Prosthetic support - P&O Care - Prosthetic and Orthotic Care

Transtibial Prosthetics

The transtibial amputation (also known as a below the knee or BK) is the most common level of lower limb amputation. Due to the preservation of the knee joint, many amputees are able to return to or exceed the level of activity prior to their surgery! P&O Care prosthetists have extensive experience with transtibial prostheses, including bilateral, or both side involvement. Let’s get you moving.

The “socket” is the rigid frame that is custom made to intimately fit the residual limb. The below knee socket is designed to comfortably support your body weight. A good socket fit is paramount to prosthetic success. Our practitioners are formally trained to take an accurate impression of the residual limb. Read more about how the socket works and how it stays on below.

The pylon is the metal component that connects the socket to the foot.

Thousands of prosthetic feet are available on the market today depending on the activity level and goals of the user.  Click here to learn more about prosthetic feet.

An optional custom shaped foam covering can be made to hide the pylon allowing the prosthesis to look similar to your sound side limb and protect the components from dust and debris.  A “skin” can be placed over the foam covering for a more life-like appearance.  Covering is usually completed when the prosthetist, patient and medical team are pleased with the fit and alignment of your prosthesis, which is typically 2-3 weeks after delivery.

Socket, Pylon, Foot - P&O Care - Prosthetic and Orthotic Care

Resource Center

Our resource center is a great place to learn more about the most complex prosthetic components. We want you to be informed and empowered about your prosthetic future. You have more options than you think, we’ll show you. Click the boxes below to learn more.

Transtibial Socket

The prosthetic socket is designed to comfortably support your body weight and should be comfortable and snug. It should not be painful to walk with a prosthesis, but it will feel unusual at the beginning. Because you can no longer bear weight through the bottom of your limb, we must rely on the pressure tolerant areas, or areas that can tolerate some pressure, of the remaining limb.

Examples of pressure tolerant areas include sides of your shin bone (tibia) and calf muscle. Gentle pressure is applied to these areas then offloads the pressure sensitive (or tender) areas like the very end of the bone.

Pressure Tolerant and Pressure Sensitive Areas Diagram - P&O Care - Prosthetic and Orthotic Care


Introduced in the late 1990’s, gel liners revolutionized the field of prosthetics. A much needed departure from the hard wooden sockets of yesteryear, gel liners added cushioning, comfort and enhanced the connection of the prosthetic limb to the amputee. Today, there are hundreds of prosthetic liners to choose from, made with different materials, fabrics and features. Many gel liners even incorporate Aloe Vera and other minerals to rejuvenate and moisturize the limb.

There are two basic liners and suspension systems for modern transtibial prosthetics, your activity level and condition of your residual limb will help determine which system is best for you.


This simple system has a pin (pin locking liner) connected to the gel liner that “ratchets” into a lock inside the prosthesis.

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This system uses a gel liner without a pin (cushion liner), one way expulsion valve and a knee sleeve to create a suction.

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P&O Care practitioners will discuss all of your options, ensuring you have a say in your care. With so many choices and advances in technology, it is easy to get lost in all of the medical jargon. We want to eliminate confusion. Knowledge is power!

Most Common Questions

Click on the question to reveal answer!

1. How high does the prosthesis come up on my leg?

The typical transtibial socket trimlines (or ends of the prosthesis) end just above the sides of the kneecap. This ensures that your knee joint is protected and your body weight is evenly dispersed throughout the limb. You will still be able to bend your knee so you can sit, kneel and walk comfortably.

2. Is my prosthesis waterproof?

No, unfortunately, because the components can corrode,  Learn more about our special use prostheses, here.

3. Will I still be able to bend my knee?

Yes, you will be able to bend your knee while wearing your prosthesis.

4. I heard that you are supposed to toughen your limb and develop callouses on your residual limb to use a prosthesis. Is this true?

Absolutely not! Since the invention of the gel liner, your skin should be soft and free of callouses.

5. I have a Van Ness Rotationplasty. Are you able to make a prosthesis for me?

Yes! Absolutely. We have made many sockets for patients with a Van Ness Rotationplasty. Check out Steve’s Testimony who receives treatment for his Van Ness Rotationplasty. Fun Fact: He is a member of the USA Paralympic Sled Hockey Team and won gold at the 2014 Sochi Olympics!

6. Do you treat patients who have had an Ertl Procedure?

Yes! The Ertl Procedure is a surgical method in which a “bony bridge” or piece of cartilage is created by your surgeon between the fibula and tibia.  The same fitting principles apply, comfort and function are paramount.  The Ertl method has been shown to reduce the movement between the tibia and fibula in some transtibial amputees.

Prosthetic Timeline

Wondering about the fitting process?

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Our Patients are busy walking. Read about their amazing experience.

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Peer Visitor Program

Need some hope and encouragement? Connect with an amputee peer visitor today.

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