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Reflecting On Prosthetic Development

In July’s blog, we speak to Donald Mandra, a 56-year-old, car enthusiast, who has been wearing the Infinite Socket TF for four years. 

When I was 17, I lost my right leg above-the-knee. When I was referred to my Prosthetist for the first time, I never thought about the progress of prosthetics or the care I was going to be given. I actually dealt with my current prosthetists, Tony Tufano’s, Uncle who owned Mutual Orthopedics on Long Island. Back then, the sockets were made out of wood, with a hinge on the knee but I was young and didn’t want to let anything slow me down in my rehabilitation. Comfort wasn’t necessarily the most important thing for me either. Now that I’m older I feel things catching up a little bit, and I have a chance to reflect on what’s important to me now, and how prosthetic technology has developed over the last 39 years. 

It would be fair to say that after my amputation, rehabilitation was learned through trial and error. My experience with Mutual Orthopedics has spanned 30 plus years, and I have always received great care, but when I started dealing with Tony, it was clear that he wanted what was best for the patient, but the technology was not there to match. Every time I fell, I learned something new; learning how to balance, how to utilize what I had to the best of its ability. The problem with conventional sockets was around the brim. Even with a softer inner liner, the comfort was never there, and I was receiving sores around the groin.

When I first saw the Infinite Socket TF on a news article on TV in 2014, I noticed that it was adjustable and had a soft brim. I informed my prosthetist Tony who investigated further, and within months he brought me into the office to be fitted with the socket. It actually fits pretty well out the box; I don’t remember any adjustments to my initial fitting, but one thing was noticeable; the comfort around the brim was immediate. I didn’t find myself having to take it off, or even wanting to take it off. I thought to myself, I can wear this all day and all night and it doesn’t give me any issues. Utilizing it increased my activity level as it didn’t create those sores around my groin anymore. Now that I can reflect, comfort should be the benchmark, as I went from being confident, but in pain, to not feeling like I have any limitations any more. 

As with all new technology, there were areas where the socket was breaking, predominantly the brim, and the tensioning device. What made the experience so seamless, however, was that for every part that broke, I informed my prosthetist, who informed LIM’s customer service, and they would ship the replacement part to be fit, all within three days. It was as though they never broke as I’d never been without the component for very long. I’ve actually been on the first Infinite Socket I purchased for 4 years now, and can’t imagine I’d ever go back to a conventional socket again. I’m now extremely excited to get my new Infinite Socket and a new knee. I had a trial with the Ottobock Genium knee and didn’t want to give it back. The combination has been working great for me especially as I spend a lot of my time working on the yard and working on a ‘67 Corvette.

One thing I have noticed is that there is still a lot of uncertainty around the socket on social media. People talk about the bulk of the socket, but in my opinion, it’s only marginally thicker, and that’s by the struts. I have no issues with the bulk and don’t really notice it as I’m comfortable. The weight is hard to quantify when you are wearing it, as the dynamic fit allows for a snug feeling around my residual limb that can be changed when I need it. As I have mentioned, comfort should be the benchmark, and I just wish everyone had the opportunity to try it. 

LIM Innovations now offers the Infinite Socket TF to candidates up to 300lbs. If you do have any questions surrounding the socket, please reach out on Facebook, or call us on 844-888-8546 and we will be happy to answer your questions.

Jill Takes Action To Regain Ability

Jill exhibiting strength and poise in her Infinite Socket.

Jill, from Pennsylvania, recounts how she persevered through years of surgeries and rehabilitation to finally regain her active lifestyle with the Infinite Socket TF.

“I’m an energetic person. I’m out and about every day doing as much activity as possible.  I love to get myself into anything active, whether it’s outdoor activities or competitive sports–I’ve always been that way.  Then, in 2009, I received a stress fracture to my left foot. The exact moment it happened is unclear, though we suspect it may have happened when I tripped in a parking lot one evening.  Surgery was needed to fix it, and the doctor did a full fusion on my foot. The fusion and all the hardware in my foot ultimately came apart, though I didn’t realize it at the time.  A few years later I couldn’t take the pain anymore and went to have a doctor look at it. In 2013, they tried to reconstruct it. The reconstruction did not go well, and infection set in.  All the hardware in my foot was removed to allow it to heal, but a year later the pain was worse, and my foot was deformed. By the end of 2016, I’d had twelve surgeries to try to save the foot to no avail.  In December of 2016, I became a below knee amputee.  

I got myself a prosthesis and was walking.  However, I was still having trouble and couldn’t figure out why I was in so much pain.  It turns out there was osteomyelitis in my tibia, and in 2017 I opted for a shorter amputation.  A year from then, the pain in my knee from osteomyelitis was still persistent. In April of 2018, I became an above the knee amputee and encountered a whole new set of challenges.  

Below-the-knee sockets had been simple for me.  I had a traditional transtibial socket, and within three months I was out jumping rope and other activities of that nature.  However, when I got my traditional above-the-knee socket, it was the most uncomfortable thing I had experienced in my entire life.  When I first put it on, my reaction was ‘you have got to be kidding me.’ It was limited, heavy and restrictive.  The brim was incredibly awkward in the crotch area and so bulky.  It made me feel really bad. I tried my best but felt that I could only be as good as the socket I had to work with, and the conventional did not work for me.  For many months it sat against my wall, and I was non-weight-bearing for an entire year. The rashes and the rubbing made the socket unwearable, and for months I’d go in once a week for adjustments and band-aid solutions to try and make it bearable.  If I do something I really full-on go for it, and I really tried to make it work. Even so, it just wasn’t usable, and I became really depressed.  

I decided I absolutely had to get walking to stop feeling bad for myself.  A support group I joined on Facebook connected me with LIM, and in April of 2019, I received my Infinite Socket TF.  This thing is absolutely amazing, and I only wish I’d found it sooner. There are so many positive things about the design that make such a difference.  It doesn’t dig into my thigh and groin area because of the low trim, and it’s lightweight as opposed to thick and heavy. The steps I’m taking aren’t restricted as they were in the conventional socket.  The word “breathable” comes to mind; I don’t feel as if my limb is encased in something hard and unnatural. Sitting is also much easier as I can loosen and tighten my socket with the ratchet strap at the top, which is also great for volume fluctuation.  The difference between the Infinite Socket and my old traditional socket is night and day. I’ve done more in the past few weeks than I’ve done in the past year. It made me feel good about myself again.” 

 

Clinician Spotlight: Patrick Kelley of Oakland O&P

The main draw of this industry is being able to get somebody up and walking again after they’ve had some sort of traumatic experience in their life.  Whether it be lower limb loss due to trauma or a disease, an ability is taken away from them. I like the sense of giving that back to patients.

 

Patrick, on the right, in front of Oakland O&P.

In 2002, I was fresh out of the military off of active duty Marine Corps and looking for a career that would be interesting and challenging. After making some phone calls, I ended up shadowing an orthotics and prosthetics company. From there, I started learning the industry from the fabrication side while working in the lab.  Eventually I ended up going to Northwestern, first for orthotics and then for prosthetics. Ultimately, I decided prosthetics was the way to go.

The main draw of this industry is being able to get somebody up and walking again after they’ve had some sort of traumatic experience in their life.  Whether it be lower limb loss due to trauma or a disease, an ability is taken away from them. I like the sense of giving that back to patients. Oakland Orthopedic Appliances is opening a new office location, which will allow for more patients to be reached.  We are aiming to target patient populations as needed, and up north is an underserved area.

Once patients are in the office, a lot of initial encounters really serve to lay groundwork for an ongoing relationship in addition to the assessment of the current clinical situation.  It’s worthwhile to get to know the patient, what their goals are for the future, how they see themselves as a prosthetic user. Really understanding how realistic the patient’s goals are and managing expectations while doing everything possible to get them there is so important.  In the prosthetics industry, your patients aren’t one time patients–you’re building a pretty intimate and long-lasting relationship together. That relationship is crucial in order to properly advocate for the patient’s needs. There’s a lot of conversations that need to be had in order to figure out what patient and practitioner feel would result in the optimal outcome, from choosing socket type to selecting the suspension and components.  

For the patients I’ve fit with LIM’s Infinite Sockets, I’ve been very happy with the outcomes.  I’ve had a great experience working with LIM from the beginning, and was a huge fan of the Infinite TF from the get-go.  Then there’s the transtibial socket which went through a redesign, and it has been vastly improved. It’s more aesthetically pleasing and less bulky; I have a few patients now on the new design who really love it.  The Infinite Socket is a great option to provide in our area and makes us stand out as providing a niche service. I can stand by the product. In general, technology in the prosthetics industry has advanced so much.  There’s new devices coming out every month to do different things or do to optimize current functions. The socket technologies and new materials being explored have incredible potential. LIM has been a part of that growth and is doing innovative design work.  

Chris Steps Up To Find A Better Fit

Chris, from Kentucky, shares how he went from being dissatisfied with his situation to finding a solution for himself in the form of the Infinite Socket TF.

On November 14th of 2014, I started the day at the gym as always.  As I was leaving to pick up my daughter, it struck me what a beautiful day it was.  I decided to go home and get my Camaro to make the most out of the drive in the pleasant weather.  Once I got going, I went a little faster than I should have down the winding road and hit a spot that flung the vehicle into the guardrail. About forty feet of guardrail went in through the headlight and exited the tail end of the car. As the metal railing tore through, it took my leg with it. I stayed conscious through all of it until I flatlined in the helicopter and woke up at the University of Kentucky hospital a few days later.  Once I came to, I was told I might never walk unassisted again.

The first two years of recovery were frustrating. Finding the medical support I needed was a nightmare. Here in eastern Kentucky, it seems like we only have general medicine doctors. They know how to help with your typical ailments like the common cold or things of that nature, but I found they didn’t have a good understanding of my amputation. I decided to take matters into my own hands and did a lot of research personally. The electronic elevated vacuum system I was on just wasn’t working well for me; I didn’t have anything but issues with it.  It was always breaking seal, losing suction and falling off, as well as being uncomfortable on the back of my leg. I also wanted to be able to go to the gym and bulk up without it ruining my socket. The desire to have a socket that moved and changed with my residual limb is what got me started on the search that led to LIM.

I talked with my prosthetist at Kenney Orthopedics and got fit with my Infinite Socket. It took me about two days to get the new socket adjusted to accommodate my needs, and then it was good to go!  I literally couldn’t do anything until I got the LIM socket. The previous summer I had tried to hike to a waterfall and couldn’t walk the 6/10ths of a mile, but once I got my Infinite Socket I walked the whole way.  It made that much of a difference. My family lives in one of the best areas for rock hunting, some of the rarest agates in the world are found around here, and we get out and hike when I’m able. The convenience of the Infinite Socket allows that. If it becomes loose throughout the day, I can adjust it. It also allows my hip to flex, which in turn, allows for more walking. Honestly, the socket was the turning point in my healing process. I was in absolute misery, and then the Infinite Socket changed everything.

Premier Partner Q&A: Anthony Tufano of Mutual Orthopedics

Anthony Tufano, CP, is the president of Mutual Orthopedics.  He strives to achieve an optimal outcome for every individual patient by combining new technologies with the traditions that have made his long-standing practice a success.

 

Infinite Socket, Mutual Orthopedics
Mutual Orthopedics CP Anthony Tufano with Infinite Socket TF patient

What brought you into the Orthotics and Prosthetics industry?

My practice is third generation.  First was my great-uncle in 1957, then my father, and now myself.  What is now Mutual Orthopedics was officially founded by my father in 1978, and I took over in 2002.  It is one of the oldest companies in the Long Island area. Some of our patients have been with us for forty years.  We have expanded to two offices, one in Brooklyn and one in Long Island, with a sizable prosthetics and orthotics laboratory at the Long Island location.

 

How have you seen the industry change over the course of your career in prosthetics?

The uptake in technology alone has changed the way we practice.  Today, we have access to a whole slew of technology that we did not have previously. We as prosthetists can make people much more comfortable than we could years ago. A while ago, everyone had a standard prosthesis.  That was the challenge back then. It was a lot easier to run the business before, but the technology wasn’t there. Currently, the struggles of operating a practice are related to the changing environment of health care, rather than technological limitations.  Prosthetists are now better able to understand patient needs and fulfill many more of their dreams due to those advancements. As a prosthetist, you want to make your patients more comfortable than they were when they came in. You want them to be able to do things they haven’t been able to do before and to maximize the potential that they have.  The best thing for me to see is a patient coming back after they’ve gotten their prosthesis with parts worn out because they’ve been using it so much.

 

Mutual Orthopedics, Infinite Socket TT-S
Mutual Orthopedics CP Anthony Tufano with Infinite Socket TT-S patient

Can you describe the working relationship you’ve had with LIM Innovations?

I have a long-standing patient who has been with Mutual Orthopedics since the 80s.  About three years ago, he came to me wanting to be fit with the Infinite Socket. After meeting with Geoff, a representative from LIM, we set the process in motion and got the patient fitted. The Infinite Socket is fun to fit, and getting it just right for the patient is a great experience.  Once the fit is flawless, it’s a slam dunk. The appeal of working with LIM is they evolve with you and listen to the input of the prosthetist. It is a collaborative process. Like any product, it has the occasional pitfall now and then, but LIM works efficiently with the clinician to find the optimal resolution.

What would you say are the benefits of the Infinite Socket versus a conventional socket?

In my opinion, the beauty of the Infinite Socket is the adjustability.  It allows for the socket to evolve on a continuous basis along with the patient’s residual limb.  I can get patients to the next level of comfort by tweaking and adjusting to accommodate fluctuations in volume.  The comfort of sitting that the Infinite Socket provides is a huge factor for patients as well. The flexible struts are a draw as well; having something that isn’t rigid when a patient is ambulating on it is a big deal. The Infinite Socket permits a dynamic fitting as opposed to a static one. I love the product.

 

Nancy’s Search for a Better Solution

Nancy, from Texas, shares her amputation journey, her opinions on the Infinite Socket TF, and discusses her near and long term goals.

Until August of 1989, my life pretty much had been normal as a young mother of three. We had attended a family reunion where I was casually playing a game of baseball. The next day I noticed my left knee was sore but blew it off because of the activities the day before. However, within a few weeks, I wasn’t able to walk without being in severe pain.

This spurred a trip to the doctor, where they took some x-rays and ultimately found a tumor in the bone at the knee joint. I knew my life was going to change forever. On my 31st birthday, September 1989, I took my first step into MD Anderson, a cancer research hospital to undergo further tests. A few weeks later they confirmed it was cancer (osteosarcoma), prompting my year-long battle. In March of 1990, they removed my knee plus some bone above it, replacing it with a mechanical knee and rods.

In 1992 and 1994 the hospital undertook revision surgery because one of the rods cracked, and continued to come loose. The issues continued until 2004, where the doctors warned that if the same thing happened again, there wouldn’t be anything else they could do due to having no more bone to work with.

In 2010 the very same rod broke, with the family not expecting amputation. Every attempt had been made at salvaging the leg, only for them to all fail. That was a hard year! In September of 2011, the decision was made. On September 30 they took the leg; so began a new battle.

Over seven years I had attempted to use five traditional sockets, none of which were usable let alone comfortable. My Mobility was far from where it should have been. I would only wear the leg when I had to go to town or something similar in nature, but never more than four hours a day at most. I hated it! I just wanted to stick to my wheelchair and forget about everything I’d been through.

In searching for something new, something better, I came across the Infinite Socket. My mind said “This is it! this is what you need!” Now I just need to find a prosthetist that would do it, as the one I had wasn’t in favor of it. He wanted me to stick to the traditional socket types, which just wasn’t working out for me, so I reached out to LIM for help finding a prosthetist in my local area who has fit their product before. They duly obliged and connected me to a wonderful prosthetist at Prostheticare, here in Texas. The process of changing prosthetist was easy and simple, and the clinician there did a great job ensuring that I got the best fit possible.

Granted I’ve only had the Infinite Socket for two months now, but I have seen a BIG improvement. It is SO comfortable and my mobility has improved greatly. I’m now wearing my leg 8 to 10 hours a day, every day! I’m able to get around so well that my husband has told me I need to slow down. I feel like my old self again, and finally in tune with my artificial leg. I went with a pin lock system with the ratchet tensioner at the top. I really love the ratchet because it’s easy to adjust the socket throughout the day to find the best fit for me. You’ll never get me in a traditional socket again.

For the first time in seven years, I’m able to go shopping without using one of those electric scooters. I’m now able to walk around the whole store without regrets, pain or sores. With any luck, I should be able to lose some of this weight I put on since the amputation and enjoy living life to the fullest once more.

My goals are to be more helpful to my family and maybe get a part-time job. My family keeps me busy but there is so much more I could do for them.  I think getting a job would help me feel even better about myself to able to contribute financially.

Introducing the 4-Hole Base Plate

In 2014 we successfully launched LIM Innovations® Infinite Socket™ TF, fitting over 1500 patients along the way. To celebrate, we are adding to the current Infinite Socket™TF components with the introduction of the 4-hole base plate.

“Our job is to invent on behalf of our users, and we only move forward with creating products that significantly improve their experience,” states Jeremy Galten, LIM Innovations’ SVP of Product. Galten continues, “The new base plate design, which no longer incorporates the pinch bolt, provides even greater security for the patient while providing clinicians maximum flexibility when connecting components.”

The four-hole base plate allows the clinician to find the optimal offset for limb length and alignment through the built-in line of progression. It continues to offer 5 mm of radial slide and 40º of angular pivot per strut. The 4-hole base plate has been also been designed to maximize structural integrity enhancing peace of mind for both the clinician and the patient.

The technical aspects of the base plate family, which comes in four shapes and sizes are broken down below.

Angular alignment built in (degrees) Posterior offset of knee with respect to socket (mm) Lateral offset of knee with respect to socket (mm)
  0 0 0
  0 22 0
  0 30 20
  15 60 20

 

The 4-hole base plate will be available on all new orders submitted after May 1st.

For further information and to order the Infinite Socket™TF visit the Infinite TF page or call 1-866-612-1998 today.

Honoring Tammy Myers

It is with a heavy heart that we share the news of the passing of beloved LIMLegend Tammy Myers.  Tammy passed away on April 6th after a valiant battle with cancer. A strong voice for the limb loss/ limb difference community, she worked tirelessly to help others adjust and live their best lives. She left a legacy of service to the limb loss community that will continue through her support group Amputees in Motion.  

Tammy became an above knee amputee in 2007 due to a blood clot. Determined to turn a tragedy into a triumph, within one year she rallied and founded her support group. She threw her heart and talents into her support group and helped countless people in the community through her efforts.  Speaking about her group, Tammy said, “I had finally found my passion and my purpose! What a blessing! I started working out, being a social butterfly, not taking no for an answer and learned I was stronger than I ever knew. After speaking to old and young people alike without judgment, I learned one can make a difference. To kick off the inspiring nature of AIM I went skydiving with my son to show that life doesn’t end after amputation; there’s always a way to do things and live your dreams.”

Tammy started to use the Infinite socket™ TF and became one of LIM Innovations® biggest cheerleaders. True to her vibrant personality, she personalized the strut covers with leopard print fabric and proudly talked about her experiences whenever possible. She credited the Infinite socket™ with allowing her to continue to live her life without limits.  

Always quick to pick up the phone to contact somebody in need of a supportive ear, Tammy helped countless amputees adjust to limb loss over the past decade. She made friends wherever she went and was an active peer visitor through the Amputee Coalition. Her bubbly personality helped to bring the timid out of their shells, and she had a knack for making everybody feel comfortable.

Tammy will be deeply missed by those who knew her. The limb loss/ limb difference community is better because of her efforts. We honor her legacy and her spirit. 

Amy’s Life In Motion

28 years ago Amy’s life was set on a different track when she received the diagnosis of Osteosarcoma. Initially, the physicians were able to save her leg from the ravages of the disease, but she was in constant pain. After a 16 year battle against pain, Amy opted to have her leg amputated above the knee on February 20, 2006. Speaking of the decision to amputate, Amy says, “I have never regretted my amputation. More so now that I have a LIM Innovations® Infinite Socket™.”

Amy was initially fitted with a conventional hard shell socket. She remembers it fitting “okay” in the beginning, but as her limb volume began to shrink and fluctuate, she struggled to get an optimal fit. Many times she was not able to use her prosthesis at all because the socket was so uncomfortable. Frustrated but undeterred, Amy continued to search for other options.

When Amy saw a Facebook Ad featuring the Infinite Socket™. She requested more information and, through that email, set her life on a path towards comfort. “I could not be happier. With the Infinite Socket™, I don’t have the fitting problems I had with the conventional socket. LIM has given me my mobility back.”

“Now when I’m asked about my leg I immediately tell them about my Infinite Socket™. Sometimes I’m asked what LIM stands for and I tell them that I think it means Life In Motion. LIM Innovations® put my life back in motion! Now when I have fluctuation issues from day to day or when working out, I can adjust accordingly, easily and discreetly. My Infinite Socket™ has truly been a blessing.”

With Amy’s living her life in motion, she is setting new goals. She is eager to compete in a mud run and all-terrain challenges; activities that she never dreamed possible when she was struggling with a conventional socket. She is grateful that her Infinite Socket™ allows her to be an active and involved Grandma to her beloved Grandchildren, and she is looking forward to continuing to volunteer with the Law Enforcement Torch Run for Special Olympics Oklahoma.

“If I could give one piece of advice, I would encourage anyone to give it a try (Infinite Socket™). Once you’ve experienced it, you’ll never go back to the conventional socket. My above-knee Infinite Socket™ has set my life in motion, and I no longer feel held back by my prosthesis.”