The TC double socket above-knee prosthesis.
The conventional total contact suction AK prosthesis presents several disadvantages, such as difficulty in wearing the socket in a sitting position, difficulty in obtaining a favourable disposition of the stump soft tissues in the socket and difficulty in avoiding stump perspiration problems. In an attempt to solve these disadvantages, a new AK prosthesis with a thermoplastic double socket was developed at the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Handicapped. The double socket is composed of an external socket attached to the lower parts and a detachable internal socket, and appears to solve all the disadvantages of the conventional prosthesis. This prosthesis is called the TC prosthesis, and abbreviation for the Tokyo Metropolitan Rehabilitation Center. The first model of this prosthesis, (TC-1) has a metal valve. A new rubber sheet valve was developed to solve several disadvantages of the metal valve in the TC-2 prosthesis. Since November 1978 the TC-1 has been fitted to 295 AK amputees, including 9 bilateral AK amputees, and since March 1980, 145 AK amputees have received the TC-2, including 6 bilateral amputees. Satisfactory results have been obtained with both prostheses.
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Article: The TC double socket above-knee prosthesis.
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ABSTRACT: The objectives were to investigate the effect of three different interface types on consumer satisfaction and perceived problems among trans-tibial amputees in the Netherlands. A postal questionnaire (based on the Prosthesis Evaluation Questionnaire) was sent to 353 patients. Responders were classified in three groups of interface types: polyethylene foam (PEF) inserts, silicone liners (SIL), and polyurethane liners (PUL). Differences concerning satisfaction and problems between interface types were computed and adjusted for potential confounding by age, gender, reason for amputation and time since first prosthesis. A total of 220 patients responded (62%). Patients wearing liners reported a significantly poorer durability and higher maintenance time compared with patients using PEF inserts. Sum-scores for satisfaction or problems did not show any significant differences between groups. Analysis of individual items showed a significant difference only for satisfaction with sitting and with walking on uneven terrain in favour of PEF inserts. In contrast to most studies, interface type was included as a possible determinant of customer use, satisfaction, and perceived problems. The perceived differences between the three suspension types are to a large extent small and non-significant. The findings do not support liner prescription as a matter of course for all trans-tibial amputees. A careful analysis of patients' preferences should be made to determine the best course of action. Further studies, preferably prospective, need to be conducted to determine which systems are most comfortable and offer least complaints.
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ABSTRACT: OBJECTIVE: To compare a seal-in liner with the common suction socket with regards to patient satisfaction and problems experienced with the prosthesis. DESIGN: Retrospective survey. SETTING: Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran and Department of Biomedical Engineering, Faculty of Engineering, University Malaya, Malaysia. PARTICIPANTS: Ninety males with traumatic transfemoral amputation who had used both suspension systems participated in the study. Two questionnaires were completed by each subject to evaluate their satisfaction and problems experienced with the two suspension systems. Interventions: Two prosthetic suspension systems: a seal-in liner and common suction socket. Main Outcome Measures:Satisfaction and problems with the prosthetic suspension systems were analyzed in terms of fitting, donning and doffing, sitting, walking, stair negotiation, appearance, sweating, wounds, pain, irritation, pistoning, edema, smell, sound and durability. RESULTS: The study revealed that the respondents were more satisfied with the seal-in liner with regards to fitting, sitting, donning and doffing. Overall satisfaction increased with the use of the seal-in liner compared to the suction socket (P<0.05). However, satisfaction with the prosthesis showed no significant differences in terms of walking (flat and uneven surfaces), appearance and stair negotiation. Furthermore, problems experienced differed significantly between the two suspension systems (P<0.05). Sweating, wounds, pain, irritation, pistoning, edema, smell and sound were less problematic with the use of the seal-in liner; whereas durability was significantly better with the suction socket. CONCLUSIONS: The results of the survey suggest that satisfaction and problems with prosthetic suspension in persons with transfemoral amputation can be improved with the seal-in liner compared to the suction socket provided that the durability of the liner is enhanced.