The First National Symposium of Prosthetics and Orthotics

28th October 1998

_____________________________________________________________________________________

Biomechanical evaluation of prosthetic sockets fabricated using fused

depository method
PVS Lee* , KC Tan † , KF Tam † , SL Lye†
*
Institute of Materials Research and Engineering, Singapore
†
School of Engineering, Temasek Polytechnic, Singapore.

Abstract: Two patellar-tendon-bearing (PTB) prosthetic sockets were fabricated for two volunteer trans-
tibial amputee subjects using fused depository modelling (FDM) technique. The FDM technique
eliminated the need to create a positive plaster mold, generating a prosthetic socket directly from the
information obtained from the computer aided design software. Gait analyses were performed for the
subjects wearing sockets generated using FDM and sockets made by the traditional lamination
techniques. Minimal gait variations between the two types of sockets were observed.

Introduction
Fused Depository Modelling (FDM) generally
described melted materials e.g. plastics, flowing
from a nozzle and deposited in thin layers,
which then solidify. Materials are deposited
layer-by-layer allowing three dimensional
objects to be produced. The use of FDM
technology is well suited to the current state of
the art in prosthetics computer aided design and
manufacturing (CAD/CAM). Present
CAD/CAM system in prosthetics is only semi
automated, involving labour and skill intensive
steps to complete the manufacturing process of
the socket. The introduction of FDM will propel
CAD/CAM in prosthetics to a truly automated
system reducing cost, improving clinical
services and accessibility to the amputee
population.
The objective of this study is to evaluate the
biomechanical properties of the socket
manufactured using FDM. This will include gait
analysis, socket material testing according to
ASTM standards and prostheses testing
according to the ISO standards. Gait analysis is
discussed in this manuscript while the others
will be the subject of another paper.
Methods
Preliminary study investigating the viability of
using FDM in the fabrication of prosthetic
sockets was conducted by Tan et al (1). Similar
procedure was adopted. Two volunteer trans-
tibial unilateral amputees participated in the
test, one adult male and one child female
amputee. Both are active wearers of the PTB
type socket. Prior to the test, a new PTB socket was
fabricated for the two subjects by an experienced
prosthetist. The sockets were firstly manufactured
using the traditional lamination method. The same
laminated socket shape was replicated by
digitisation using a 3D laser scanner. The data was
reconstructed in 3D and a solid model was
generated using CAD software. The 3D data was
further exported to a 3D Concept Modeler FDM
machine from Stratasys, Inc, USA to manufacture
sockets. The material of the FDM fabricated
sockets was P301 polyamide. Both the laminated
and the FDM sockets for each patient were fitted
with the Otto Bock modular system and Sach foot
(Otto Bock, GmbH, Germany).
Gait analysis (Figure 1) was conducted for subjects
wearing the two types of sockets using a five-
camera Vicon (Oxford Metrics, UK) motion
analysis system with two Kistler force platforms
(Kistler Instruments AG, Switzerland). Prior to
data acquisition, the subjects were asked to walk
with the prosthesis for at least 15 minutes to
become accustomed to the sockets. All data
collection was performed on the same day without
the subjects doffing the socket at any interval
during the test. Both standing and walking data
were collected. The Vicon tracks the position of
retro-reflective markers placed on anatomical
landmarks of the subjects and records the load
actions measured by force platforms. Once the 3-D
co-ordinates of the markers situated at the required
anatomical landmarks are tracked, using inverse
dynamics, the ground reaction forces are
transformed to give the forces and moments at the
desired joints. In addition, temporal–distance
parameters were also recorded.
 The First National Symposium of Prosthetics and Orthotics
28th October 1998
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was effective. The average temporal-distance data

of the stump wearing FDM and laminated sockets
are as shown in table 1. Only the results of the
female subject are presented in this paper. The male
subject experienced complication in socket fit,
regardless of the two types of sockets.

Female subject (Left Laminated FDM

amputee) socket socket
Cadence (steps/min) 105 109
Walking Speed (m/ s) 1.13 1.09
Stride Time (s) 1.14 1.10
Step Time (s) 0.58 0.56
Stride Length (m) 1.29 1.19
Step Length (m) 0.73 0.67
Figure 1: Gait analysis Stance (% gait cycle) 63.16 60
Results and Discussion Table 1: Temporal-distance measurements
The socket fabricated using FDM is as shown in It was observed that there was minimum gait
Figure 2. The male subject socket was 228 mm deviation when comparing the two types of socket.
in length with a wall thickness varying from 7 Nevertheless, a higher walking speed was recorded
mm at the proximal end tapering to 3 mm at the with the subject wearing laminated socket. The
distal end. The weight of the socket is 332 g and ground reaction forces of the stump wearing the
fabrication time is 29 hours. The total length of two types of socket showed similar profiles. The
the socket for the female subject is 299 mm, magnitude of the ground reaction forces were
similarly with a tapered wall thickness varying approximately the same (Figure 3)
from 7 mm proximally to 3 mm distally. The
weight of the socket is 458 g and fabrication
time is 39 hours. laminated FDM
400

300

200
N

100

0
0 20 40 60 80 100
-100
% of gait cycle

Laminated FDM Figure 3: Ground reaction force of the female

Figure 2 : Laminated and FDM generated
socket
The socket material P301 polyamide showed
some level of flexibility. Initial sockets
fabricated with a uniform wall thickness of
3mm were abandoned due to problems with
socket suspension. Upon weight bearing, the
proximal brim had the tendency to flare open
causing the socket to lose its supracondylar
suspension effect. Nevertheless, by increasing
the thickness of the socket wall at the proximal
brim to 7 mm ensured supracondylar suspension
subject wearing the two different types of socket
The knee flexion-extension angle diagram,
normalised to 100% of the gait cycle, of the sound
and prosthetic limb is as shown in Figure 4. This is
typical of a unilateral amputee showing continued
knee extension of the prosthetic limb in the early
stance phase when the sound limb registered
flexion. Comparison of the two types of sockets
indicated during stance, knee extension is more
evident with the laminated socket than that of the
FDM socket (Figure 5)
 The First National Symposium of Prosthetics and Orthotics
28th October 1998
_____________________________________________________________________________________

Prosthesis Sound leg

(Flex)

80

60
degrees

40

20
0
(Ext)

-20 0 20 40 60 80 100

% of gait cycle

Figure 4 : Knee flexion and extension angle of

sound and prosthetic limb

laminated FDM
(Flex)

80
60
degrees

40

20

0
(Ext)

-20 0 20 40 60 80 100

% of gait cycle

Figure 5 : Knee flexion and extension angle of

the prosthetic limb wearing the two different
types of sockets.

Conclusion

The preliminary investigation has established

the functional characteristics of the FDM socket
to be similar to that of a laminated socket.
Nevertheless, further studies need to be
conducted to establish its durability based on
ASTM and ISO standards.

Acknowledgements

The authors wish to thank the Staff of the

Orthopaedic Diagnostic Centre, Department of
Orthopaedic Surgery, NUS for their technical
advice and the use of their facilities
References

[1] Tan, K.C., Lee, P.V.S., Tam, K.F., Lye,

S.L., “Development of Artificial Limbs
Using Digitizer, CAD and RPT – A Case
Study”, Proceedings of the
CAD/CAM/CAE for Internet and Intranet
Conference & Exhibition, Singapore, May
1998.