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A finite element model to assess transtibial prosthetic sockets with elastomeric liners.

ABSTRACT: People with transtibial amputation often experience skin breakdown due to the pressures and shear stresses that occur at the limb-socket interface. The purpose of this research was to create a transtibial finite element model (FEM) of a contemporary prosthesis that included complete socket geometry, two frictional interactions (limb-liner and liner-socket), and an elastomeric liner. Magnetic resonance imaging scans from three people with characteristic transtibial limb shapes (i.e., short-conical, long-conical, and cylindrical) were acquired and used to develop the models. Each model was evaluated with two loading profiles to identify locations of focused stresses during stance phase. The models identified five locations on the participants' residual limbs where peak stresses matched locations of mechanically induced skin issues they experienced in the 9 months prior to being scanned. The peak contact pressure across all simulations was 98 kPa and the maximum resultant shear stress was 50 kPa, showing reasonable agreement with interface stress measurements reported in the literature. Future research could take advantage of the developed FEM to assess the influence of changes in limb volume or liner material properties on interface stress distributions. Graphical abstract Residual limb finite element model. Left: model components. Right: interface pressures during stance phase.

SUBMITTER: Cagle JC

PROVIDER: S-EPMC5999538 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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A finite element model to assess transtibial prosthetic sockets with elastomeric liners.

Cagle John C JC Reinhall Per G PG Allyn Kate J KJ McLean Jake J Hinrichs Paul P Hafner Brian J BJ Sanders Joan E JE

Medical & biological engineering & computing 20171213 7

People with transtibial amputation often experience skin breakdown due to the pressures and shear stresses that occur at the limb-socket interface. The purpose of this research was to create a transtibial finite element model (FEM) of a contemporary prosthesis that included complete socket geometry, two frictional interactions (limb-liner and liner-socket), and an elastomeric liner. Magnetic resonance imaging scans from three people with characteristic transtibial limb shapes (i.e., short-conica ...[more]

PMID: 29235055

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Project description:Creating a secure and comfortable linkage between the residual limb and prosthetic socket in persons with lower limb amputation is a critical factor for successful rehabilitation, including ambulation and other activities of daily living. Unwanted rotation within the socket can be a clinical problem for prosthesis users. One way of addressing issues experienced with transverse plane control of the socket may be through increased friction interface forces. It has been proposed that friction at the residual limb/socket interface may be increased by adding texture to interface components. Three-dimensional (3D) printing may be used to fabricate sockets with texture patterns added to the inner socket surface. Hence, the aim of this study was to investigate the effects of socket texturing on transverse plane rotation of the socket on a mock residual limb under two suspension conditions: passive suction and active vacuum. To conduct this study, we developed a mechanical testing protocol as no standardized tests currently exist to assess prosthetic sockets. Sockets with 14 different texture patterns were fabricated using the Squirt-Shape™ 3D printer. Textured sockets were compared to an Original Squirt-Shape (OSS) socket and a smooth thermoformed socket. Sockets were fitted with a mock residual limb and bi-axially loaded to 350 N compression with simultaneous rotation (2.5°, 5° and 7.5°) using a custom rotation assembly attached to a uniaxial hydraulic material testing system. There was a statistically significant three-way interaction between suspension, angle and texture (p < 0.0005). Torques between textured and reference sockets, for all rotation angles and both suspension conditions, were significantly different (p < 0.0005). Using newly developed testing protocols, it was demonstrated that some texture patterns significantly increased torque (i.e., resistance against unwanted rotation) in the transverse plane compared to both OSS and smooth sockets, especially for passive suction. Rotation testing of sockets may provide insight into socket design to improve suspension in the transverse plane.

Project description:BackgroundAmong the different factors affecting socket comfort, the pressure applied on residual limb tissues is a crucial parameter for the success or failure of any prosthetic device. However, only a few incomplete data are available on people with transfemoral amputation, in this regard. This work aims at filling this gap in the literature.MethodsTen people with transfemoral amputation wearing 3 different socket designs were recruited in this study: 2 ischial containment sockets featured by proximal trim lines that contain the ischial tuberosity and ramus and greater trochanter, 2 subischial sockets with proximal trim lines under the ischium level, and 6 quadrilateral sockets with proximal trim lines that contain the greater trochanter and create a horizontal seat for the ischial tuberosity. The pressure values at the anterior, lateral, posterior, and medial areas of the socket interface were recorded during 5 locomotion tasks (ie, horizontal, ascent, and descent walking, upstairs and downstairs) by using an F-Socket System (Tekscan Inc., Boston, MA). Gait segmentation was performed by exploiting plantar pressure, which was acquired by an additional sensor under the foot. Mean and standard deviation of minimum and maximum values were calculated for each interface area, locomotion task, and socket design. The mean pressure patterns during different locomotion tasks were reported, as well.ResultsConsidering all subjects irrespective of socket design, the mean pressure range resulted 45.3 (posterior)-106.7 (posterior) kPa in horizontal walking; 48.3 (posterior)-113.8 (posterior) kPa in ascent walking; 50.8 (posterior)-105.7 (posterior) kPa in descent walking; 47.9 (posterior)-102.9 (lateral) kPa during upstairs; and 41.8 (posterior)-84.5 (anterior) kPa during downstairs. Qualitative differences in socket designs have been found.ConclusionsThese data allow for a comprehensive analysis of pressures acting at the tissue-socket interface in people with transfemoral amputation, thus offering essential information for the design of novel solutions or to improve existing ones, in this field.

Project description:BACKGROUND: Biological mass transport processes determine the behavior and function of cells, regulate interactions between synthetic agents and recipient targets, and are key elements in the design and use of biosensors. Accurately predicting the outcomes of such processes is crucial to both enhancing our understanding of how these systems function, enabling the design of effective strategies to control their function, and verifying that engineered solutions perform according to plan. METHODS: A Galerkin-based finite element model was developed and implemented to solve a system of two coupled partial differential equations governing biomolecule transport and reaction in live cells. The simulator was coupled, in the framework of an inverse modeling strategy, with an optimization algorithm and an experimental time series, obtained by the Fluorescence Recovery after Photobleaching (FRAP) technique, to estimate biomolecule mass transport and reaction rate parameters. In the inverse algorithm, an adaptive method was implemented to calculate sensitivity matrix. A multi-criteria termination rule was developed to stop the inverse code at the solution. The applicability of the model was illustrated by simulating the mobility and binding of GFP-tagged glucocorticoid receptor in the nucleoplasm of mouse adenocarcinoma. RESULTS: The numerical simulator shows excellent agreement with the analytic solutions and experimental FRAP data. Detailed residual analysis indicates that residuals have zero mean and constant variance and are normally distributed and uncorrelated. Therefore, the necessary and sufficient criteria for least square parameter optimization, which was used in this study, were met. CONCLUSION: The developed strategy is an efficient approach to extract as much physiochemical information from the FRAP protocol as possible. Well-posedness analysis of the inverse problem, however, indicates that the FRAP protocol provides insufficient information for unique simultaneous estimation of diffusion coefficient and binding rate parameters. Care should be exercised in drawing inferences, from FRAP data, regarding concentrations of free and bound proteins, average binding and diffusion times, and protein mobility unless they are confirmed by long-range Markov Chain-Monte Carlo (MCMC) methods and experimental observations.

Dataset Information

A finite element model to assess transtibial prosthetic sockets with elastomeric liners.

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A finite element model to assess transtibial prosthetic sockets with elastomeric liners.

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