Dynamic alignment of transtibial prostheses through visualization of socket reaction moments.

Background And Aim: Dynamic alignment of transtibial prostheses is generally performed based on visual interpretation of gait without the benefit of any kinetic analysis in the clinic. The aim of this technical note was to present and discuss the possibilities of assisting dynamic alignment of transtibial prostheses through visualization of socket reaction moments.

Technique: Smart Pyramid™ (currently Europa™) was used to measure the socket reaction moments under various alignment conditions from an amputee with transtibial prosthesis. The socket reaction moments were plotted to visualize the effect of alignment changes on them, and they were clinically interpreted.

Discussion: Socket reaction moments could complement information available to prosthetists to optimize prosthetic alignment. They could be used to reduce excessive loading on sensitive areas, to improve gait stability, or to communicate the outcome of dynamic alignment with the amputees. Further research is needed to identify the contribution of kinematics and kinetics for optimal alignment.

Clinical Relevance: Dynamic alignment of transtibial prostheses is currently tuned subjectively based on prosthetists' experiences and skills. Socket reaction moments may potentially provide objective information for prosthetists to align transtibial prostheses in the clinic.