Prosthetic & Orthotic Information and Education


Use and Care for Above Knee Prosthesis

New Prosthesis Wearers:

Your body will need time to adjust to your prosthesis. Take your time and do not do excessive exercise or walking for the first several weeks. Do not walk more than 15 minutes at a time for the first few days. Check your residual limb several times a day for the first two weeks and check for unusual skin conditions. This will exhibit itself as blisters, bruising or any skin discolorations that do not return to its natural tone in 10 to 15 minutes. (Contact your Prosthetist immediately if you notice any skin complications or related issues.)

The following is a general list of instructions, your particular case may differ. Be sure to follow the specific instructions your Prosthetist gave you at your appointment. 

Belt Suspension Prosthesis

  1. If you wear a gel liner, this is always applied to your residual limb first. Only one liner is applied and make sure it is wrinkle free.
  2. Apply the correct ply of prosthetic socks to the residual limb, over the liner or against the skin if no liner is used. Socks come in different plies, so make sure the proper sock is used. 
  3. Apply the prosthesis over the socks. The prosthesis should be applied onto the residual limb as far as it will go while in a seated position.
  4. Before standing, apply the suspension belt securely around your waist. 
  5. Now stand. Once you are standing make sure the prosthesis is "rotated" correctly and the knee is fully extended /straightened. 
    1.  The ischial tuberosity (pointy bone located in your gluteal or buttocks area) should be placed on the back shelf of the prosthetic socket. If this is not positioned properly, you cannot determine if the sock applied is the correct ply. 
  6. Sock Management
    1. If the ischial tuberosity is slipping and you are "wedging" into the socket, you need to increase the ply of socks applied to the residual limb. This may occur at any point during the day. 
    2.  If you receive excessive pressure on a bone in the groin area, check the position of the socket on the residual limb. The prosthesis may be rotated too far in either direction. If the position is correct, you may need to increase the ply of sock. Make sure that the sock is not bunched up at this area, but that it is folded over the top of the brim and laid flat. 
    3. If you are receiving excessive pressure distally (on the bottom of your residual limb) you may need to increase the ply of sock.
    4. If the ischial tuberosity does not sit on the posterior shelf, you need to reduce the ply of sock applied to the residual limb. This may occur at any point during the day.
    5.  If the sides of the residual limb towards the bottom of the socket feel as though they are being "stretched" you may need to decrease the ply of sock.
    6. All adjustments should be made one ply at a time. Patients do not shrink at 3 and 5 ply increments.
  7. Once you are sure the fit is correct, tighten the suspension belt to its proper level before walking. 
  8. You will probably receive "uncomfortable" pressure applied to the buttocks at first. This is common. The area should "toughen" over time. 
  9. When seated, the prosthesis will more than likely slide slightly distally (down) on the residual limb, this is normal. 

Proper Application of Suspension Component and Care: Waist Belt

  1. Apply the belt above your hip(s) and tighten the closure. If you have a pelvic band and hip joint, the band should be placed just below the waistline on the prosthetic side. 
  2. DO NOT pull one side of the belt harder than the other as this will rotate the prosthesis incorrectly. 

Locking Liner Suspension Prosthesis (Pin or Strap)

  1. Invert the gel liner as far as possible without tearing the liner at the bottom. The object is to achieve no "air pocket" between the bottom of the limb and the liner. 
  2. Apply the liner to the residual limb. There should be no interface between your skin and the liner, unless otherwise directed by your Prosthetist. Check to make sure there is no space between the bottom of the limb and the bottom of the liner. 
  3. Slide the liner completely onto the limb with no pulling on the liner. There should be no wrinkles in the liner. Your care provider may instruct if there is a front or not, and you may use a lubricant on your skin. Be sure to discuss with your prosthetist how much lubricant is advisable. Too much and your liner will tend to slip and slide. 
  4. Once the liner is donned, check to make sure the pin/strap receivers are positioned correctly. The receiver should be in line with your residual limb and not canted to a side, front or back. Also check and make sure the pin or suspension screw is attached to the receiver completely and is secure. Apply the correct ply of prosthetic socks to the residual limb. Socks come in different plies, so make sure the proper sock is used.
  5. Apply the limb with sock(s) and liner into the prosthesis. If you have a lanyard strap, feed the strap through the "locking" mechanism located in the bottom of the socket and secure the strap through the buckle on the front top of the socket. 
  6. Now stand. Once you are standing, make sure the prosthesis is "rotated" correctly and the knee is fully extended/straightened. 
  7. Sock Management 
    1. If the ischial tuberosity is slipping and you are "wedging" into the socket, you need to increase the ply of socks applied to the residual limb. This may occur at any point during the day.
    2. If you receive excessive pressure on a bone in the groin area, check the position of the socket on the residual limb. The prosthesis may be rotated too far in either direction. If the position is correct, you may need to increase the ply of sock.
    3. If you are receiving excessive pressure distally (on the bottom of your residual limb) you may need to increase the ply of sock.
    4. If the ischial tuberosity does not sit on the posterior shelf, you need to reduce the ply of sock applied to the residual limb. This may occur at any point during the day.
    5. If the sides of the residual limb towards the bottom of the socket feel as though they are being "stretched" you may need to decrease the ply of sock. All adjustments should be made one ply at a time. Patients do not shrink at 3 and 5 ply increments.
  8. Once positioned correctly, the pin should be engaged in the lock or strap fastened securely through the buckle. 

Suction Socket Prosthesis: Skin Fit, No Liner

  1. Remove the valve from the valve seat.
  2. Apply a "pull" sock over the residual limb encompassing most of the top of residual limb. If your prosthetist has instructed you to use the prosthetic liquid powder, apply a liberal amount over the top of the residual limb. Also, apply lotion to the brim (top) of the prosthetic socket.
  3. Apply the prosthesis to the residual limb and put the end of the pull sock through the valve seat. Make sure the prosthesis is rotated and positioned correctly.   
     a) The ischial tuberosity (pointy bone located in your buttocks area) should be placed on the back shelf of the prosthetic socket. If this is not positioned properly, you do not have the prosthesis positioned correctly.
  4. Carefully stand with the prosthesis on the residual limb as far as possible. Use an assistive device while standing to reduce the chance of falling. Using one hand, grab the pull sock and begin pulling the sock through the valve seat. "Pump" your residual limb while pulling the sock down and off. The purpose is to pull soft tissue into the socket, not just pull the sock off.   
  5. Once the sock is pulled through the valve seat, check to make sure your residual limb is "filling" the bottom of the socket. This is achieved by simply pushing a finger through the valve opening and feeling for soft tissue placement.
  6. Apply the valve to the seat and screw it in snugly.
  7. After sitting, air may need to be removed once you are standing again. This is achieved by using the valve release mechanism. 

Instructions Given for Care of the Prosthetic Socks and Nylons

Only use the prosthetic socks and sheaths provided by your care provider. Each type of sock has its own cleaning instructions. Follow the instructions provided to you by your prosthetist. Every person is unique. Your prosthetist will give you specific instructions for your case.
Routine checks on your prosthesis should be completed by your prosthetist in two weeks, then in three months, and followed up with an appointment six months after initial delivery.

Use and Care of your Custom Foot Orthosis

Initially, an orthosis may be worn for short periods of time in order to accommodate its use in your everyday activities. You should gradually increase your wearing time until you achieve regular and consistent use of the orthosis.

During this time, you and/or a caregiver MUST make several daily inspections of your skin to check for blistering, sores, or any sign of skin breakdown that may occur.

Please check your feet a minimum of 3 times each day. More often if you are a diabetic.

If you notice any irritation, or have any spots you are concerned about, STOP wearing the orthosis and call our office for an appointment so that adjustments can be made. You may want to follow up with your doctor for further care.

Appropriate Footwear

Choosing the correct footwear will maximize the effectiveness of your orthosis. Appropriate footwear includes most walking, cross-training, athletic, and extra depth style shoes. These types of shoes have ample side support, low heels, and removable insoles. Most casual or dress shoes do not have these features. Talk to your orthotist if you have questions about the proper footwear.

Wear

It is advisable to always wear a sock to reduce friction between your skin and the orthosis. The sock should be pulled just tight enough to remove wrinkles.

The orthosis may cause your feet to perspire more than usual, so you may need to change your socks often in hot or humid weather.

Care

A well-constructed orthosis may last for many years. Wear and tear will occur depending on your level of activity. Watch for signs that the orthosis is wearing and call us to about repairs or replacing the orthosis.

NEVER ATTEMPT TO REPAIR THE ORTHOSIS BY YOURSELF!

Your orthosis may be cleaned with a damp cloth. If odor is a problem, use a mild soap or rubbing alcohol and allow it to dry at room temperature. Never use heat or harsh chemicals on the orthosis, in order to avoid damaging the orthosis or your skin.

Follow Up

You should be seen in our office at least once every six (6) months for an evaluation and maintenance. Your orthotist may want you to follow up sooner if necessary. If you should have any questions before your next scheduled appointment, please contact our office, we are happy to help.

Return Policy

Our fees and the fitting and fabrication are based on the delivery of a medical device prescribed by your physician, not the outcome of treatment and therefore are not refundable. If you feel like your device needs to be adjusted, we are happy to make any adjustments within the first 90 days of having your device at no charge.

Use and Care for Below Knee Prosthesis

New Prosthesis Wearers:

Your body will need time to adjust to your prosthesis. Take your time and do not do excessive exercise or walking for the first several weeks. Do not walk more than 15 minutes at a time for the first few days. Check your residual limb several times a day for the first two weeks and check for unusual skin conditions. This will exhibit itself as blisters, bruising or any skin discolorations that do not return to its natural tone in 10 to 15 minutes. (Contact your Prosthetist immediately if you notice any skin complications or related issues.)

Proper Donning and Wearing of Your Prosthesis: No Gel Liner Socket

  1. If you wear a silicone sheath, this is always applied to your residual limb first. Only one sheath is applied and make sure it is free of wrinkles.
  2. Apply the correct ply of prosthetic socks to the residual limb. Socks come in different thicknesses called "ply". It is important that the proper ply of sock is used.
  3. If your prosthesis has a one, remove the soft liner from the prosthesis and apply it to your limb. Approach the limb with the liner from the back of the limb and apply onto the limb until the patella tendon bar is in the proper location.
    1. The indention towards the top front of the liner/socket is known as the patella tendon bar. This "bar" should be positioned at mid-patella tendon level. The mid-patella tendon level is the mid-point between the bottom of the patella (kneecap) and top of the tibia (shin). 
  4. Place your residual limb, and if you have one, the liner into the prosthesis. The socket should line up correctly with the patella tendon bars matching. 
  5. When standing, pressure should be applied by the patella tendon bar at mid-tendon level (see 3a). No adjustments need to be made to the ply of the sock as this is a proper fit.
  6. Sock Management: 
    1. If the bar applies pressure to the bottom of the patella or excessive pressure to the bottom of your residual limb while standing, you need to increase the ply of socks applied to the residual limb. This may occur at any point during the day. 
    2. If the bar hits the tibia (top of the shin) while standing, you need to reduce the ply of socks applied to the residual limb.
    3. All adjustments should be made one ply at a time. Generally, patients do not shrink in 3 and 5 ply increments.

Gel Liner with Patella Tendon Bar Socket

  1. Invert the gel liner as far as possible without tearing the liner at the bottom. The object is to achieve no "air pocket" between the bottom of the limb and the liner.
  2. Apply the liner to the residual limb. There should be no interface between your skin and the liner, unless otherwise directed by your prosthetist.
  3. Slide the liner completely onto the limb with no pulling by you on the liner. There should be no wrinkles in the liner. Your prosthetist will have instructed you if there is a front or not and if you may use a lubricant on your skin.
    1.  The indention towards the top front of the liner/socket is known as the patella tendon bar. This "bar" should be positioned at mid-patella tendon level. The mid-patella tendon level is the mid-point between the bottom of the patella (kneecap) and top of the tibia (shin). 
    2. If your liner has a pin locking system: Once the liner is donned, check to make sure the pin is positioned correctly. The pin should be in line with your residual limb. This means that the pin is not canted in one direction more than another. Also, check and make sure the pin is screwed in the receiver completely and is secure.
  4. Apply correct ply of prosthetic socks to the residual limb. Socks come in different plies, so make sure the proper sock is used. If you do not wear a soft-liner, skip to #7.
  5. Take the liner out of the socket and apply it to your limb. Apply the liner onto the limb until the patella tendon bar is in its proper location. 
    1. The indention towards the top front of the liner/socket is known as the patella tendon bar. This "bar" should be positioned at mid-patella tendon level. The mid-patella tendon level is the mid-point between the bottom of the patella (kneecap) and top of the tibia (shin).
  6. Apply limb with socks and liner(s) into prosthesis.
  7. When standing, pressure should be applied by the patella tendon bar at mid-tendon level (see 3a). No adjustments should be made to the ply of sock, as this is a proper fit.
  8. Sock Management:
    1. If the bar applied pressure to the bottom of the patella while standing, increase the ply of sock applied to the residual limb. This may occur at any point during the day. 
    2. If the bar hits the tibia (top of shin) while standing, reduce the ply of socks.
    3. All adjustments should be made one ply at a time. Changes do not occur in 3 and 5 ply increments.
    4. You may need to adjust the ply during the day. 

Gel Liner with Total Surface Bearing Socket

  1. Invert the gel liner as far as possible without tearing the liner at the bottom. The object is to achieve no "air pocket" between the bottom of the limb and the liner.
  2. Apply the liner to the residual limb.;
  3. Slide the liner completely onto the limb with no pulling by you on the liner. There should be no wrinkles in the liner. Your prosthetist may instructed if there is a front or not and if you may use a lubricant on your skin.
    1.  If your liner has a pin locking system: Once the liner is donned, check to make sure the pin is positioned correctly. The pin should be in line with your residual limb. This means that the pin is not canted in one direction more than another. Also, check and make sure the pin is screwed in the receiver completely and is secure.
  4. Apply correct ply of prosthetic socks to the residual limb. Socks come in different plies, so make sure the proper sock is used.
  5. Apply limb with socks and liner into prosthesis.
    1. If there is excessive pressure being applied "upward" onto the bottom of the residual limb, then increase the ply of socks. 
    2. If the excessive "pull" on the residual limb while standing, then decrease ply of socks. 
    3. All adjustments should be made one ply at a time. Changes do not occur in 3 and 5 ply increments.
    4. You may need to adjust the ply during the course of the day.

Proper Application of Suspension Component and Care

Waist Belt

  1. 1) Adjust waist belt for snug fit over the hips.
    1. The belt should be over a shirt or pants to prevent skin irritation. 
    2. The belt should not cause difficulty in breathing. 
    3. If the elastic pick-up strap creates a "V" in the belt with tension applied, the belt is not tight enough around the waist.
  2. Put the billet through the buckle and fasten it in its proper hole. When standing, there should be slight tension applied to the elastic pick-up. 
    1. Too much tension will put excessive pressure "upward" on the residual limb. It will also put excessive strain on the lower back and hips. 
    2. No tension will cause the prosthesis to "piston" or "drop" on the limb while walking.
  3. Apply the Velcro strap above the knee snugly, but not too tight. Minimum to moderate pressure is applied to the skin. 
    Care: Wash the waist belt by hand in cool or warm water and allow it to air dry. Do not use bleach, only mild detergents. 

Suspension Sleeve

  1. Pull or roll the suspension sleeve up onto the thigh. This will need to be discussed with your prosthetist to determine which technique to use. Half of the sleeve should be above the prosthesis and half on the prosthesis. 
  2. Make sure that the sleeve is wrinkle free. The prosthesis will be allowed to "piston" or move on the residual limb for each wrinkle.
  3. Once the sleeve is applied wrinkle free, fold the top half in half and lightly pull upward at the fold.
  4. Depending upon the type of material used, which your prosthetist can detail for you, fold or pull, the remaining portion back up on to the thigh. If the sleeve is pulled onto the thigh it will "push" the residual limb into the socket. Also, excessive tension will be applied to the skin if the sleeve is pulled. This may cause skin rash, itching and or sores/ulcers. 
  5. The suspension will work better with the surface of the sleeve on the skin or the gel liner. Your prosthetist will check for proper length of prosthetic sock for this suspension.

Care of Sleeve

  1. At night, allow the sleeve to stay "up" not left rolled down on the prosthesis. This will prevent premature stretching of the sleeve.
  2. If you have two sleeves, swap them once a week. This will prevent premature stretching of the sleeves. 

Care of Liners 

  1. Follow the instruction booklet given to you by your prosthetist. Clean the liner after each usage with soap and water. 
  2. Clean the inside of the liner once a week with alcohol. Switch the liners daily. This allows the liners to dry and prevent premature stretching. 

Instructions Given for Care of the Prosthetic Socks and Nylons

Only use the prosthetic socks and sheaths provided by your care provider. Each type of sock has its own cleaning instructions. Follow the instructions provided to you by your prosthetist. Every person is unique. Your prosthetist will give you specific instructions for your case.
Routine checks on your prosthesis should be completed by your prosthetist in two weeks, then in three months, and followed up with an appointment six months after initial delivery.

Use and Care Of Your Custom Knee Ankle Foot Orthosis Or Ankle Foot Orthosis

Initially, an orthosis may be worn for short periods of time in order to accommodate its use in your everyday activities. You should gradually increase your wearing time until you achieve regular and consistent use of the orthosis.

During this you and/or a caregiver MUST make several daily inspections of your skin to check for blistering, sores, or any sign of skin breakdown that may occur.

If you notice any irritation, or have any spots you are concerned about, STOP wearing the orthosis and call our office for an appointment so that adjustments can be made. You may want to follow up with your doctor for further care.

Appropriate Footwear

Choosing the correct footwear will maximize the effectiveness of your orthosis. Appropriate footwear includes most walking, cross-training, athletic, and extra depth style shoes. These types of shoes have ample side support, low heels, and removable insoles. Most casual or dress shoes do not have these features. Talk to your orthotist if you have questions about the proper footwear.

Wear

The orthosis should be placed on your foot and leg first, then inserted into the shoe. If this is not possible, placing the orthosis into the shoe first, then sliding the foot into the orthosis may be an acceptable alternative. If you are not sure, check with your orthotist.

NEVER WEAR AN ANKLE FOOT ORTHOSIS OR A KNEE ANKLE FOOT ORTHOSIS WITHOUT SHOES! The orthosis is slippery if worn without shoes and may cause you to fall and injure yourself and/or damage the device beyond repair.

It is advisable to always wear a sock to reduce friction between your skin and the orthosis. The sock should be higher than the orthosis and pulled just tight enough to remove wrinkles.

The orthosis may cause your feet to perspire more than usual, so you may need to change your socks often in hot or humid weather.

Care

A well-constructed orthosis may last for many years. Wear and tear will occur depending on your level of activity. Watch for signs that the orthosis is wearing and call us to about repairs or replacing the orthosis.

NEVER ATTEMPT TO REPAIR THE ORTHOSIS BY YOURSELF!

Your orthosis may be cleaned with a damp cloth. If odor is a problem, use a mild soap or rubbing alcohol and allow it to dry at room temperature. Never use heat or harsh chemicals on the orthosis, in order to avoid damaging the orthosis or your skin.

Follow Up

You should be seen in our office at least once every six (6) months for an evaluation and maintenance. Your orthotist may want you to follow up sooner if necessary. If you should have any questions before your next scheduled appointment, please contact our office, we are happy to help.

Return Policy

Our fees and the fitting and fabrication are based on the delivery of a medical device prescribed by your physician, not the outcome of treatment and therefore are not refundable. If you feel like your device needs to be adjusted, we are happy to make any adjustments within the first 90 days of having your device at no charge.

Use and Care Of Your Custom Knee Orthosis

Initially, an orthosis may feel awkward or out of place and it will take some time until you are used to wearing it in your everyday activities. Always wear the orthosis as prescribed by your physician. If allowed, wear the orthosis for short periods of time and gradually increase your wearing time until you achieve regular and consistent use of the orthosis.

During this time you and/or a caregiver MUST make several daily inspections of your skin to check for blistering, sores, or any sign of skin breakdown that may occur.

If you notice any irritation, or have any spots you are concerned about, STOP wearing the orthosis and call our office for an appointment so that adjustments can be made. You may want to follow up with your doctor for further care.

Wear

Always apply the orthosis according to your physician’s instructions and the manufacturer’s suggestions. The orthosis should be applied to the knee while in a sitting position with the knee at a 45° angle, making sure that the orthosis is not twisted on the leg
In most cases, the upper calf strap should be tightened first, making sure not to restrict circulation. Secure the lower calf strap, then the upper thigh strap. Finally secure the lower thigh strap.

It is advisable to always wear the knee orthosis directly against your skin.
The orthosis may cause your leg to perspire more than usual, so you may need to hand wash the orthosis or the liners with cold water and a mild detergent.

ALWAYS ALLOW THE ORTHOSIS TO AIR DRY!

If your leg becomes swollen, remove the orthosis and sit or lie down with the affected leg raised. Continue use of the orthosis ONLY after the swelling subsides.

Care

A well-constructed orthosis may last for many years. Wear and tear will occur depending on your level of activity. Watch for signs that the orthosis is wearing and call us to about repairs or replacing the orthosis. Inspect the hinges and screws periodically for tightness and retighten as needed. If something seems out of place, please call our office for an appointment.

NEVER ATTEMPT TO REPAIR THE ORTHOSIS BY YOURSELF!

Follow up

You should be seen in our office at least once every six (6) months for an evaluation and maintenance. Your orthotist may want you to follow up sooner if necessary. If you should have any questions before your next scheduled appointment, please contact our office, we are happy to help.

Return Policy

Our fees and the fitting and fabrication are based on the delivery of a medical device prescribed by your physician, not the outcome of treatment and therefore are not refundable. If you feel like your device needs to be adjusted, we are happy to make any adjustments within the first 90 days of having your device at no charge.

Use and Care Of Your Custom Fitted Soft Spinal Orthosis

Initially, an orthosis may be worn for short periods of time in order to accommodate its use in your everyday activities. THE ORTHOSIS SHOULD BE WORN ACCORDING TO YOUR PHYSICIAN’S GUIDELINES. You should gradually increase your wearing time until you achieve regular and consistent use of the orthosis. Call our office for an appointment if any pain or discomfort lasts for more than the first few days.

During this you and/or a caregiver MUST make several daily inspections of your skin to check for blistering, sores, or any sign of skin breakdown that may occur. Slight reddening of the skin under the orthosis is normal and should disappear a few minutes after the device is removed.

If you notice any lasting irritation, or have any spots you are concerned about, STOP wearing the orthosis and call our office for an appointment so that adjustments can be made. You may want to follow up with your doctor for further care.

Wear

The orthosis should be worn over a cotton undergarment.

Suggested application of the orthosis:

  • Place the orthosis around your back with the opening in the front. You may find it easier to put on by placing the garment open on a flat surface and lying on top of it.
  • Fasten the orthosis starting at the bottom.
  • Tighten the pull straps until the orthosis fits firmly and snugly.

Care

NEVER ATTEMPT TO REPAIR THE ORTHOSIS BY YOURSELF!

Remove pads, stays and any removable metal parts before washing.

Hand wash in cool water using a mild detergent.

Lay the device flat to dry. DO NOT MACHINE DRY.

Follow up

You should be seen in our office at least once every year for an evaluation and maintenance. Your orthotist may want you to follow up sooner if necessary. If you should have any questions before your next scheduled appointment, please contact our office, we are happy to help.

Return Policy

Our fees and the fitting and fabrication are based on the delivery of a medical device prescribed by your physician, not the outcome of treatment and therefore are not refundable. If you feel like your device needs to be adjusted, we are happy to make any adjustments within the first 90 days of having your device at no charge.