the effect of prosthetic socket texturing on suspension...dr. quinlan's post-doctoral...

1
The Effect of Prosthetic Socket Texturing on Suspension Julia Quinlan 1 , Lilly Tran 1 , Jessica Yohay 1 , Brad Poziembo 2 and Stefania Fatone 1 1 Northwestern University Prosthetics-Orthotics Center and 2 Prosthetic Design Inc. Department of Physical Medicine and Rehabilitation, Northwestern University Prosthetics-Orthotics Center Longitudinal testing set up. Load cell Socket Instron Actuator Funding Support This work was supported by the Office of the Assistant Secretary for Health Affairs, through the Neuromusculoskeletal Injuries Research Award under Award No. W81XWH-16-1-0485. Dr. Quinlan's post-doctoral fellowship was supported by the National Institute on Disability, Independent Living and Rehabilitation Research of the U.S. Department of Health and Human Services, Administration for Community Living (grants 90AR5010 and 90AR5031). Time (s) Displacement [mm] Pull 250 N Pull 650 N Pull 500 N Position at 0 N Position at 750 N = 1 x BW Loading Pull 100 N Un-Loading Testing protocol. Aim To evaluate the effect of socket texturing on socket suspension using mechanical testing. Smooth socket, original SQUIRT-Shape Socket texture, and SQUIRT-Shape socket with added texture. Original SQUIRT- Shape socket SQUIRT-Shape Socket with added Texture Smooth thermoformed socket Mock Limb Fabrication Transtibial plaster cast was used to create a dual durometer polyurethane mock limb wherein a harder core mimicked muscle and bone tissue and a softer outer shell mimicked skin and subcutaneous tissue. A stainless steel pylon threaded with wire was used to create an attachment point between the mock limb and materials testing system. All sockets were made to fit the same mock limb. Components of transtibial mock limb. Urethane limb Plaster cast Pylon Urethane limb design Hard core Soft shell Pylon Mock limb with liner inside the socket Liner Sealing sleeve Tested socket Testing Protocol During longitudinal testing, pre-compression of 750 N was applied to the mock limb and socket to mimic the load experienced by a prosthesis user. All sockets were then subjected to preselected distraction force magnitudes of 100N, 250N, 500N and 650N, with 10 cycles at each force magnitude. Introduction Fused deposition modelling of prosthetic sockets, such as with the SQUIRT-Shape Rapid Prototyping System [1], results in a textured surface as compared to conventionally smooth sockets. Texturing sockets may improve suspension by increasing the coefficient of sliding friction between the socket and liner. This serves to minimizing the lower limb prosthesis slipping off the residual limb during activities. Sockets A selection of different texture patterns were programmed and 3D printed using the SQUIRT-Shape System [1]. A smooth thermoformed socket and a SQUIRT-Shape socket with original texturing consisting of horizontal striations approximately 1.2 mm in depth were used as controls. Apparatus A hydraulic materials testing system (Instron, Norwood, MA) was used to test socket displacement in the longitudinal direction. Discussion Mechanical testing demonstrated that textured sockets improved socket suspension by minimizing longitudinal displacement of the socket relative to the liner clad mock limb. While certain textures appeared to minimize longitudinal displacement the most, the best texture pattern for clinical use will ultimately be one that also minimizes rotational motion without undue wear on the liner and sufficient socket durability for everyday use. Additional mechanical testing of rotational displacement for the same set of socket textures is currently underway. Conclusions Mechanical testing of sockets serves as pre-clinical research on the feasibility of texturing to improve suspension. For texture patterns that improve suspension, further work is needed to assess the coefficient of friction and strength to ensure that textured sockets are sufficiently durable for testing on human subjects. References [1] Rovick J. Automated Fabrication of Sockets for Artificial Limbs. PhD Dissertation, Northwestern University, 1993. Hypothesis Socket texturing will decrease longitudinal displacement. Suspension Horizontal striations Vertical striations Rotation Suspension and rotation Combined texture Results The smooth thermoformed socket displayed slightly more longitudinal displacement than the original SQUIRT-Shape Socket. All textured sockets displayed less longitudinal displacement than the smooth thermoformed socket and original SQUIRT-Shape Socket. The half-hemisphere heavy/dense texture pattern resulted in the least longitudinal displacement of all textured patterns. Reference socket displacements. Textured socket displacements. Dimensions of socket textures that can be programmed for 3D-printing. Textured socket Horizontal Spacing Depth Cross-sectional view of socket Socket Liner Limb Original SQUIRT-Shape socket with horizontal striations and socket fabrication. Methods and Results Black represents heavy/dense texturing. Green represents light/sparse texturing.

Upload: others

Post on 18-Mar-2020

0 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: The Effect of Prosthetic Socket Texturing on Suspension...Dr. Quinlan's post-doctoral fellowship was supported by the National Institute on Disability, Independent Living and Rehabilitation

The Effect of Prosthetic Socket Texturing on Suspension Julia Quinlan1, Lilly Tran1, Jessica Yohay1, Brad Poziembo2 and Stefania Fatone1

1Northwestern University Prosthetics-Orthotics Center and 2Prosthetic Design Inc.

Department of Physical Medicine and Rehabilitation, Northwestern University Prosthetics-Orthotics Center

Longitudinal testing set up.

Load cell

Socket

Instron

Actuator

Funding Support This work was supported by the Office of the

Assistant Secretary for Health Affairs, through the NeuromusculoskeletalInjuries Research Award under Award No. W81XWH-16-1-0485. Dr.Quinlan's post-doctoral fellowship was supported by the National Instituteon Disability, Independent Living and Rehabilitation Research of the U.S.Department of Health and Human Services, Administration for CommunityLiving (grants 90AR5010 and 90AR5031).

Time (s)

Dis

pla

cem

ent

[mm

]

Pull 250 N

Pull 650 N

Pull 500 N

Position at 0 N

Position at 750 N= 1 x BW Loading

Pull 100 N

Un-Loading

Testing protocol.

Aim To evaluate the effect of socket texturing on socket suspension using

mechanical testing.

Smooth socket, original SQUIRT-Shape Socket texture,and SQUIRT-Shape socket with added texture.

Original SQUIRT-Shape socket

SQUIRT-Shape Socket with added Texture

Smooth thermoformedsocket

Mock Limb Fabrication Transtibial plaster cast was used to create a dual durometer polyurethane

mock limb wherein a harder core mimicked muscle and bone tissue and a softer outer shell mimicked skin andsubcutaneous tissue. A stainless steel pylon threaded with wire was used to create an attachment pointbetween the mock limb and materials testing system. All sockets were made to fit the same mock limb.

Components of transtibial mock limb.

Urethane limbPlaster cast Pylon Urethane limb design

Hard

core

Soft shell

Pylon

Mock limb with liner inside the socket

Liner

Sealingsleeve

Testedsocket

Testing Protocol During longitudinal testing, pre-compression of 750 N

was applied to the mock limb and socket to mimic the load experienced bya prosthesis user. All sockets were then subjected to preselected distractionforce magnitudes of 100N, 250N, 500N and 650N, with 10 cycles at eachforce magnitude.

Introduction Fused deposition modelling of prosthetic sockets, such as

with the SQUIRT-Shape Rapid Prototyping System [1], results in a texturedsurface as compared to conventionally smooth sockets. Texturing socketsmay improve suspension by increasing the coefficient of sliding frictionbetween the socket and liner. This serves to minimizing the lower limbprosthesis slipping off the residual limb during activities.

Sockets A selection of different texture patterns were programmed and

3D printed using the SQUIRT-Shape System [1]. A smooth thermoformedsocket and a SQUIRT-Shape socket with original texturing consisting ofhorizontal striations approximately 1.2 mm in depth were used as controls.

Apparatus A hydraulic materials testing

system (Instron, Norwood, MA) was used totest socket displacement in the longitudinaldirection.

Discussion Mechanical testing demonstrated that textured sockets

improved socket suspension by minimizing longitudinal displacement of thesocket relative to the liner clad mock limb. While certain textures appearedto minimize longitudinal displacement the most, the best texture patternfor clinical use will ultimately be one that also minimizes rotational motionwithout undue wear on the liner and sufficient socket durability foreveryday use. Additional mechanical testing of rotational displacement forthe same set of socket textures is currently underway.

Conclusions Mechanical testing of sockets serves as pre-clinical

research on the feasibility of texturing to improve suspension. For texturepatterns that improve suspension, further work is needed to assess thecoefficient of friction and strength to ensure that textured sockets aresufficiently durable for testing on human subjects.

References[1] Rovick J. Automated Fabrication of Sockets for Artificial Limbs. PhDDissertation, Northwestern University, 1993.

Hypothesis Socket texturing will decrease longitudinal displacement.

Suspension

Horizontal striations Vertical striations

Rotation Suspension and rotation

Combined texture

Results• The smooth thermoformed socket displayed

slightly more longitudinal displacement than theoriginal SQUIRT-Shape Socket.

• All textured sockets displayed less longitudinaldisplacement than the smooth thermoformedsocket and original SQUIRT-Shape Socket.

• The half-hemisphere heavy/dense texture patternresulted in the least longitudinal displacement ofall textured patterns.

Reference socket displacements. Textured socket displacements.

Dimensions of socket textures that can be programmed for 3D-printing.

Textured socket

Horizontal Spacing

Depth

Cross-sectional view of socket

Socket

Liner

Limb

Original SQUIRT-Shape socket with horizontal striations and socket fabrication.

Methods and Results

Black represents heavy/dense texturing. Green represents light/sparse texturing.