Education
Find answers to common questions about the prosthetic & orthotic experience, including pre-amputation and post-amputation care.
FAQ
How often should I see my prosthetist or orthotist?
Outside of any problems you experience or direction you receive from your physician or therapist, it is recommended that you come in at least every six months for a check-up.
How can I exercise with a prothesis?
Start with good advice. Consult with your prosthetist. They can properly assess whether your prosthesis is suitable for the sport you have in mind. An expensive sports prosthesis is really not necessary for most recreational forms of sports. Good advice and a small adjustment to your daily prosthesis – such as mounting a toeclip for cycling – is often sufficient.
Let yourself be guided. It may be wise to be guided by a physical therapist. Think of drawing up a good build-up schedule together with achievable goals and preventing injuries.
Take good care of your residual limb and prosthesis. Exercizing will put more stress on both your residual limb and your prosthesis. Inspect and take good care of your residual limb and contact your advisor or doctor immediately if you have any doubts or complaints. And always clean your prosthesis well after exercizing and have it checked regularly.
How can I best care for my residual limb?
For optimal wearing comfort of your prosthesis and to prevent infections and other complaints, it is important that you take good care of your residual limb.
To help you with that, follow these few tips:
- Wash your residual limb every day. This can be done without soap, or with a mild soap. Use plenty of water so that no soap residue remains. The skin around the residual limb must also be kept clean and dry to prevent infections. In warm weather it is wise to wash your residual limb more often.
- It is better not to use body milk or other skin products on your residual limb before putting on the sock or liner. That can cause irritation.
- If you are not wearing your prosthesis, we recommend that you wear a shrinker sock. This ensures that your residual limb stays in shape, which is important for the wearing comfort of the prosthesis. This also applies if you have to lie in bed for a long time due to circumstances.
- Check your residual limb every day for pressure sores. You can recognize a pressure spot by red spots on the skin. This is especially important if you are wearing a prosthesis for the first time. Do you find a red spot that does not disappear within a few days, or do you have a wound? Please contact your orthopedic advisor immediately.
How do I maintain my prothesis?
A prosthesis is a valuable asset in all respects. Proper maintenance of your prosthesis is good for wearing comfort and for the longevity of use. You can of course always ask Ottobock.care for advice. To help you on your way, we give you a few tips below. Do you have specific questions about the maintenance of your prosthesis? Please contact your orthopedic advisor.
Five tips for maintaining your prosthesis:
- Clean the socket daily with a damp cloth. If you want to clean the socket intensively, you can use a disinfectant if necessary. In that socket, make sure that you thoroughly clean the socket afterwards with a damp cloth. Allow the socket to dry thoroughly before donning the prosthesis. If your socket is covered, for example with leather, do not use alcohol, water or soap. If you use a liner with a pin system, we recommend that you thoroughly vacuum the adapter of the pin system (in the socket) once a week with the vacuum cleaner.
- Also clean the inside of the liner every night. Always use unscented soap for this. Perfume can damage the material of the liner and thus cause skin irritation. After cleaning, rinse the liner with lukewarm water until all soap residue is gone. Finally, pat the liner dry with a lint-free cloth and let the liner dry further on the plastic stand, with the fabric cover on the outside.
- Never expose the liner to heat, heating or sunlight for extended periods. The material of which the prosthesis is made cannot withstand this well.
- Do not disassemble your prosthesis yourself. The parts are attached to each other in a special way by an expert. If there is something wrong with your prosthesis, do not try to solve it yourself, but contact your Ottobock.care adviser.
- Your prosthesis is designed to withstand the same forces as normal human limbs. Too much force can damage your prosthesis. If you have a profession or practice a sport that involves more force than is typical, please report this to your prosthetist.
How is a prothesis fitted?
A prosthesis is fitted by making an impression of your residual limb, using a plaster model or a digital scan or on the basis of measurements.
We will then make a fitting appointment with you. During fitting, we carefully check the fit and position and adjust them where necessary.
If the prosthesis fits well, you and your prosthetist will practice with your new prosthesis. During this practice phase you will learn to handle your prosthesis independently and it will be optimally adjusted. The length of the exercise program differs per prosthesis and per person.
Do I need a prescription if I want to have an adjustment made?
Not usually. However, if the adjustment involves a significant change or replacement prosthesis or orthosis, you will need a prescription.
Why do I need a prescription?
Insurance companies require a prescription for all new devices and many replacement items.
How long do appointments take?
This varies greatly depending on the care you need. More information can be provided to you upon scheduling an appointment.
Can I reschedule my appointment?
Absolutely. Please call our office as soon as you know you will be unable to make the appointment, and we will be happy to reschedule.
Can members of my family attend appointments with me?
Yes, of course! We love getting to know you as a person. Coming to understand your family, hobbies, background and life experiences will help us formulate goals and a care plan to meet those goals. Having loved ones support you through this process is always important, and it is always an asset to have a second set of eyes or ears to catch details you may miss or ask questions you may not think of in the moment.
Can you put me in touch with a patient that you have fitted with the same type of device so that I may ask some questions?
What do I do if my prosthesis is bothering me once I get home?
How do I clean my orthosis or prosthesis?
Can I shower with my prosthesis or orthosis?
What kind of shoes should I wear with my prosthesis or orthosis?
Can I walk barefoot or wear different shoes with my prosthesis?
Can I drive with a prosthesis?
- Hand controls (easy to use, great for bilateral amputees)
- Accelerator Switch (often removable)
- Some patients are able to drive manual vehicles, however automatic vehicles are recommended.
Do I need to remove my prosthesis in order to go to the bathroom?
Will I be able to walk stairs in my prosthesis?
Can I play sports in my prosthesis or orthosis?
I currently wear a prosthesis, but I think I need a new one. Can you help?
Can I change the components of my prosthesis (i.e. ankle or foot)?
What should I do if the fit or function of my orthosis or prosthesis changes?
Can I adjust the prosthesis or orthosis myself?
Will my prosthesis be covered by my insurance provider?
Both leg prostheses and arm prostheses are reimbursed from the basic insurance.
For each prosthesis, we submit the application to your health insurer. We have contracts with all health insurers in the United States. All we need from you to submit your application is a prescription from your doctor – or your medical indication.
How is a prosthetic leg attached?
There are different systems for attaching a prosthetic leg to your residual limb. For all systems, the most important parts are the liner and the prosthetic socket.
Liner
The liner is a stocking made of silicone – or gel material – and is rolled over your residual limb. This creates a vacuum between the residual limb skin and the inside of the liner. The prosthesis is attached to the liner. The liner also protects the residual limb, which improves the wearing comfort of your prosthesis.
Prosthesis Socket
The prosthetic socket is a custom-made hard socket that is placed over the liner around your residual limb.
Think of the socket as the suspension system of the prosthetic leg. There are five systems for attaching the prosthetic socket to a residual limb.
- Pin suspension
- Vacuum Suspension
- Condyle suspension (anatomical shape of the residual limb)
- KISS system (Velcro suspension)
- Lanyard suspension (liner with string)
The ‘correct’ suspension depends on your residual limb shape, residual limb length, your health, muscle strength and personal wishes. With the right suspension you prevent the prosthesis from sinking and walking costs as little energy as possible. Ask your advisor what is the best solution for you.
Confirm lower leg prosthesis
There are a number of ways to suspend a lower leg prosthesis.
Liner with pin
The lower leg prosthesis is attached to the liner with a pin system. The pin is on the end of the liner. As soon as you step into the prosthetic socket, the pin clamps into a locking mechanism at the bottom of the socket. Remove the prosthesis leg by pressing a button on the outside of the prosthesis.
Liner with sleeve
A sleeve is an extra vacuum sleeve that is rolled over your residual limb and attached to the outside of the sleeve. When you step into the prosthetic socket with the liner (without pin) a vacuum is created by the extra stocking on the outside. An exhaust valve at the bottom of the shaft pushes excess air out of the system while running.
Liner with rubber ring on the outside (seal-in)
A rubber ring on the outside of the liner and an ejection valve at the bottom of the prosthetic socket work together to create a vacuum in the socket when walking. By spraying alcohol spray into the tube, it is easier to get in with the non-slip rubber ring, the air can escape through the ejection valve and the rubber ring creates a vacuum with the hard tube. The residual limb with liner is then suspended in the tube and can be removed by pressing the button on the valve.
Active vacuum system
Like the sleeved liner, the active vacuum system uses a pinless liner and a sleeve. The pump mechanism in the lower leg tube or prosthetic foot actively extracts air from the socket while walking.
Lanyard suspension (liner with string)
The liner is attached to the tube by a rope mechanism (Lanyard suspension). This string is screwed to the end of the liner that you wear around your residual limb. The string runs out through an opening in the bottom of the prosthetic socket. By pulling the string, the residual limb is pulled into the prosthetic socket. When the residual limb is properly seated in the socket, secure the string.
Suspending a lower leg prosthesis using the anatomical shape of the residual limb (KBM principle)
A prosthesis does not need to be attached with a liner. By making clever use of the anatomical shape of the knee, the prosthesis can be attached to your residual limb (condyle fitting).
Condyle Fitting
The leg is slightly narrower above the knee than the knee itself. By making the tubular shape in such a way that it runs in above the knee, it remains attached to it: the KBM principle. This system is called condyle fitting and uses a soft inner tube with butt socks and a hard outer tube. An extra elastic stocking or sleeve can be used for even better hold or a firmer feeling.
Suspending an upper leg prosthesis using a vacuum
There are a number of ways to suspend a thigh prosthesis.
Liner with rubber ring on the outside (seal-in)
A rubber ring on the outside of the liner and an ejection valve at the bottom of the prosthetic socket work together to create a vacuum in the socket when walking. By spraying alcohol spray into the tube, it is easier to get in with the non-slip rubber ring, the air can escape through the ejection valve and the rubber ring creates a vacuum with the hard tube. The residual limb with liner is then suspended in the tube and can be removed by pressing the button on the valve.
Liner with pin
The lower leg prosthesis is attached to the liner with a pin system. The pin is on the end of the liner. As soon as you step into the prosthetic socket, the pin clamps into a locking mechanism at the bottom of the socket. Remove the prosthesis leg by pressing a button on the outside of the prosthesis.
KISS system (Velcro suspension)
The liner is fitted with Velcro. When putting on the leg prosthesis, the Velcro is pulled out through the bottom of the socket. The Velcro goes through a kind of pulling eye and is folded back on the same strap. At the top of the front of the liner is a teardrop-shaped piece of Velcro. The strap has an eye – the towing eye – that sticks to the liner. The tube therefore has two pulling eyes: one at the bottom and one at the top of the front.
Suspending a thigh prosthesis without a liner
It is also possible to attach the prosthesis to the residual limb without a liner. Without a liner, the residual limb goes directly into the prosthetic socket. Due to the soft muscle tissue of the thigh residual limb, this provides sufficient vacuum.
Vacuum on bare skin
To be able to wear the prosthesis around bare skin, first pull a double-walled pull-on bag made of parachute fabric around the residual limb. With this you step into the prosthetic socket. While leaning on the prosthesis, pull the pull-on bag completely out through the valve hole and the residual limb sits at the bottom of the prosthesis socket. Then the valve hole is closed with a cap of the ejection valve.
A prothesis for the first time
Learning to wear a prosthesis takes a lot of time and practice. One of the things you have to learn to deal with is that you have no feeling in your prosthesis. For example, if you wear a prosthetic foot, you won’t feel like you’re walking on gravel, grass, or a wobbly boulder. A prosthetic foot does not transmit these signals to your brain. You should therefore practice a lot to avoid unsafe situations.
A prosthesis is not water resistant
Whatever prosthesis you wear, it is important that you know that it cannot go under water. To shower and swim with your prosthesis, you can do two things. You can use a special bath prosthesis or you can wear a protective cover around your prosthesis. You can also use special non-slip feet to prevent slipping in wet areas.
One year warranty
The warranty against manufacturing and material defects on your prosthesis is one year. Your advisor will ensure that you always have a properly functioning prosthesis under all circumstances.
What if my prosthesis or orthosis breaks?
My skin is red after I remove my prosthesis or orthosis. Is that normal?
How long should I wear my brace each day?
How often should I replace a brace?
How is my prosthesis made?
When should I have a new socket fabricated for my prosthesis?
Is swelling normal in my residual limb?
What can I do to help reduce swelling?
What happens if my residual limb gets smaller and the prosthesis is too big to fit now?
How long will my first prosthesis last?
How do I learn to use my prosthesis?
Why does my AK socket have to go so far up into my groin?
Will I need to use a cane or walker with my AK solution?
How high does a transtibial prosthesis come up my leg?
Is my prosthetic leg waterproof?
Will I still be able to bend my knee with a BK prosthetic solution?
I heard that you are supposed to toughen your limb by developing callouses in order to use a prosthesis. Is that true?
I have a Van Ness Rotationplasty. Are you able to make a prosthesis for me?
Do you treat patients that have had the 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.