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We Change, They Adjust: A Guide to Adjustable Socket Technology

Posted by Bryan Potok, CPO on

Your residual limb naturally changes throughout the day and having a prosthetic socket that fits just right will help you go about your day worry-free. Over the last 5 years, creative and prosthetic minds developed more ways to improve the bond between a person and their prosthesis. The development of socket-less sockets and adjustable sockets have made adjusting prostheses possible in just a few seconds, so you can do away with midday bathroom visits just to add a sock ply or gel pad. Even better, these technological advancements allow you to develop a more personalized bond with your prosthetic limb through micro-adjustments that you can facilitate in minutes.

Adjustable sockets ultimately try to close the technology gap and innovation speed between sophisticated microprocessor components (below the socket) and the socket interface. Often times, the socket interface is the weak link between the amputee and prosthetic limb. But with these innovations in adjustable socket technology, amputees are presented with more options that can maximize comfort and daily motion.

To understand better how these systems work and what they can do for you, we put together a primer on some of the latest offerings from various companies.

RevoFit Adjustable Prosthetic Socks

Ottobock and Click Medical created innovative, adjustable sockets that are more accessible through Ottobock's Central Fabrication Service in Salt Lake City, Utah. Designed and patented by Click Medical, RevoFit micro-adjustable sockets are designed to accommodate fluctuations in limb shape by allowing prosthetic users to micro-adjust their socket fit during the day. Some of its key features are:

  • Adjustability. Rather than adding prosthetic socks to your socket, the RevoFit features an adjustable socket that allows you to quickly and even single-handedly adjust the fit any time during the day.
  • Custom, movable panels. Targeted to specific limb areas, these panels allow you to fine-tune compression within the socket.
  • Accommodates daily volume changes. The RevoFit is designed to accommodate daily volume changes—a feature that is not available in ordinary sockets—which reduces the hassle of post-delivery adjustments.
  • One-hand release. Yet another game-changing feature of the RevoFit is its one-hand release dial. Donning and doffing are made easy by simply pulling the dial with one hand to release.
  • RevoFit Adjustable sockets

    Click here for more information about RevoFit™.

    Socket-less Socket™

    Martin Bionics reinvented sockets by eliminating the static socket shape—say goodbye to the hard ischial seat and suction loss! It truly molds and conforms to your body, giving you a custom-fit socket with every use. Some of its key features are:

    • Virtual weightlessness. This Socket-less Socket is 40% lighter than the original Socket-less Socket. This is because the design and materials are NASA-inspired. The lightness of the socket will surprise you will definitely allow you to do more during the day.
    • Rock-solid. It features a floating Femoral Lock Pad which dynamically captures the limb, making you feel like your socket is a part of you. Because of this, it is known to be exceptionally stable as it conforms to your body.
    • Micro-adjustable. Unlike conventional prosthetics, it enables the user to micro-adjust to maximize comfort with each use. Now you can gain full control over how your socket feels.
    • Easy on, easy off. Donning and doffing is as easy as wearing your favorite pair of shoes.
    • Cooler feel. Through the AirHammock Modular Inner Socket, heat dissipates and allows you to stay cool.

    Martin Bionic's Socketless adjustable ak socket does not have an ischial seat.

    LIM Innovations: The Infinite Socket TT and Infinite Socket TF

    San Francisco-based company LIM Innovations created the Infinite Socket, which is said to leverage digital technology and adjustable design to match the unique needs of the wearer. According to LIM Innovations' YouTube page, "the Infinite TT is a custom-molded, modular, and adjustable socket system for transtibial amputees. The thermoplastic carbon-fiber frame, hinging posterior strut, and BOA closure system draw in the medial and lateral walls to improve biomechanical control. The advanced pressure distribution system incorporates height adjustment and air bladders, designed in response to activity demands, pressure areas, and shape change. The color options of soft shell covers allows patients to choose the right style for them." The Infinite Socket focuses on 4 patient benefits:

    • Adaptability. It’s the only socket that truly accommodates changes in one's body, giving the user natural comfort.
    • Adjustability. Allows users to gain full control of fit and function. User can adjust the socket on a daily basis.
    • Comfort. Maximum comfort of the wearer is a priority. To achieve this, the Infinite Socket features advanced fabrics and a superior design.
    • Freedom. Because of its design, users can explore the world, somewhat prosthetic sock-free, so they can enjoy an active lifestyle and live life on their own terms.

    The Infinite Sockets TT for bk amputees, users can adjust their socket daily.

    The Infinite sockets TF allow self adjusting micro-adjustments each day by the amputee.

    To deliver all 4 benefits, LIM Innovations uses LIM CAPTURE, which takes measurements and images to create a 3D digital version of a mold to perfect an Infinite Socket that's unique to each user's limb. LIM CAPTURE also empowers prosthetic clinicians to facilitate adjustments during the final fitting to shorten the fitting process. With this innovation, you can now say goodbye to test sockets.

     

    Here’s a comparison of the Infinite TT and the Infinite TF:

     

    Infinite TT

    Infinite TF

    Allows for easy loosening of the socket fit while sitting down, flexing your knee, and relaxing. Permits dial-in fitting while you're active.

    Modular frame and carbon fiber struts makes it easier for prosthetists to modify adjustments, in response to the patient's body fluctuations. Flexible brim can also be loosened while sitting down, and tightened while walking.

    Integrated textiles and adjustable parts are fine-tunable as you go for greater ease and comfort.

    Structural frame is made to flex or spring.

     

    Depending on your lifestyle, body weight, body fluctuations, and your overall medical condition, each technology or product mentioned above is different. However, all are predominantly similar as they focus on giving maximum comfort, empowerment, easy adjustments, innovation, and proper fit. The differences lie in customer preference. For example, while LIM Innovations’ Infinite Socket allows users to flex, Martin Bionics does not as it focuses on cooling the socket. 

    Some final thoughts

    Traditional prosthetic sockets are like a wooden clog—fixed and rigid in shape; they don’t allow for change or minor adjustments to accommodate the natural daily fluctuations of a user’s residual limb. In contrast, all three technologies mentioned above have sockets that are very adjustable. These allow the wearer to go beyond the limitations presented by existing prosthetic technology, which requires test sockets and countless fittings.

    But socket fitting is more than just a science, it's already evolved as an art form. The focus on human functional experience has paved the way for these products to address the shortcomings of traditional and outdated sockets. Some of the issues that can be addressed by these new technologies include: a heavy feeling in the residual limb due to a poor-fitting socket; and acquired skin allergies or chafing due to misalignment of the prosthetic or increased friction between the residual limb and prosthetic limb.

    In contrast, custom, modular devices, such as those mentioned above, give amputees the freedom to perform the adjustments themselves, saving time, money, and effort.

    Furthermore, these innovations are beneficial not only to the prosthetic user, but also to clinicians and healthcare providers. In giving their patients more control over their prosthetics, it allows them to save time and effort from constantly seeing their patients for numerous fittings. 

    Consult with your prosthetist

    Having a positive relationship with your prosthetist will also help facilitate open communication. Ask as many relevant questions as possible, and do your research before consulting your health care provider.

    Comparison Chart

    Before your go to your prosthetist, this chart may help you figure out which of the three innovative products will work best for you. You can also show this to your prosthetist, so you can have a quick, visual summary of which system would be perfect. Consider your lifestyle, daily activities, your hobbies, and what can benefit you the most in terms of price and usability. 

    Function

    LIM Innovations

    Martin Bionics

    Click Medical

    Custom to Mold

    X

     

     

    Custom to measurement

     

    X

     

    Covered by insurance

    X

    X

    X

    Semi Rigid structure

    X

     

     

    Rigid Structure

     

    X

     

    Easy Don/Doff

    X

    X

    X

    Open Design

    X

    X

     

    Hybrid design

     

    X

     

    TF

    X

     

     

    TT

    X

     

     

    TR

     

     

     X

    TH

     

     

     X

    Hip Disarticulation

     

    X

     

    Symes

     

     

     

    Liner with pin

    X

     

     

    Liner with lanyard

    X

     

     

    Sleeve

     X

     X

     

    Use with any Liner type

     X

     X

    X

    Sharkskin suspension

     

    X

     

    Adjust through clothing

    X

     

    X

     

     ***Some notes:

    • LIM Innovations uses a 3D mold versus Martin Bionics uses software and measurements
    • LIM Innovations have flex built into the struts, versus Martin Bionics has a rigid design
    • LIM Innovations reinvents socket interface, Martin Bionics does the same with options to progress into a revolutionized design with hybrid systems
    • All three promote easy donning and doffing
    • Open design is inherent in LIM Innovations and Martin Bionics
    • Martin Bionics is accessible to the world
    • Martin Bionics provides options for upper extremity and hip disarticulation. LIM Innovations does not.

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    Link to this page
    <a href="https://amputeestore.com/blogs/amputee-store-blog/guide-to-adjustable-socket-socketless-technology">We Change, They Adjust: A Guide to Adjustable Socket Technology</a>

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    5 comments


    • Why not design a socket that has an inflatable inner core,that can be tightened or loosened by adding air or expelling air. The military has the material for this use. I know because I’ve used it. I was a Navy SEAL ( Vietnam ). An air bladder inside the sides of the socket that could be inflated or deflated with a touch of button . Why hasn’t this been done ? Left AK .

      Paul K BArnes on

    • How much do they cost?

      Krista on

    • OMG GOD I HAD THIS IDEA 15 YRS AGO AND HAVE DATES AND DRAWING TO PROVE I TOLD HANGER 2003 WHY NOT HAVE STRAPS LIKE A SKI VEST WITH ADJUSTABLE , 3 STRAPS AND CAN PULL TO TIGHTEN OR LOOSEN THEY WOULDNT LISTEN .15 YRS AGO ,OMG CANT BELEIVE NO ONE ELSE 200 OR OLDER DIDNT THINK OF THIS IDID ,WELL GREAT I KNOW WORKS ALL SEND PICTURS OLD LEG WE PUT STRAPS ON TO TRY IN 2004 .CHUCKJ

      chuck hultberg on

    • LIM is not recommended for anything more then walking, it is not a good fit for active amputees. Martin is (from what I can tell) only available for above knee amps. Click is “ok” but your entire limb changes and the panels only cover mostly the middle third of your stump; this leads to a loose bottom and loose by the knee for us below knee amps; I’ve found this leads to an incredibly embarrassing farting noise… also; poor comfort and too much sloppy-ness. Overall; these are all failures in my mind for higher activity level and for amps that experience more than one ply of change per day

      Joshua Karczewski on

    • Two questions:
      1. What is the comparison in cost compared to an original styled one?
      2. I’m a very active and working 67 year old male… will these new styled legs hold up as well? [both below the knee, right is 13 years old, left is 7 years old (both are old and beat up but working just fine)].

      Cliff Newman on

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