Amputee Treatment Center Forum

GENERAL CATEGORY => General Discussion => Topic started by: Steve C on January 15, 2012, 05:50:49 PM

Title: A angry leg
Post by: Steve C on January 15, 2012, 05:50:49 PM
I've winged about my current leg loads of times. Heres another rant to blow off some steam...
Has anyone had a thin liner seem to create a fold in the skin (my problem area is in the back about 5'' below the knee) and make it seriously painful? It seemed to have made a blister but to be honest I can't really tell. The edge of the crease was white until it scabbed over (sorry for the mental picture)
It's right about where 'real' skin meets skin graphs. I'm wearing a large adhesive bandage on it now which does seem to help with the pain...
Any way to prevent this from happening again? It seems that the more I wear my leg the bigger chance of it happening.
Title: Re: A angry leg
Post by: chrysochloridae on January 16, 2012, 02:12:18 PM
Hi steve, Happy new year to you!

This sort of thing can cause a problem. I find that skin grafts can be problematic as the skin is not as elastic as the undamaged section. I've found thinner liners absorb less shear and so can cause problems over sensitive areas.

An Invaginated scar (deep, healed scar which produces a 'crater' in the flesh - often caused by slow healing wounds) is always problematic. Changing the liner is one option, but this would likely mean new sockets and all the fun and games associated with that. Alpha Custom liners can be made to have gel filling these areas - but they are expensive.

The simpler answer is trying some of the various prosthetic lotions and potions on the affected area. I have a few people who swear by Alps Prosthetic Lotion. Otto Bock Derma Repair and Derma Prevent are also really good.

Has this been an ongoing problem Steve or has it only begun recently? I tend to find people struggle with this sort of thing in hotter weather or by being more active than usual
Title: Re: A angry leg
Post by: Steve C on January 17, 2012, 08:30:12 AM
Happy New Year Golden Mole! ;)

Thanks for the information! I do have a good few invaginated scars as you mentioned. The problem areas is one of those. Actually there are a three problem more areas but one seems to be the main culprit.

I was using alpha liner with extra cotton socks and suspension sleeves on the old leg and there was never a problem. The liner now is very thin with the pin system. It seems like I can't do any physical labour anymore with the new leg and its thin liner. It just hurts too much and thats even if the problem areas aren't acting up. To be honest the new leg has to be taken off or loosened from time to time even if I'm not doing physical work. The lotions may work great to fix the problem areas but may not address the other problems.

I'm thinking I just need a thicker liner and a new socket to fit. I may just need that extra bit of padding for whatever reason... problematic nerve endings, having the physical work 'pump up' the muscle in the back and making the socket too tight etc...

I seriously don't relish the thought of starting over but I tend to think I'm at the 'point of diminishing return' with the new leg. My and my limbfitter have been trying to make this leg work for 2(?) years.
The fact I've had the leg for 2 years makes me nervous. My opinion is the leg has never been right or without causing pain so it needs to be fixed or replaced. I hope they feel the same way!

I was onto my new prosthetist (the one who made me this new leg went off to a impoverished area to help out people there about a month or two ago) and I have a appointment on Monday with my new prosthetist.

On a side note, I'm in the process of repairing my old bombproof, work leg. I cracked the socket and had it repaired by a man who does bodywork in fibreglas on cars. It cracked again so I repaired it again myself. It cracked again so I am back mixing up resin and hardener etc. Hopefully, it will last long enough to see me with a new, pain-free leg I can use everyday, doing everything!

Title: Re: A angry leg
Post by: pin-hi on January 17, 2012, 11:55:18 AM

I think in general, as end users of prosthetic devices and products, we need to be more assertive with our legists. If they are making sockets or pin systems or let's say, "upgrades" that make wearing the leg impossible, they are not doing their job. We are entitled to comfortable, functional prosthesis and if that's not what we are getting, they need to re-do them until they are right. Period.

Please don't sign off on the next adjustments or new socket until you know it will work for you. If you have a greater comfort level with the thicker Alpha liners and suspension sleeves, he should be able to retro-fit the newer leg pin socket to match your older leg's socket.

Just my opinion.

David in Canada.
Title: Re: A angry leg
Post by: chrysochloridae on January 17, 2012, 05:46:33 PM
What thickness Alpha liners has he got you? I find the 3mm one problematic for bony/scarred stumps. I would say 6mm Alpha liners are the best.

Willow Wood have brought out 2 new pin liners since you last had sockets made the Alpha Hybrid and Alpha Silicone range. They only do these in the 6mm version. Might be worth having a chat with the new prosthetist guy about trying one of these new types - i've found em pretty good and a bit more durable (and a longer warranty on them!)

If your old Work Leg is proving comfortable still then it could be worth asking for a copy of it to be taken using a CAD-CAM system or using duplicating foam (page 41)

IMHA 2 years is plenty of a breaking in period! If its not right after 2 years then i personally would start from scratch / copy a functional socket.
Title: Re: A angry leg
Post by: Steve C on January 17, 2012, 09:25:33 PM
I agree completely. My worry is that they insisted I pay in full for the leg before taking it home. I am going to press them to make my end product a leg that I can wear for all occasions. I'm sure they will but the incentive of being paid is gone.

I measured one of my somewhat worn Alpha liners from the old leg and they appear to be 6mm in the front, about 2-3 mm in the back. I also need to use four thick cotton socks on average as the leg was my first weight bearing leg (from 2001) and my leg has reduced in size. The liner (pin) for the new leg is a grey Icecross 1mm (or a compacted 2mm). He advised me to use that liner to make the leg more responsive. He's a lovely fella with good ideas I just don't think they worked for me personally.

Two years is a massive amount of time. In their defence I didn't wear it first because if the discomfort. It a scandal on my part. I paid for the thing myself, about E6400 (euro) and no health insurance, but dispite the cost to me I still found it easy to just wear the old leg. Especially if a outdoor job needed to be done and the new leg would have made it impossible. I just donned the old one and ended up getting into the habit. I did cop on and made myself wear it. Thats when the numerous visits and leg tweeking started.

I would love a clone of the old leg. Of course if they could make it without me needing the 4 extra cotton socks it might be perfect. Maybe thats why the old leg feels so good, all the padding!
Title: Re: A angry leg
Post by: pin-hi on January 18, 2012, 04:41:10 AM
I may be mistaken Steve, but I'm quite sure Alpha has a 9 mm. thickness liner as well. (this may allow you to not use the extra socks with your older leg.)
 I have the luxury of having full coverage for legs and liners etc. having gone under the train while working. Workers Compensation Board pays. I can't imagine what I'd do in your position of having to pay out of pocket. You may not have the option of shopping around for a prosthetist  considering your location.

Well, give the fellow the opportunity of making it all good for you. Take everything into him, the new leg, the old leg, liners and in no uncertain terms tell him the new leg is shite and you need it made right. Maybe copy and print the contents of this thread so he can see the comments we've made.

Please let us know how it goes. David
Title: Re: A angry leg
Post by: pin-hi on January 18, 2012, 05:02:19 AM
My retired prosthetist once made an internal cast copy socket of an old leg of mine. He used what looked like an oversize condom type thing and filled it with mold or casting material and it made a very close copy of the original socket. I believe he did this to make new socket inserts for my right leg which had a soft leather insert to protect the short, bony residual limb. (stump)

I have some 9 mm. Alpha liners kicking around here, which I used on my old left leg, which I will wash thoroughly and send to you if you want to give that size a go without having to pay for them. (used of course, but in good repair). Let me know.

Title: Re: A angry leg
Post by: chrysochloridae on January 19, 2012, 02:10:00 PM
Alpha liners do do a 9mm. Really good for bony residual limbs i find.

Sounds like you've got an Iceross Dermo or Synergy. They are alot thinner than the standard Alpha liners and don't have gel at the front (well, their new cushion one does but thats their first!) - Excellent for very fleshy stumps with no scarring; on the whole not so good for very bony stumps with heavy scarring.

Alpha liners have always gone for comfort, if they worked for you then i'd stick with them. Some of their new kit seems pretty good (Hybrid and Silicone), but i can't give you any long term experience of these liners till i get some feedback from the people testing them.

If your prosthetist has CAD-CAM machine then they could copy and reduce your big socket and make it 3 socks smaller... (assuming your overall shape has remained roughly the same). Also steve, if the big socket is for an Alpha liner, they do Volume Management pads
Title: Re: A angry leg
Post by: annieg on January 19, 2012, 08:41:21 PM
Wow, I'm always impressed when someone asks for advice and gets such informative answers.  This site has such helpful people!  Hope you are all doing well in the new year.   annieg
Title: Re: A angry leg
Post by: Steve C on January 20, 2012, 08:50:39 AM
I am too Anne. When I go in I will have loads of information so hopefully I can steer them in the right direction.

Thanks again Pin-Hi and Chrysochloridae!

Sometimes I think a exact copy of the old socket may be good and just get a thicker liner, but I'll ask if my limbfitter has a Cad-cam. I kind of doubt they do but I haven't a clue really. If they can copy the old one slightly smaller that might just do the trick. I would think that my leg has changed some though. It could be all the padding that is making a socket feel great that if it were smaller wouldn't feel good. A new socket from scratch might end of being what I have to do.

I'll pick your brain some more,
I think I know the answer to this one but if a abrasion appears on the leg I'm assuming the best thing is to not wear the leg at all. Or at least keep it to a minimum so that air can get to it and heal it. Is there a way to speed up the healing? I have to wear it at times during the day for errand/chores but even with a bandage it seems to set back the healing.

Also, can some amps just not be suited for a pin system? Or is it just a matter of putting the leg on correctly?

By the way I finished the repair on the old leg. I'll put a few pictures up later for a laugh. It won't win any beauty contests but hopefully four layers of fibreglas will keep the crack from worsening.
Title: Re: A angry leg
Post by: pegleg jack on January 20, 2012, 07:25:06 PM
OHIO WILLOW WOOD COMPANY, handles ALPA-MAX on the 9-MM  size for i am wearing two of them right now as i type this and have ordered twomore today cause i have worn a hole in one of the cause of the way my left leg is shaped. and i cant do any thing about it right now cause it would take a major surgery to fix it, my tibula bone sticks way out to  the front  of my leg and it rubs up against my socket therefore wearing a hole in it, usually takes about 3 years to do it so i get my moneys worth, and then i use LOCTITE SUPER GLUE LIQUID and rub it over the area on the outside of my liner and it will give me a couple of more months of wearing.
Title: Re: A angry leg
Post by: pin-hi on January 20, 2012, 07:58:56 PM
Some wearers, like myself, are not suited to pin systems. I tried them and always felt a severe tugging feeling at the end of my stump, especially the right one. Also, they said moisture in the liner would diminish as time went on but it never did for me. I would take off the pin system leg and I would be sore and swimming! I had them get me back to the no pin liners and sleeves pretty quick as I wasn't going to be doing much walking with the pin system. Just my experience of course. David
Title: Re: A angry leg
Post by: herb on January 21, 2012, 12:20:50 PM
Hi Steve

sorry to hear you are having problems. My residual leg also has a lot of scarring and skin grafts. In two areas I have only skin grafts covering the bone. Because those 2 areas can not tolerate any pressure at all my prosthesis has small windows cut out over those areas in the outer socket and then the inner socket is heated and pushed out slightly in those windows so I do not get any contact on those areas. It works for my situation. I also check those areas every morning when I shower and if there is any tenderness or redness I use the crutches without wearing my prosthesis for a day or two to let the area heal. If I do not take that time off the prosthesis I am big trouble for a month with an infection.
I know you have been having problems for some time and you really need to find a prosthetist that can make you a properly fitting prosthesis.
Come to new hampshire and meet mine and visit for a while.
good luck
Title: Re: A angry leg
Post by: chrysochloridae on January 21, 2012, 04:05:42 PM
I'd definitely leave it off for a few days until it heals - open wounds and liners (warm moist) environment are good breading grounds for bacteria.

Herb has hit the nail on the head, stopping problems before they become major is definitely the way forward.

I've seen many people on liner systems to try to prevent skin breakdown, but many of them experienced problems due to the distal pressure required for a pin system. (Most) Liners also come in a Cushion option (i.e. no pin and lock) and use a suspension sleeve; this has a number of advantages 1) you can put a cushioned end pad into the socket to give more gel cushioning to the end of the stump, 2) you can add a valve in and turn it into a suction socket which in itself has numerous advantages.

if you came in to see me and told me that you'd battled on with a socket for 2 years without success then i'd likely have a rethink and make a new socket.

PLJ, good to hear from you! The Alpha liners are notorious for that happening. I found a great trick is to use one of the Alpha Gel cups on against the skin then the Liner over the top of it - that way the hole wears in the gel cup (which cost a fraction of the price of a new liner)
Title: Re: A angry leg
Post by: Steve C on January 22, 2012, 09:44:17 AM
Thanks everybody.

I just may try your trick on making the liners last longer Jack. Thats one of the great things about the site here, learning little tricks from others!

I sometimes think that I may not be pinsystem material. My first one was years ago. I got it from the NHS (national health service) but I never wore it. It was very painful so I just kept wearing the old one. Looking back I wonder if I were even putting it on right! When I went for this new leg, he seemed to really to enthusiastic about his ideas about the thin pin liner and socket. His ideas were because I am so active he would make me a very responsive leg (of course now I have had to adjust my life to fit the leg and I'm not near as active with work or fun). Even with me being very careful with lining it up just right at the end of the day it just didn't suit me. He's a great fella and limbfitter and maybe it was worth a shot but you can't win them all.

If I go for a visit Herb I would need some thing organised. In the house, Guinness, Jameson and a list of all the unmarried women in your area. Haha. Might as well mix business with pleasure.
Are sore spots a routine thing for you? If so we seem to be in the same boat to some degree.

I'm actually feeling optimistic about my hopeful new leg. The suspension sleeves I've been using with my new limbfitter aren't the alpha sleeves but from endolite (black on the inside). The alpha sleeves cost between double or triple the price but the endolite don't last. The socket cuts through the liner knee pretty quickly. I had the edge of the socket lined and I'm almost thinking of making a flap using strong cloth that is taped to the socket and adds one more layer to grind through.

I meet the limbfitter tomorrow. I'll let you know how I get on.
Title: Re: A angry leg
Post by: herb on January 23, 2012, 09:42:22 AM
Hi Steve

we can arrange all your needs. We have all the brews you requested. We may even have some you might like better. I drink Sam Adams Double bock which for me is similar but much smoother than Guinness.

The are lots of beautiful woman around.

When I was a younger I had problems with sores on my stump, especially in hot weather when I was especially active. I know when to stop now and avoid most of the problems.

Hope all goes well with your limbfitter appointment.
Title: Re: A angry leg
Post by: Steve C on January 23, 2012, 07:58:17 PM
I've had the the double Bock by Samuel Adams. Its nice for a something different but Guinness is near and dear to my heart (or is it my liver). Tradition!

The appointment went good today. She seems nice and seems that she knows her stuff. She suggested herself that need a new socket. She wanted to stay with the thin liner and put in a cushin pad, but I opted for the same liner I was wearing with the old leg and including one cotton sock for good measure. She cast my leg and I should have the socket on Monday!

She kept the leg (for parts I assume (foot etc) and she had me keep the sleeve. It wasn't returnable so I get a very expensive souvenier. To be honest the pin liner and the leg itself came all in one price so I never really knew how much the liner was. She said it cost me "E700 (euro) which in US currency is about $900. I had no idea. The alpha liner as I remember seem to come in at around E300.

I also asked if there was a way to make the foot not so stiff. To be honest I forget what foot it is but as I do remember there wasn't any elastomers to change out (I remember it resembled a C leg but with a bottom plate creating a heel) so maybe adjusting it is impossible. The ground where I am is very lumpy/stoney and if I had a euro for everytime stepping on a stone tried to make my knee bend the wrong way...

Title: Re: A angry leg
Post by: Joe A. on January 27, 2012, 01:10:43 PM
 Yes we are in the same boat only some of us can lean on the helm while some are stuck sculling like a slave from one of those Charlton Heston kine. The best advice I can offer is to stay away from Alpha. Nothing can take the place of a good fit
Title: Re: A angry leg
Post by: Steve C on January 27, 2012, 02:21:28 PM
Hey Joe! Not a fan of the alpha? Why so? (I like to all the pros and cons regarding liners). I went with the alpha as it was what I was wearing on the only leg that didn't cause me problems. But then, maybe it was just the socket or even just the thickness of the liner. What liner would you suggest that is 6mm? I'm fairly locked into the 6mm liner now as the leg is near finished now and I just think I need the padding.
Title: Re: A angry leg
Post by: pegleg jack on February 03, 2012, 05:53:05 PM
joe a and steve, am going to have to disagree with you on ALPHA LINERS, am currently wearing ALPHA MAX LARGE 9MM and have had real good luck with them on fit and lasting me for some time, my last pair lasted me for almost three years before i wore a hole in them right on the end of my tibula bone, just recieved four new ones but they ordered the wrong one so i am having to take them back and have them order the right ones ALPHA MAX 9MM. ALPHA  also makes a 6mm for i have four of them laying on my pool table right now that are going back.
Title: Re: A angry leg
Post by: anne f. on February 11, 2012, 02:22:54 PM
Hmmm, this is really interesting thread, I have a fairly new leg (7months old) and have gone thru 5 Alpha liners in that 7 months!!!  Yes, you read that right 5 liners.  Despite my cp doing everything he can to try and relieve the pressure behind my knee all 5 of the liners start showing wear behind the knee within days of starting to wear them.  Actually I don't ever feel any pain behind the knee with regards to the socket, I just start seeing the white color where the liner is breaking down and then it starts to deteriorate and then within the week there are actual holes in the silicone and then comes the pain as my skin gets sucked out thru the hole, and that pain can be very uncomfortable.

My limb seems to have become very bony all of a sudden (my amp was 12 yrs ago) and after reading the above I now believe maybe I won't be able to get away with the 6 mm Alpha anymore, although now that I think about it, I have always had a problem with Alpha liners wearing thru.

At one time my cp switched me over to Iceross and the liner was seriously indestructable, but despite it having these lines/waves manufactured in behind the knee which were designed supposedly to make bending the knee easier it was still very bulky (the liner was very thick), my biggest problem with it though was that evidently they don't make the Iceross with a small distal umbrella, my liner was kind of straight up and down not tapered and it had a huge umbrella where the pin was attached and with my tapered limb there was a load of air space  down out the bottom where the liner did not follow the shape of my limb, so that was when I was switched back to Alpha.

My insurance has reluctantly agreed to the cost of another casting for a new socket and I am on the lookout for a new type of liner as I have said to my cp I will never agree to have another Alpha.  I don't consider myself to be hard on the liner but I do live a normal life and if the Alpha liner can't stand up to everyday walking and a bit of housework then I am not sure how they stay in business, especially at the outrageous price they charge.

Steve, I also have a difficult like you were talking about, mine is a small fold of skin along the scar line.  When they did my amp they wrapped the skin from the back of my calf up around the front where the stitches were.  Right along the stitch line I have like a pucker in the skin where it inverts when my liner is on.  It only gives me grief when I have been really active or gone on a marathon length walk and then it becomes swollen, red and sometimes blistered.  For me the only way I can take away the discomfort is to smear a small dab of vaseline on the area before donning the liner, it seems to stop any tugging or shear forces on the skin but whatever you do only use the smallest of dabs because you don't want to interfere with the ability of the silicone to adhere to the rest of the stump holding it snug.  Probably something you have already tried but thought I would mention it just in case you haven't.

anne F
Title: Re: A angry leg
Post by: Steve C on February 12, 2012, 08:03:38 AM
You wore through 5 Alpha liners in 7 months? Impressive. Where they the green ones or the gold ones? The gold ones are stronger. The makers of Alpha liner should hire you as some sort of test pilot for any new liners. Alphas are the only liners (so far) that I haven't had a problem with. Of course I have only tried four (three being variations of alphas). Alphas (green), Alpha Max (gold), Alpha pin and Icecross pin.

Myself, I was referred to their 'problem solver' after my limbfitter went overseas. She made a leg that has a secondary socket make of some sort of orange dense molded foam. I assume to make alterations easier but not having to alter the actual socket. I have my new leg now and it was made to accomodate the alpha max and two socks. I had asked for the socket to accomodate the liner and one sock but I think she forgot. I figured I could live with it and save her from making in the outer socket again. The extra padding may be needed anyhow.
I have another appointment, this week I think, after wearing it for 2 weeks. There is pain that needs to be addressed (around the fibula and the left edge of the end of the tibula). It a bit odd to be wearing the old leg and the new leg during the day. The old leg's foot (blatchford) is worn out and the toes do basically nothing. I've adapted but it has the toe strength of a antique pegleg. The lack of toe strength is something I never even noticed until I put on the new one.
Title: Re: A angry leg
Post by: anne f. on February 12, 2012, 03:04:07 PM
Steve I don't know what color I would call my Alpha liner, I guess its a goldy tan flesh type color and its an  Alpha original uniform medium with small umbrella if I remember hearing the cp properly.  I am not sure why the  liners keep breaking down, like I say my socket fit feels fine until the liner is broken thru and then walking is very uncomfortable, I have also tried adding  socks to see  if I am too far into the socket as my cp says that some people can actually be too far in and get used that feel and think its ok but its not, but when I add a sock I get feel totally uncomfortable.
My cp actually added a leather patch trying to lift me forward away from the back where the liners wear but it has been a disaster.  He added the patch a month ago, a day or so before I was headed down to Scottsdale Arizona to attend the Barrett Jackson car show.  We got down there and walked around the first day and I developed the biggest sore I have ever had (about the size of an american nickel) the sore is on side of my knee to the outside of the front and I have been nursing it for a month, trying to get it to heal, it totally ruined my holiday.
That idea of Jacks to use the Locktite liquid glue sounds great, I would like to try it, Jack where did you buy the glue?

Anne F.
Title: Re: A angry leg
Post by: pegleg jack on February 12, 2012, 05:50:12 PM
anne, i get it from HOME DEPOT, and for your liners wearing out behind your knee, i had that problem for a while and had them cut the back of my liner down to where it was not bunching up my skin and liner and then rubbing on the socket, i wear mine out on the end where my tibual bone is and it pionts out and wears and rubs on my socket and after about 6 months to a year i have a hole in it where the  cloth has worn away, and question have you tried a half sock to take up the space at the end of your limb or stump. Have done that on occasion and it works, what we do it take a two or three ply sock and cut to wear it is only about three inchs long and depend on if i am wearing a sock or not, i will put inside my liner or if i have a sock on will put it inside my sock.  My new liner are the ALPHA ORIGINALS 9mm. OHIO WILLOW WOOD, is trying out a new cloth on the liners havenot wore them as of yet, still have one set of the old ALPHA MAX 9 MM left to wear out before i use them. and all of them are a tan color. even the new ones. ANNE hope that this has helped you out.
Title: Re: A angry leg
Post by: anne f. on February 12, 2012, 11:19:50 PM
Actually I think my cp told me that the last liner I wore thru was a new material for Alpha and they were hoping it would last longer but we had a good laugh when for me it actually wore thru  little bit faster.  I have also tried every combination of socks and 1/2 socks and nothing seems to help.
A lot of my problems stem from the fact that my limb is still atrophying, who new that 12 years since my amp and this would still be happening.  The minute I get a new leg I feel great and get really active and then lose weight and lose the fit again.

anne f.
Title: Re: A angry leg
Post by: pin-hi on February 13, 2012, 02:44:43 AM
I'm currently using custom liners on both legs made by Otto Bock. Prosthetist takes casting of your residual limb, (stump), and sends the casting to Otto Bock. They then manufacture the liner to match the casting. They are very durable and comfy but I don't know if they do them for pin system liners.
Title: Re: A angry leg
Post by: anne f. on February 13, 2012, 11:19:51 PM
I noticed that they had some very reasonably priced Alps liners listed on e Bay the other day, anyone ever tried the Alps liner?

anne f.
Title: Re: A angry leg
Post by: chrysochloridae on February 15, 2012, 04:17:40 PM
Hi all, really interesting to read through this thread.

On the Alpha liner front; they aren't durable at all - but they've always said that hey are made for comfort not durability! 5 Alpha liners in 7 months is pretty impressive by anyone's standards; Good work ann! LOL
Alpha liners are particularly bad when using Locking liners as they don't have a stabilizing matrix to re-enforce the end of the liner (hence for years Alpha liners were renowned int he industry for the end attachment/umbrella tearing off the liner)

Alpha have released 2 new types of liners the HYBRID and the SILICONE. The Hybrid is the same gel with Kevlar additive to increase durability (i've found them to be about 25% more durable than the standard Alpha Classics (Max, Spirit, Original); the Hybrid is retrofittable into existing Alpha liner 6mm sockets.

The Alpha Silicone liner is  meant to be their heaviest duty liner yet,  I'm currently trialling 2 heavy duty users on them - i shall keep everyone informed

The Hybrid and Silicone liners also have some nice features (flexible panel for the knee, Accordion (flexible) umbrella) - check out WillowWood's website for more info

Alps liners are about half as durable as Alphas; they are good on comfort but poor on durability and terrible for controlling pistoning!

Alpha also have a Custom service like Otto Bock. My preference are the Bock liners overall - super durable, nice and comfortable, do exactly what they claim to do (typically German designed equipment - efficient and functional but costs a little more! - saying that all of Otto Bocks liners are cheaper than even the most basic Alpha (Otto Bock SiliconeGel = 300E, $400USD)
Title: Re: A angry leg
Post by: Dolphin on February 17, 2012, 11:40:34 AM
Hi,  I agree with fit and alignment being the most important.  If your socket hurts while it is being made you should not even think of accepting it.  I made the mistake of paying my copay and ended up with legs I could never wear and ended up donating all the components.  You should stay in a check socket until it fits and no pain, also do not let your insurance company get charged for something you can never wear.  If more people would do this, more amputees are more likely to get a leg that fits and is contort able to wear all day.  Remember of course once you have a permanent prosthetic that is good and you have been wearing it, if you gain or lose weight you will probably have to have socket modifications made or a new socket.
As far as liners are concerned, a liner should fit your residual limb like it was made for it, some of us do not fit an "off the shelf liner" and require a more custom approach and their are many companies that do that and more are coming out with them.  Also liners do not last forever and should not be used forever because they do stretch and should be replaced.

Hope this helps
Title: Re: A angry leg
Post by: pegleg jack on February 17, 2012, 05:35:10 PM
i must be a werdo cause i wear ALPHA MAX 9MM and i get from three to five years wear out of them  and i am a very activer person, were mine go is right in front just where your tibula sticks out on me any way, and then the material gives up and i start sucking air and know when i  need new ones cause of  the air bubbles coming up the inside of my liners, and yes fit is the one and foremost item per your leg it must fit right or you will have trouble walking, i have gone through four test sockets per leg before they got my last set that fit to my standards and i can tell you that my standards a very high when i comes to fit, especially being a bilaterial bka, and here lately i have been having some problems cause of wieght fluckuations up five to ten and then down the same amount a couple of weeks later, so i just keep me a roll of 200 mile and hour tape handy and take out and add when needed, and the way they feel to night i need to add some tape to the left one around the lower end of the socket, feels  like there is GRAND CANYON down there aand needs to be filled in some, will see tommarrow how it feels, right now i dont have any socks on at all just my 9mm liners, and both are tight where it should be and i am walking and standing fairly good and can stay up for longer period of times than before. will close for i have ranted on long enough for this go around.
Title: Re: A angry leg
Post by: stinker373 on February 17, 2012, 10:33:51 PM
I have been reading all this info and its great to see.  Its very necessary to post how we do repairs on our limbs and hopefully pics to go with the rapairs would help others greatfully.  Not everyone can afford repairs by the proth guys because of expence.  David you certainly have the right idea, keep the info comming.  :)