Patient-Specific Optimization of Prosthetic Socket Construction and Fabrication Using Innovative Manufacturing Processes : A Project in Progress

Despite improved medical prevention and successful treatment of potential risk factors, the number of new amputations is constant over last years. According to the demographic changes and developments the number of amputations will increase and will cause considerable health care system costs. The current prosthetic socket construction and fabrication process does not take patient specific parameters into account, is based onto subjective estimations, competence and capabilities of the orthopedic technician and therefore causes a high rate of inappropriate prosthetic supplies. This essential drawback clearly shows that a substantial necessity exists to develop more objective planning systems and to gain a higher quality in the prosthetic socket construction. The central objective of the presented work is to improve the currently empirical process of prosthesis design in orthopedic technology with the aid of modern imaging techniques and computer technology by taking into account patient-specific consistence of the amputation stump. Based on patient-specific 3-D models, the 3-D visualization, quantification and simulation of the individual biomechanical tissue changes in the amputation stump in a static state, as well as under dynamic conditions during the interaction with the prosthetic socket will be evaluated using finite element analysis. The computeraided visualization and virtual simulation of soft tissue deformation and of the contact forces in the interface between the patient-specific deformable model and the amputation stump at the computer individually planned model of the prosthetic socket will serve as basis for a reproducible construction and fabrication of individually adjusted exoskeleton prosthetic socket systems as well as a computersimulated “virtual try-on” before construction and fabrication of the prosthesis even in the absence of the patients. The manuscript will present the aims on capturing and quantifying the complex process of tissue changes during the prosthetic treatment, in particular the effect of biomechanical changes in structure and load distribution within the amputation stump in the simulation. In the following we would like to present our implementation concept to optimize the current prosthetic socket construction and fabrication process by combining three existing powerful software products (Mimics, 3-matic and ANSYS) into one uniform software platform. Based on this virtual study of influencing factors and planned changes of the final result, it would be possible for the first time to verify the clinical efficiency of prosthesis assembly and to establish an objective quantifiable quality control.. Through the developed and optimized workflow the manufacturing process will be cheaper and enormous shorter. Through the use of telemedicine based analyse and supply systems even states where none or less specialists are available would benefit from the technology. An important market is therefore also seen in developing countries, where until now no efficient orthopaedic technology exists. Optimization of Prosthetic Socket Construction & Fabrication Kovacs et al.