Blatchford’s latest version of the Orion Knee (Orion 3) has closed the technology gap with other leading bionic knees in the same price range. The one remaining question is: do prosthetists trust it as much they do its competitors, especially regarding service and support?
What’s On This Page?
- A Quick Look at the Orion Knee
- Sensor & Microprocessor Capabilities
- Benefits & Drawbacks of the Orion Knee’s Design
- Compatibility with Prosthetic Feet
- Water & Dust Resistance
- Device Weight & User Weight Limit
- K-Level Rating
- User Software
- Clinical Insights
- User Feedback Survey & Results
- Considerations Before Buying an Orion Knee
- Related Information
A Quick Look at the Orion Knee
The following video provides a good technical overview of the Orion:
Orion Knee Key Features
Sensor & Microprocessor Capabilities
To understand how bionic knees work in general, please see A Complete Guide to Bionic Legs & Feet.
The short story is that the microprocessors in bionic knees have three main tasks:
- automatically adjusting the resistance in the knee to ensure the proper level of support through each stage of the Stance Phase regardless of terrain;
- ensuring the optimal release point for the knee to begin the Swing Phase and also the proper foot clearance during this phase, especially when ascending stairs, ramps, etc.;
- assisting in stumble recovery.
The Orion Knee handles the Stance Phase much like the other leading knees in the same price category, namely Ottobock’s C-Leg and Ossur’s Rheo. In brief, sensors help maintain situational awareness of:
- the terrain;
- the nature of the current task (standing, sitting, walking, etc.);
- the movement and speed of the knee.
The Orion’s microprocessor then adjusts the knee’s hydraulic resistance to match the situation. For example, when descending stairs or slopes, the Orion progressively increases resistance to provide better support and control.
The Orion’s stumble recovery feature is also similar to that of other bionic knees. When its microprocessor detects a stumble, the Orion immediately increases support to aid in recovery and prevent a fall.
In the Swing Phase, the Orion users microprocessor-controlled pneumatics to:
- assist in the transition from the Stance Phase to the Swing Phase;
- achieve proper foot clearance during the Swing Phase;
- extend the knee to support the transition from the Swing Phase back to the Stance Phase.
This use of pneumatics is similar to how Plie Knee handles the Swing Phase except that the Orion does not periodically require the user to manually adjust the pneumatic air pressure.
In addition to these core technologies, the Orion also provides specific support for:
Benefits and Drawbacks of the Orion Knee’s Design
There was a time when the Orion Knee’s technology was considered inferior to that of the C-Leg, Rheo, and even the Plie. This has not been the case since the launch of the Orion 3 in September 2016. The intended core behavior of most non-premium bionic knees is now quite similar. The differences have more to do with performance and, as always, compatibility with individual users.
There is little to differentiate the performance of non-premium bionic knees. In a June 2020 study titled “Retrospective Analysis of Four Different Microprocessor Knee Types”1, researchers compared the experiences of 602 users of the C-Leg, Rheo, Orion, and Plie bionic knees across the following key measures:
- Patient Satisfaction
- Quality of Life
- Injurious Falls
- Outcomes with Aging
The conclusions were:
- Overall, there was a high degree of parity among the four different microprocessor knees.
- There were no meaningful differences in mobility, though both the C-Leg and the Orion did have slightly higher scores in user satisfaction.
- When examining injurious falls, while there were no statistical differences in injurious fall rates over the prior 6-month period between the 4 MPKs, the difference reached a level of significance for C-Leg and Orion (reduced falls) when compared to injurious fall rates for patients with amputation due to diabetes or vascular disease using non-microprocessor knees.
Put another way, the Orion and the C-Leg seemed to have a slight advantage over the other knees in a couple of categories but the differences were not significant.
This study is especially important because a) it is quite recent, and b) it is the only study that we could find directly comparing leading bionic knees that wasn’t funded by one of the knee manufacturers.
Compatibility with Prosthetic Feet
The Orion Knee is compatible with Blatchford’s Elan bionic foot, as well as the following Blatchford mechanical feet:
We could not find any official declarations that using a non-Blatchford foot will void the Orion’s warranty. However, it is probably wise to verify this with a prosthetist.
The Orion Knee’s battery can last for up to three days depending on the level of activity.
If completely drained, the battery requires up to eight hours to fully charge.
As with most bionic limbs, it is best to charge the Orion’s battery each night.
Water & Dust Resistance
The Orion Knee is described as “weatherproof”, meaning it can be worn in the rain or splashed with freshwater but it cannot be submerged.
The knee is considered dustproof.
We have not been able to find an official IP rating for the knee.
Device Weight & User Weight Limit
The Orion Knee weighs 1.5 kilograms. The maximum allowable user weight for the knee is 125 kilograms.
The Orion is recommended primarily for K3 use, though it may also be suitable for high K2 or low K4 users whose main focus is improved stability while walking.
For a thorough understanding of K-levels, please see the Amputee Coalition’s web page on this topic.
The Orion Knee does not offer user software. It does, however, offer configuration software for prosthetists.
User-controlled settings, such as switching to the cycling mode, are activated by pushing a button on the device.
Blatchford offers a three-year warranty on the Orion Knee including any repair costs due to defects. For this warranty to remain in effect, the knee must be serviced 20 months after purchase.
Users can also pay to extend the warranty to six years. For the warranty to remain valid under this option, the knee must additionally be serviced at 40 and 60 months after purchase.
For repairs or service inspections, Blatchford provides a loaner knee upon request. The loaner is free for the first 45 days. Rental fees apply after 45 days.
According to our information, the Orion Knee typically sells for between $30,000 and $40,000 US including the socket, prosthetic foot, and all prosthetist fees.
The following comments are from clinicians with extensive experience with the Orion Knee:
The Orion Knee is now on its third generation. Technological advancement has made this microprocessor knee sharper and more reactive to the user demands than earlier versions. A recently published study found that the Orion was one of two MPK’s that achieved a clinically significant difference in the reduction of falls. It does this through the utilization of an inertia unit as well as a hydraulic unit to tell how quickly the amputee is moving and to provide adequate support depending on the terrain. The knee is intuitive to use but we strongly recommend physical therapy for gait training during the rehab process. This therapy should follow a weekly schedule and should include an exercise regimen at home. The Orion is not a good solution for patients with ambitions to be in or around water as it is not waterproof. In that case, we’d generally look at the C-Leg, Genium, Plie, or even the Genium X3, depending on the nature of the water activities. It is also not ideal for those with low mobility (i.e. K2 users), where the Kenevo MPK might provide a better solution.
Abe Ellithy, Bionic Prosthetics and Orthotics Group
San Antonio, Texas
User Feedback Survey & Results
Are you or have you previously been an Orion Knee customer? If so, please share your insights with others looking at the Orion Knee as a possible prosthesis.
We do not yet have a sufficient number of survey participants to publish fair and accurate results for the Orion Knee.
As soon as we do, we’ll update this section.
Considerations Before Buying an Orion Knee
In our opinion, there is little reason to choose one non-premium bionic knee over another based on technology alone. Therefore, the Orion Knee, which is typically less expensive than either the C-Leg or the Rheo due to aggressive price discounts, certainly warrants consideration for prospective K3 users.
However, as part of our research into bionic knees, we read through the transcripts of a legal action brought by the US Federal Trade Commission (FTC) in 2017 to block Ottobock’s takeover of Freedom Innovations.
There was a lot of testimony in those transcripts regarding most of the bionic knees on the market at that time. Much of this was contested and even contradictory. However, one set of observations stood out to us because it involved prosthetists going on the record to raise questions about the adequacy of Blatchford’s sales & support network, among other criticisms.
We have no way of validating these criticisms, which are also now more than three years old. But because they stood out to us, we think it would be prudent for prospective purchasers of the Orion to ask a prosthetist whether these issues have been addressed.
For a list of competitive devices, see Current Options for Microprocessor Knees.
For a comprehensive description of all current lower-limb technologies, devices, and research, see our complete guide.
Click here for more information on Blatchford.