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How To Put On Above Knee Prosthesis

Does It Hurt To Walk On Prosthetic Leg

How to put on an above knee prosthesis with Pin Liner (Shuttle Lock System)?

The feeling of walking with a prosthetic is very difficult to describe its like trying to describe how it feels to taste ice cream to someone without a tongue. Its really difficult to use at first and feels like walking on a boot with an extremely thick sole, with tight laces that go all the way up to your knee.

Another One Visit Prosthetic Solution For Above Knee Amputees

Especially for above knee amputees with a lower activity level, we have Connect TF. Connect TF is an adjustable socket and can be re-adjusted throughout your life. It is a;custom fitted socket, which can be adjusted in height, angle and circumference, so it will always fit the shape of your leg. It also conveniently means that you won’t need a completely new socket every time you experience a physical change, like muscle gain or loss.

This socket has rigid but flexible shells and with the easy handle, you can put on your prosthesis, or remove it, while you are seated.

You can use the Connect TF socket in combination with a liner with a locking system. This ensures you that there is a safe connection, and it can be built with almost all common components.

Would you like to learn more about how it works in practise? In the video below we show you how it works and what the benefits are for you.

A Note On Phantom Limb Pain

Phantom limb pain, or pain that seems to come from the amputated limb, is avery real problem that you may face after an amputation. About 80% ofpeople with amputations experience phantom limb pain that has no clearcause, although pain in the limb before amputation may be a risk factor,says Keszler.

Mirror therapy, where you perform exercises with a mirror, may help with certain types ofphantom limb pain. Looking at yourself in the mirror simulates thepresence of the amputated leg, tricking the brain into thinking its stillthere, stopping the pain, explains Keszler.

In other cases, phantom limb pain might stem from another conditionaffecting the residual limb, such assciaticaor neuroma. Addressing these root causes can help eliminate the phantompain.

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Rehabilitation Is An Ongoing Collaborative Process

Once youve selected your prosthetic leg components, you will needrehabilitation to strengthen your legs, arms and cardiovascular system, asyou learn to walk with your new limb. Youll work closely withrehabilitation physicians, physical therapists and occupational therapiststo develop a rehabilitation plan based on your mobility goals. A big partof this plan is to keep your healthy leg in good shape. Your healthy legis worth its weight in gold, emphasizes Keszler. While prosthetictechnology is always advancing, nothing can replicate a healthy leg.

Johns Hopkins Comprehensive Amputee Rehabilitation Program

Having the support of a dedicated team of experts is essential when recovering from the amputation of a limb. At Johns Hopkins, our team of physiatrists, orthotists, prosthetists, physical and occupational therapists, rehabilitation psychologists and other specialists works together to create your custom rehabilitation plan.

How Soon After Amputation Can You Get A Prosthesis

Above Knee Prosthesis Helps Amputees Find Ultimate Freedom ...

Some individuals receive a temporary prosthesis immediately following amputation or within two to three weeks after surgery. Usually, a prosthetic device fitting begins two to six months after surgery once the surgical incision has healed completely, the swelling has gone down, and your physical condition improves.

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The Problem: A Loose Socket Fit

Possible Cause:;;If you find that your socket no longer fits like it used to, it’s most likely due to a change in the size and shape of your limb. If you’ve had revision surgery, or have recently gained more than 2 percent of your body weight, the socket won’t fit properly and putting it on will be difficult.;

Possible Solution:;In general, you can manage fluctuating socket volume by layering prosthetic socks;, wearing a stump shrinker or accommodating volume loss with gel. Maintaining a constant weight is also crucial to maintaining good socket fit. A whole new socket may be necessary if your limb has changed significantly.;

Why Do Amputees Live Shorter Lives

Patients with renal disease, increased age and peripheral arterial disease have exhibited overall higher mortality rates after amputation, demonstrating that patients health status heavily influences their outcome. Furthermore, cardiovascular disease is the major cause of death in these individuals.

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Sitting Down And Standing Up With A Prosthesis

Once you know how to put on the prosthesis and take it off, sitting down and standing up are the next everyday actions you will learn. Users with a transfemoral amputation fitted with a knee joint with sitting assistance can put weight on both legs while sitting down. The Prosedo, Kenevo, C-Leg® 4, Genium or Genium X3 from Ottobock have this function, for example. This results in significant relief for the sound side, which helps prevent premature problems from excessive strain. Users with a transtibial amputation should also put the same amount of weight on both legs when sitting down and standing up for the same reason.

A One Visit Prosthetic Solution For Below And Above Knee Amputees

How to put on an above knee prosthesis with Vacuum Liner

One Visit Prosthetics with Direct Socket makes use of a unique fitting process. With Direct Socket this is directly on your leg which results in a snug fit and a secure suspension between the liner and the socket. For above knee amputees, we use a silicone brim at the top of the socket. This brim reduces the contact of the solid socket with solid surfaces like chairs, which makes it a lot more comfortable to wear.

The socket design can be combined with most standard prosthetic leg components, so once you are fitted with the necessary parts, and trained to used the prosthesis properly, you can walk out the clinic with your new,;final custom prosthetic leg after only one visit!

Would you like to learn more about how this works in practice? In the videos below we show you step by step how it works in practice and how this unique fitting process is built around you as a prosthetic user!

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The Principles Of Above

Mediolateral Stability

When one watches the walk of a typical above-knee amputee, two characteristics of gait often are particularly apparent. First, sidesway, i.e., lateral movement of the torso from side to side, is exaggerated. Second, the amputee usually walks with his feet farther apart than does a normal individual of similar build. The average individual walks in such a manner that the lateral distance between successive points of heel contact is from 2 to 4 in. In order for the gait of an amputee to appear as normal as possible, therefore, he must walk with a base equally narrow. The amputee with a walking base of from 6 to 12 in. never can achieve a normal gait appearance. If such an amputee is asked why he walks with a wide base, he usually gives as the reason that it is more comfortable or that he feels more secure with his feet farther apart.

The Weight-Bearing Line
Variations in Vertical Force
Forces in Shear
Floor Reaction and Load Line
The Support Line
Use of the Hip Abductors
The Pelvic Lever
Distribution of Lateral Pressure
Considerations of Mechanical Advantage
Adduction of the Stump
Foot Position

Knee Control

Involuntary Control
Voluntary Control
Initial Flexion
Ankle Position and Toe Break

Above Knee Leg Prosthetics

An above knee or transfemoral prosthesis is custom made for a person who has had a AK or TF amputation. The prosthesis consists of a custom made socket, liner, knee, pylon, and foot. Sometimes the prosthesis may consist of a sleeve or other harness, depending on the suspension system used for that patient.

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Above Knee And Below Knee Prosthesis: Seal


Seal-in suction suspension is designed to be used with a total surface-bearing socket. Total surface bearing is a general loading of the entire residual limb.

With seal-in suction suspension, the user rolls a silicone liner onto the residual limb creating a seal. The seal-in liner includes a flexible rubber ring called the Hypobaric Sealing Membrane . The HSM creates a suction seal with the socket to suspend the prosthesis. This type of suspension works best with longer, cylindrical limbs. It can be used with some below the knee or above the knee prostheses. Seal-in liners are available with the seal secured in a specific position, it can be custom made where your prosthetist decides at what height it should be located, or the seal may be a separate piece where the wearer places it on the correct location on the limb. There is also a liner with multiple seals. .

How Do They Work


All microprocessor controlled knees feature sensors, a microprocessor, software, a resistance system and a battery.

The knees internal computer controls an internal fluid, which may be hydraulic or pneumatic. The internal computer monitors each phase of your walking pattern using a series of sensors. The continuous monitoring and control of fluid allows the processor to make adjustments in resistance so you can walk more efficiently at various speeds and walk more safely down ramps and stairs.

You may ask, why do I need resistance when Im walking? If you think about what we call the gait cycle, it makes more sense.

The gait cycle is divided into two major phases: stance phase and swing phase. The stance phase happens when your foot is on the ground, when you are applying weight to your leg. The swing phase is when your foot is in the air and swinging forward.

When your foot is in contact with the ground, your leg normally flexes, or bends, sometimes even when you are standing still. The amount of flexion is relatively small you dont want your knee to buckle under you! The muscles of a biological leg are adding resistance, or support, to prevent buckling. When you take a step and put weight on your foot, your knee flexes a little, acting like a shock absorber. This is another time that your muscles are active to stabilize your knee. This also helps take stress off the rest of the body.

Quick Facts

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Proper Function & Fit

On delivery day, we will ensure your prosthesis is fitting and functioning properly before sending you home with your new device. We will follow up with you to adjust your fit and alignment as you progress, and to maintain the components of your above the knee prosthetic leg in Kansas City.

HOPE for the Best.

Standard Features Of An Above Knee Prosthesis

Socket This is the part of the artificial limb that your residual limb fits into. It can be made of thermoplastic, metal or laminated material.

Knee Joint There are various types of knee joint. Some are designed to swing; others are designed to stay in a locked position for walking but can be unlocked for sitting. Note: Prosthetic knee-joints are only used when your amputation is at a level through the natural knee-joint or higher up the leg.

Shin Tube This lies between the prosthetic knee joint and the prosthetic foot. It is made of strong lightweight material such as carbon fibre, aluminium or titanium.

Prosthetic Foot & Ankle There are many different types of feet and ankles available. Your individual needs will influence the choice made.

Cosmesis/Cover This a cosmetic cover that gives shape and appearance to the limb. Most artificial limbs are covered with a continuous foam tube that is shaped to match your remaining limb as closely as possible. It may then be covered with stockings.

Suspension This holds the artificial limb on to your stump. The type of suspension you need will be assessed when you are ready for your measurements to be taken.

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How To Put On Your Prosthesis

When you first take delivery of your artificial limb, your prosthetist and physiotherapist will show you the correct way to put it on and take it off. You should not put the limb on until you have been shown how to do this correctly and you are confident that you know what to do.

A stump sock should be worn next to the skin between your residual limb and the socket. Stump socks come in different thicknesses depending on the material. These include wool, terry towelling, cotton or nylon. Use a clean sock every day and remember that your residual limb may change in size and shape, which could mean that you have to add or take off socks to help the artificial limb fit more comfortably.

1) Pull on or roll your sock onto your residual limb making sure there are no wrinkles. The seam should be away from your scar.

2) Push the inner socket onto your residual limb making sure that your residual limb is fully into the liner. The small depression or shelf should fit just under your kneecap .

3) Pull a thin nylon sock over the top of the liner. This helps the liner slide into the hard outer socket.

4) Place your hands on either side of your knee and liner and push the liner into the outer socket. Your residual limb should feel firm inside the socket. Make sure when you push in that the inner lines up with the outer socket and that it is not twisted.

5) If you have a strap, pull it firmly over your knee and fasten it securely

The Problem: Skin Irritation On Your Knee Cap

How To Put On And Take Off An Above Knee Prosthesis

Possible Cause:; The; prosthetic liner and/or BK sleeve is pulled too taut over your knee. Or,;if redness is occurring along the bottom third of your knee cap, it could be caused by;volume loss in your limb.;

Possible Solution:;Use an anti-chafing cream or liquid powder along your knee cap to help your prosthetic liner or below-the-knee sleeve glide on easily.;

Excessive;redness;along the bottom third of your knee cap is typically the result of insufficient layering of your prosthetic socks. ;To manage fluctuations in limb volume, start with a one ply or filler sock and continue adding ply until your prosthetic socket fit is comfortably snug. It’s not uncommon to experience a good fit along your knee and looseness along the bottom of your liner or sleeve. You may want to consider a half sock to accommodate volume loss along the bottom half of your prosthetic socket.;

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The Problem: Pain Along The Inner Brim Of An Above Knee Prosthetic Socket

Possible Cause:;Sudden weight gain, especially around the holidays, can create what’s called an adductor roll. This extra skin roll sits on top of the inner brim and creates discomfort with every step when it’s compressed.;

Possible Solutions: Try a;different technique to apply your prosthesis.;Many people have successfully coaxed their adductor rolls;inside;their sockets using a nylon slip-on aid. Others have used a nylon slip-on aid along with anti-chafing lotion or using a specialized sheath like GlideWear or AK Brim Sheath along the top of your socket.;However, if your weight gain is;30lbs;or more, a new socket may be warranted. Keep in mind that if adductor rolls are left untreated they may become a permanent fixture on your limb and very difficult for your Prosthetist to reduce with a new socket.

The Problem: Small Red Bumps Or White

Possible Cause:;Shaving your residual limb or wearing a prosthesis that rubs the skin can irritate the hair follicles, which can lead to folliculitis. Hair follicles are also irritated by sweat buildup. Damaged hair follicles are more susceptible to bacteria, yeast, and other fungi, and so more likely to become infected.;

Possible Solution:;Products called drawing salves, such as ichthammol, can help draw out infection and other objects, including ingrown hairs, from the skin. It’s also a good idea to let the hair on your limb grow, rather than shaving it.;

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Benefits Of Using The Prosthesis

If you find that you are a suitable candidate for the prosthesis, but you are not yet sure that this is indeed the right choice for you, consider some of the benefits of using a prosthetic device: In many cases, a prosthetic limb will give you more ability to train and involve in physical activities than other options.

Upward movements help the bloodstream and the digestive system, and studies have shown that amputations who regularly exercise enjoy higher self-confidence and a better general health sense than stationary patients.

The prosthesis gives you increased functional independence.In other words, you may be able to perform many of the activities that you used to do before the loss of the limb, without relying on the assistance of others.Even aspects that are perceived as marginal, such as independent walking to the bathroom, or independent clothing, are perceived as significant victories.Leg Amputated people who use prostheses and wheelchairs simultaneously report that they feel less of the stigma of the disabled, wearing a prosthesis.

That is, most amputees who are healthy enough, have access to the prosthesis, use the prosthesis or at least try to use it, are getting great benefits.

Walking Safely On Stairs And Ramps

How To Put On And Take Off An Above Knee Prosthesis

You will always encounter obstacles in daily life, such as curbs, stairs in the home or a ramp leading up to the garage. Walking safely on stairs and ramps is a constant part of your daily life, and is practiced with you during gait training. The individual components of your prosthesis determine what walking technique is right for you.

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Prosthetic Legs Are Not One Size Fits All

If your doctor prescribes a prosthetic leg, you might not know where tobegin. It helps to understand how different parts of a prosthesis worktogether:

  • The prosthetic leg itself is made of lightweight yet durable materials. Depending on the location of the amputation, the leg may or may not feature functional knee and ankle joints.
  • The socket is a precise mold of your residual limb that fits snugly over the limb. It helps attach the prosthetic leg to your body.
  • The suspension system is how the prosthesis stays attached, whether through sleeve suction, vacuum suspension/suction or distal locking through pin or lanyard.

There are numerous options for each of the above components, each withtheir own pros and cons. To get the right type and fit, its important towork closely with your prosthetist a relationship you might have forlife, recommends Keszler.

Aprosthetistis a health care professional who specializes in prosthetic limbs and canhelp you select the right components. Youll have frequent appointments,especially in the beginning, so its important to feel comfortable with theprosthetist you choose.


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