jocko

C-Leg / Rheo Comparison

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After ~38 years and 12 or so legs, I’ve decided to take the plunge into the micro-processor world. I’m RAK since 1970, will turn 44 this May and can still be considered fairly active, although golf has pretty much taken over my sporting life from the baseball and hockey of years gone by.

My prosthetic guy is certified for both C-Leg and Rheo…he doesn’t favor one over the other really. I was able to snag a C-Leg for 1 month and a Rheo for about 3 weeks. Every week or so I’d stop back in and try a different foot, maybe get some programming tweaks, etc.

Both of the knees offer great stability. Like probably everyone else in here with one of these, I tried all sorts of ways to make it break unexpectedly…it’s not easy, let me tell ya. If I had to give an edge to one over the other, it would be slightly in Rheo’s favor. This may not make sense, but the Rheo was almost too stable for me…there are times when I want a nearly instant break, or at least a very fast one. An example for me would be getting in the car…I want that foot on the floor immediately - I hated standing there for about 3 seconds while the knee casually made it’s way down. Also, going down stairs “foot over foot” was way too slow…it looked great, but I wanted to go about twice as fast as that knee would allow.

For pure walking, I give the edge again to the Rheo…there was no doubt at all the foot would be right where I wanted it for every step. Also, it was smoother that the C-Leg (or any hydraulic unit for that matter) since there was no “snap” at full extension, if you can understand what I’m saying. Perhaps also contributing to the higher walking marks for Rheo was the really nice Flex-Foot, unavailable with the C-Leg (wink wink).

After reading all that, you’ll probably guess I went with the Rheo. Nope. After almost 2 months of going back and forth, I ended up going with the C-Leg. Actually, I was so torn between the 2, I started a spreadsheet listing every possible factor that could impact my decision, assigning a weight to it depending on how important it was to me. A perfect score would’ve been 110…the C-Leg came in at 99, the Rheo at 97.

Honestly, in about 5 years when I’ll be replacing this one, I’ll probably go with a Rheo. I think it’s a great concept that just needs to be refined a little, both functionally and aesthetically. Oh, I should also say I went with the Trias+ foot on the C-Leg…I can’t imagine anyone short of a sprinter not being satisfied with the feel and energy return. I've had a suction socket since 1986 and would never go back to socks...I forget the name of the style I have, but it's the soft plastic on the inside with the harder stuff on the outside.

Couple of quick final comments…

The charging hardware on the Rheo SUCKS. I go to bed in the dark and get up in the dark. Plugging that ridiculously small plug into that ridiculously small hole was a pain the a**. The C-Leg, while having a bigger plug, can easily be plugged in by feel because of its shape.

The “20 step warm-up” deal on the Rheo is stupid too. Hey, in the morning, my 16th step was usually at the top of the stairs…this thing shouldn’t need to re-learn my gate every day.

The C-Leg is waaaay cool looking…the Rheo looks like a high school science project. While I respect the technology and the engineering behind it, I think they could have come up with something better than a big blue rubber rectangle. Like I said, in 5 years this thing will probably look like a stealth bomber, but right now, it’s just plain fugly. Also, the big blue rubbery cover grabs onto my pants every time I sit down.

I’m a little more at ease with the C-Leg in terms of service…I travel a lot for my job…C-Leg techs are all over the place while the Rheo camp is still a little limited.

Whichever one you end up buying, get the rotator! I’ve never had one before…I have no idea why. Anyway, the first steps I took with it felt horrible…I was ready to fall every time the foot hit the floor. But after about an hour, I’m now totally addicted and will never have another leg without it. My golf game will definitely improve with it too.

One thing I had on my last leg and on this one is one of those little buttons to press that let’s you swing the leg in all sorts of unnatural positions. I don’t know what they’re called, but they have won me several beers (bet anyone in a bar you can balance a drink on the bottom of your foot while standing up). They’re also good for changing shoes, which is probably what most people like about them I guess.

Anyway, there’s my story…final total, about $58k…insurance paid every penny except my $500 deductible. Oh, and I’ve used the Otto Bock 3R80 for the past 5 years...a fine "dumb" hydraulic unit that now pales in comparison to this new stuff.

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hi jacko,

i think you made the right choice between the two, i feel the c-leg is better than the rheo especially looks - for now anyway. as for me, i like most in the uk dont have the benefit of insurance and have to rely on uk-nhs, i have just been issued with the new 3r80, which i have to say is far superior to the old 3r80, which i first used back in 2000, and my old mauch xg. i to was told that i had to have the trias+ foot, but in use thought the trias was a step backwards when compaired with my old vari-flex - i just could not get a smooth action, i then thought why cant i fit my old flex foot - so i did, and the improvment was instant, i will go as far to say that i feel the vari-flex foot must be one of the lightest and best foot available today, and together with my new 3r80 make a great combination. i often wonder what it would be like to trial the c-leg as im curious how it could possibly make any "real" impovments for me - especially when considering the price factor?

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hi jacko,

i think you made the right choice between the two, i feel the c-leg is better than the rheo especially looks - for now anyway. as for me, i like most in the uk dont have the benefit of insurance and have to rely on uk-nhs, i have just been issued with the new 3r80, which i have to say is far superior to the old 3r80, which i first used back in 2000, and my old mauch xg. i to was told that i had to have the trias+ foot, but in use thought the trias was a step backwards when compaired with my old vari-flex - i just could not get a smooth action, i then thought why cant i fit my old flex foot - so i did, and the improvment was instant, i will go as far to say that i feel the vari-flex foot must be one of the lightest and best foot available today, and together with my new 3r80 make a great combination. i often wonder what it would be like to trial the c-leg as im curious how it could possibly make any "real" impovments for me - especially when considering the price factor?

With my 3R80 (rec'd in 2002) I used the Axtion foot...first time I tried the Flex with the Rheo the difference was unbelievable. The 3R80 is definitely a fine unit...I had only 1 rebuild in 2007. The older Mauch hydraulics always seemed to need rebuilding every 18 months or so. The real driving force for me getting a new leg at all was, while doing the rebuild on the knee, my leg guy noticed the foot was pretty much falling apart. Looking closer at the socket also we noticed some cracks, so I decided to go new. At first, I had no interest at all in the microprocessors...I honestly thought they were all hype. While my 3R80 was in for repair, the loaner knee I got was, you guessed it, a C-Leg. After about 2 weeks my knee came back from Ohio and he took back the C-Leg. I didn't realize how accustomed I got to the C-Leg until I took the first couple of steps with the newly rebuilt 3R80. It was night and day. He ended up letting me keep the loaner C-Leg for another 3 weeks or so, then he put me on the Rheo. Basically, I'm keeping my old leg (with the new 3R80)...he's putting a used Axcion on it and I'll end up using it in situations where I might put the C-Leg at risk...you know, going to the beach, using waders while fishing, that kind of thing.

Again though, I don't think anyone would go wrong choosing a Rheo now, but I think in 5 years it'll be even better. Hopefully also, the powers that be at Otto Bock will eventually allow other feet...a Flex on the C-Leg would be unbeatable I think. And it's not only the warranty issue, it's the design and pylon length required that seems to negate the Flex ability. I was all for trying to match a Flex to the C-Leg, figuring screw the warranty. My size 12 though requires such a height in the foot that it simply can't work with the pylon of the C-Leg.

Now, as far as what kind of improvements you would see with a microprocessor over the 3R80, it's tough to describe. After a day or so, your mind seems to be retrained to not even think about your next step. All the work seems be done for you by the knee. I've been walking on these things in various incarnations since 1970. I thought I was pretty good at controlling them in all sorts of situations. Even you probably don't even think about your "next step" all the time. Your body knows what to do and muscle memory just seems to take over. The C-Leg (and Rheo) takes that concept to a whole new level. The foot is in the position I want before I even knew I wanted it there, if that makes sense. I had to get rid of nearly 40 years of "pushing" that knee forward to ensure a smooth landing. Now that pushing is done for you.

The main thing I've noticed is my ability to simply walk faster with less effort...I notice it everywhere. I went to an NHL game the other night with a friend. We're cheap bastards by nature, so we park about 8 blocks away for free rather than pay $15 at the arena. I've made that walk a dozen times this season...I'm in decent shape, but was always a little winded by the time we would reach our seats. The first time I made that walk with the C-Leg, I felt totally different. I realized only a fraction of the effort was required to accomplish the same thing. I've talked to others that say they've reduced lower back pain, had more energy during the day, didn't bother using handicap parking spaces anymore, etc. It's still tough to describe though. If you get the chance, definitely try one.

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hi again,

i think you have hit the nail on the head, the "real" difference then between good hydraulic knee units and the c-leg is the reduced amount of effort required to walk - thats it. though when i say "thats it" i dont wish to short change the c-leg after all the more the effort to walk is reduced the more mobile and "normal" an amputee becomes, and this is the ambition of us all - i guess

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Thanks for all the info, jocko - I've found your descriptions of the two knee units really interesting! :)

Lizzie :)

PS What's wrong with walking 8 blocks? :D

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Interesting comparison.

I am 49 RAK after a motorbike /lorry job. Accident Nov 06, First leg March 07.

No insurance here - the offending lorry dissapeared, and can't blame the one I hit! Hey Ho. My left leg is a mess but it works.

I too had the Rheo and Cleg choice. A gift from my mother.

Went to three leading private prosthetists. 2 proposed the C-leg and the third the Rheo. The research papers give the the rheo a slight edge over the C. I went with the Rheo £15,000 rather than £20K or £25k and also percieved 5 year costs to be less. These prices were for the whole leg inc socket and foot. Initially I thought the Rheo would be more adaptable as can have any number of modes via the PDA rather than 2 with the C. I have a liner/bayonet socket anFreedom Renegad foot

I wasn't offered he facility to try the 2 legs.

I wholly concur with the aesthetics comments.

I complained about the charging initially, but then discovered that orientation was easy as the lead is marked. I connect straight away.

Day to day I find the Rheo excellent on all types of terrain, loose ground, sand, ladders, slopes. Stairs are a joy.

I have a superb NHS prothetist. Have the latest Mauch and an elation foot (foot new today), preferred the Mauch to the IP+ and the 3R60 I was offered. Love the free and locked function's of the Mauch. This has a suction socket which I find more secure than that on the other.

I wear either leg all day. The Rheo is noticably better and safer all round, but a well set up traditional is still excellent.

Would like to try the C - some have said it is better for flying, I use the MAuch in preference to the Rheo when flying. Water resistant one next year?

The combination of the Rheo and the Proprio foot would be amazing, just need someone to programme it!

I am fortunate to have 2 good well fitted legs

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hi Lizzie 2,

how far is '8-blocks', us brits still use miles and meters :blush:

I am a Brit, Gaza. :)

As far as I know (but, I may be wrong? :unsure:) there are 20 blocks to a mile, so 8 blocks would be about 0.4 miles, so that's approx. 640 metres (?). :wacko:

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U.S. blocks can vary widely, especially when you get into larger and newer cities. Lizzie's estimate appears to come close to our short, residential, blocks. Parking eight long city block away from a sporting venue, which is itself surrounded by a massive parking lot, actually can be quite a challenge.

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U.S. blocks can vary widely, especially when you get into larger and newer cities. Lizzie's estimate appears to come close to our short, residential, blocks. Parking eight long city block away from a sporting venue, which is itself surrounded by a massive parking lot, actually can be quite a challenge.

Yes, and it was uphill both ways...and there was a blizzard...and we were dodging sniper fire even worse than Hillary ever saw !!!!!!!

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:D :o :D

I must say that reminds me of listening to my parents talking about how tough they had it, walking to school as kids themselves. They slogged through the blizzards, uphill both ways, dodging wildlife............. my sister and I, walking around a mile each way over level city sidwalks, were definitely considered "pampered."

Then I went back to their childhood homes. In Dad's small town, the school was situated diagonally across an intersection from his house. But Mom was the winner: HER school was a little one-room schoolhouse deposited in the middle of her front yard. They boarded the teacher. Mom walked approximately ten steps to and from school!

Oh, the poor, suffering children.......!

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How can you have two sorts of one type of distance measurement?! :wacko: That's a bit like me using miles and nautical miles! :ph34r:

So, go on, how far exactly was the 8 blocks you walked, jocko? :)

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Lizzie, you piqued my curiosity, as I've never actually thought of a block as being a set measure of distance... it's more a description of a construction/geographic feature to me.

Soooooo.... I looked up "block" in my trusty Websters, and, sure enough, there was no definition relating to specific distances. The closest they came to "block" as we've been bandying it about here was something like "one side of a rectangular plot of land laid out for buildings, homes, or similar structures."

That does, indeed, leave it up to jocko to let us know how long "his" eight blocks were... based on my own experiences with city blocks, I'm willing to hazard a guess that it could be substantial! :)

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Lizzie, you piqued my curiosity, as I've never actually thought of a block as being a set measure of distance... it's more a description of a construction/geographic feature to me.

Soooooo.... I looked up "block" in my trusty Websters, and, sure enough, there was no definition relating to specific distances. The closest they came to "block" as we've been bandying it about here was something like "one side of a rectangular plot of land laid out for buildings, homes, or similar structures."

That does, indeed, leave it up to jocko to let us know how long "his" eight blocks were... based on my own experiences with city blocks, I'm willing to hazard a guess that it could be substantial! :)

Tough crowd, tough crowd.

Well, having grown up right next to the BIg Apple, I know an average city block in NYC is 1/20th of a mile. So, an average 8 block walk in a city (which I was in, but it was Minneapolis instead of NYC) is about 2/5 of a mile. Adding in the actual widths of the streets you must cross at each bock, I would guess our unwillingness to pay for parking causes us to walk 1/2 mile...and that's with a beer in one hand and a smoke in the other (in addition to the sniper fire and other hazards I've previosuly noted)!

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Hi Jocko ,

My name is Eladr and I joined to the forum couple of days ago. I am a "7 months old" right AK due to an accident on 31 Jan 2008. So I am a complete "fresh" AK amp compared to you.I've come across your porst re C-leg/Rheo Comparison. It's been very useful and helpul for me as I am going to get the C-leg soon. My problem is that I cover it myself. No insurance , no NHS, etc .

I realise that like any other mechanical or computerised device the C-leg may have fault and breakdown therefore I experience high level of anxiety as I will have to plunk down a significant sum of cash and if my C-leg was dead after a warranty period I would be up the s**t creek without a paddle. Having said that,I anyway go with the C-leg as it seems to be the only option for me.

I've read lots of opinions from AK amps on both C-leg n Rheo but all this sounds fine in theory. I've been walking on my temporary prosthesis(four bar knee by Streifeneder and OB dynamic foot) for four months now. I walk quite smoothly using a cane. I've been able to get the C-leg for two hours and it worked great for me. I am eagerly waitning for my two weeks C-leg trial which should due in a week or so.

You seem to be an "old trouper" and I wanted to ask you the following: Did you have any serious brakdown or glitches with you C-leg after a warranty has been expierd?

Are you happy with the Trias plus foot ? Does it have good energy response ?

I am looking forward to hearing from you

Warm regards

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I have had a C-leg for 3 years. I would consider my functional level as "extremely high activity".

Each year, after a year of wearing the leg, it has started to loose resistance during the swing phase, due to internal leaks. I have also had one pylon sensor fail. So, each year I've had it, it has been shipped back to Otto Bock for service.

The last two times were covered under warranty; this time I'm not sure if they will cover it or not, as my leg has the 3-year warranty (new ones have a 5 year warranty). When you ship it back, they give you an equally worn out leg as a loaner, which has me quite irritated at present. Each time it has been returned from service it has functioned like new, and lasted for a good year.

Otto Bock actually recommends the older legs be shipped back every year for service, and the newer ones shipped back every other year.

According to my prosthetist, service outside of warranty generally runs between US$2000 and US$4000. Therefore, I would plan on spending that amount on the leg each year it is out of warranty, if you are an aggressive user of the leg.

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I wouldn't have an electronic knee if I was paying for it myself unless I knew all about it and could repair it myself out of warranty. I value my ability to walk too much. These are HUGE amounts of money we are talking here... for what? We've all read the good things people say about these devices, but ultimately what do you really NEED. I reckon you get more than adequate function from a hydraulic knee, or an electronically controlled pneumatic knee (available at a fraction of the price of these knees) for most amputees. Don't be sucked in to believing all the hype, no one NEEDS these knees.

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....as my leg has the 3-year warranty (new ones have a 5 year warranty).

Hi Will,

I am confused about the warranty that the new C-leg comes with. I've just read again on their website that OB offers a "three-year warranty and an optional extended five-year warranty can also be purchased ".

Have I missed something and may be OB has changed the warranty policy for the C-leg?

Eldar

Right AK

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When C-Leg 2 came out, I'm fairly certain they offered it with a five-year warranty, and an every other year free rebuild.

However, I suspect they saw the same yearly failure rate with C-Leg 2 as with C-Leg 1, so they may have reduced the warranty back to 3 years.

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By the way, I disagree with the notion that no one needs an electronic knee. I would gladly pay everything out of pocket to keep my C-leg going. It has allowed me to do many things I didn't think possible, including flying aircraft. I also haven't fallen in over 2 years (and I am bilateral). However, low activity users may not need the extra functionality the C-leg offers.

In general I have found that people who get an electronic knee early in their recovery will refuse to switch to a non-electronic knee, while most that have used a four-bar or other non-electronic knee for years never seem to be happy with an electronic knee.

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By the way, I disagree with the notion that no one needs an electronic knee. I would gladly pay everything out of pocket to keep my C-leg going. It has allowed me to do many things I didn't think possible, including flying aircraft. I also haven't fallen in over 2 years (and I am bilateral). However, low activity users may not need the extra functionality the C-leg offers.

In general I have found that people who get an electronic knee early in their recovery will refuse to switch to a non-electronic knee, while most that have used a four-bar or other non-electronic knee for years never seem to be happy with an electronic knee.

You can do those things with other legs. There are legs designed for greater activity than C-Legs, and for other activities. No one NEEDS legs which cost £58k full stop. Of course, if you've got one and it works well for you, you will feel protective of it and defend it's use. I feel the same about my leg, but for different reasons.

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By the way, I disagree with the notion that no one needs an electronic knee. I would gladly pay everything out of pocket to keep my C-leg going. It has allowed me to do many things I didn't think possible, including flying aircraft. I also haven't fallen in over 2 years (and I am bilateral). However, low activity users may not need the extra functionality the C-leg offers.

In general I have found that people who get an electronic knee early in their recovery will refuse to switch to a non-electronic knee, while most that have used a four-bar or other non-electronic knee for years never seem to be happy with an electronic knee.

You can do those things with other legs. There are legs designed for greater activity than C-Legs, and for other activities. No one NEEDS legs which cost £58k full stop. Of course, if you've got one and it works well for you, you will feel protective of it and defend it's use. I feel the same about my leg, but for different reasons.

I had taken an extra long break from this forum, not because I wanted to, but because of some computer issues. Anyway, as a follow-up to this discussion I started long ago, here's what the finished leg looks like...Device_MemoryhomeuserpicturesIMG-1.jpg

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Hey there Jocko. Sweet leg!! :biggrin:

You are from my part of the planet! Had you gone to the ACA when it was held in Minneapolis a couple (or few) years back?

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There is a newer microprocessor knee on the market now. It is the Freedom Innovations Plie. I purchased one in December. It is getting good revues and is cheaper then the others. This one cost me (my company) 32K for everything. I went with their foot; the Renegade MX as I was going to try this foot on my next leg anyways. The Plie is water resistant , just cannot submerge it and has changeable batteries so I always have an extra charged up. As I have not tried any other micro knees, I cannot compare but am quite happy with this one's performance.post-2337-1238817802_thumb.jpg

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