes. Budget may be available to those living in Scotland, Wales and Ireland however this is separate to the MPK funding and will be dealt with on a case by case basis and subject to budgetary constraints and availability. We would advise you to speak with your local prosthetic clinic to discuss with your prosthetist in more detail.