Abstract
Title: Computational Design, Fabrication, and Evaluation of Optimized Patient-Specific Transtibial Prosthetic Sockets
Principle investigator: Dr. Hugh Herr
Background: The overall goal of this application is to further develop and clinically assess a computational and data-driven
design and manufacturing framework for mechanical interfaces that quantitatively produces transtibial prosthetic sockets in
a faster and more cost-effective way than conventional processes. Traditionally, prosthetic socket production has been a
craft activity, based primarily on the experience of the prosthetist. Even with advances in computer-aided design and
computer-aided manufacturing (CAD/CAM), the design process remains manual. The manual nature of the process means
it is non-repeatable and currently largely non-data-driven, and quantitative data is either not obtained or insufficiently
employed. Furthermore, discomfort, skin problems and pressure ulcer formation remain prevalent. Through the proposed
computational modeling framework, a repeatable, data-driven and patient-specific design process is made available which
is based on scientific rationale.
Objective/hypothesis: The main hypothesis of this proposal is that a socket, designed using the novel computational design
framework, is equivalent to, or better than, a conventional socket (designed by a prosthetist) in terms of: 1) skin contact
pressures, 2) gait symmetry, 3) walking metabolic cost, 4) skin irritation levels as assessed by the dermatologist, and 5)
comfort as evaluated from a questionnaire. Our hypothesis is supported by the presented pilot data which shows reduced or
equivalent skin contact pressures and subject reported comfort levels for several critical anatomical regions.
Specific Aims: 1) Subject-specific biomechanical modeling for N=18 subjects, 2) Computational design and fabrication of
sockets for N=18 subjects, and 3) Clinical evaluation of novel sockets for N=18 subjects.
Study Design: A cohort of 18 subjects will be recruited for this study. MRI data will be recorded for all subjects. Through
image segmentation geometrically accurate 3D finite element analysis (FEA) models will be constructed. Further, non-
invasive indentation testing will be performed which, through combination with inverse FEA, provides accurate subject-
specific mechanical properties for all subjects. The resulting predictive FEA models will then be used in a novel, data-
driven, and automated computational design framework for prosthetic sockets, to design prosthetic sockets for all subjects.
The framework optimizes the socket designs, as assessed by skin contact pressures and internal tissue strain, through
iterative adjustment of the virtual tests sockets. Final designs are subsequently 3D printed. To evaluate the prosthetic sockets
with each of the subjects each subject will do a standing and walking exercise using their conventional sockets or the novel
sockets. Meanwhile skin contact forces, walking metabolic cost, and gait symmetry are recorded. After the exercises, skin
irritation will be assessed by a dermatologist, and socket comfort is assessed using a questionnaire. Together this data
provides a quantitative and qualitative evaluation and comparison of the novel and conventional sockets.
