Alternative Sockets & Outcome Measures

Name the different alternative sockets

Knee disarticulation

MAS

Hi-Fi

Sub-Ischial

Adjustable

No socket (osseointegration)

Possibility of distal load bearing

Longer limb = lower energy consumption

Preserves the growth plate in children (avoids appositional bony overgrowth)

Muscles remain intact (increased stability and control)

Intact femoral condyles increase rotational stability and assist suspension

Possibility of lower socket trimlines (sub-ischial) - improved comfort

Advantages for knee disarticulations

Disadvantages for knee disarticulations

Cosmesis - mismatches knee centers and a bulky socket

Limited knee and suspension options

Knee options for knee disarticulation

Polycentric - shank tucks under for sitting

Outside hinges - match knee center but has no mechanical friction - completely based on patient and their alignment

Others if cosmesis is not a concern to them

Suspension options for knee disarticulations

Anatomical - door, foam insert (stovepipe)

No room for pin lock

Suction is also an option