Method: Retrospective observational study on 4,578 Veterans hospitalized for LLA and discharged 2003- 2004, looking at time to all-cause mortality from the amputation surgical date up to the 3 yr anniversary.

Results: 1,300 (28.4%) persons received a prescription for a prosthetic limb within 1 yr after the surgical amputation. About 46% (n = 2,086) of all Veterans w LLA died within 3 yr of the surgical anniversary. Among those who received a prescription for a prosthetic limb, only 25.2% died within 3 yr of the surgical anniversary. 

Discussion: The time to receipt of the prescription for a prosthetic limb (prosthetic fitting) was associated with lower mortality.

Conclusions: 

• It is important that patients who would benefit from a lower limb prosthesis obtain one as soon as they are medically stable. 
• Early fitting may provide a psychological boost to patients’ motivation, further promoting their overall health.
• Patient-centered care and early prosthetic fitting, is associated
  with longer survival.

Reference:​ Kurichi JE, Kwong P, Vogel WB, Xie D, Cowper Ripley D, Bates BE. Effects of prosthetic limb prescription on 3-year mortality among Veterans with lower-limb amputation. J Rehabil Res Dev. 2015;52(4):385-96. doi: 10.1682/JRRD.2014.09.0209. PMID: 26348602; PMCID: PMC4563808

This summer, Dr. Timothy Dillingham and his son Rhys visited Botswana with a goal to help persons with limb loss obtain a comfortable, durable socket.  Through the UPenn-Botswana Partnership they visited several locations and fit 17 persons in a 7 day time period.  They had four hockey bags loaded with these modular devices and a backpack with hand tools.  

Many of these persons were not able to obtain a prosthetic, while others had devices that were old and uncomfortable.  The adjustable system was fit within 1-2 hours and allowed subjects to walk without issue.  See more about this trip in our tab "International Relief Efforts" under "Research".

Here is more on this article:  ​Two UB-UPENN Staff Members Provide 17 Batswana with Lower Limb Prostheses | University of Botswana

Adjustable prosthetics are the future direction for prosthetic technology.  Patients are seeking out ways to adjust their prosthetic when their limb changes and prosthetists are taking note of this demand.  Many patients report their limb goes through changes during the day and being unable to adjust can lead to skin irritation or even tripping and falling.  

Persons with recent amputation will experience drastic changes in their limb volume over the first year.  Using socks is one way to fill in the missing volume, however too many socks can reduce total contact and therefore a proper fit.  iFIT's patented buckle system allows the wearer to adjust their socket whenever and wherever they are.  All sockets are further modifiable by the prosthetist so they can accommodate even large changes in volume.

An active 55-year-old male weighing 220 pounds desired an adjustable
prosthetic socket.  He was experiencing many issues with his suction socket such as frequent blisters in irritation.

• He was fit with the iFIT Wide Transfemoral prosthesis with his micro-processor knee attached.
• The prosthesis was modified during a follow-up visit 2 weeks later by trimming the socket brim and flaps to accommodate limb shrinkage.
• During a follow-up 4 months later, the patient reduced 5cm distally and 4cm proximally and was moved to a Standard size.

He reported improvement in socket fit and reduced skin irritation.  This patient now continues to wear the iFIT socket full time and has not slowed down in his active lifestyle.  He is able to fish on his boat, has fixed his roof and has pretty much not slowed down since his being fit with his iFIT transfemoral socket. 
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The iFIT transfemoral socket is a great alternative to suction sockets which can fit improperly if the wearer gains or loses volume.  The subject reported he feels secure and stable during his many activities and does not miss the high brim of previous sockets.  To obtain an iFIT transfemoral socket, the best place to start it by speaking with your prosthetist. They can then determine the size you will need and get you fit quickly and efficiently using the adjustable system.

• A group of 22 volunteers with transtibial limb loss rated the iFIT socket as significantly better in terms of comfort, stability and fit versus their conventional prosthesis (iFIT average rating was 29.3±4.51 out of 35 possible points versus 25.2±6.8 for conventional socket).
• No falls or limb ischemia were reported or noted during follow up.
• Gait biomechanics revealed no differences across any temporal characteristics.
• Intrasocket peak pressures were significantly lower for the iFIT prostheses overall (P = .0014), at the anterior tibia (P = .0002), and the lateral side of the residual limb (P = .013).

This study provided preliminary evidence to support the feasibility of the iFIT system as it compared favorably to participants' conventional prostheses across all outcome measures. 
                                                                       Read full study

Dillingham, T., Kenia, J., Shofer, F. and Marschalek, J., 2019. A prospective assessment of an adjustable, immediate fit, transtibial prosthesis. PM&R, 11(11), pp.1210-1217.

A study recently published by Miller et al. found that receiving a prosthesis within the first three months post amputation was highly beneficial in the following:

• Individuals who receive a prosthesis within 0 to 3 months after amputation were 48% less likely to use the Emergency Department (ED) compared to those who did not receive a prosthesis.
• Individuals who experienced a fall/FRI had 2.8 times the odds
  of ED utilization.
• The current study underscores the value of prostheses
  during the rehabilitation process after LLA.

The iFIT system can help get patients fit faster. iFIT’s stability, strength and durability allows for immediate and early ambulation.  

Study: Miller, T.A., Paul, R., Forthofer, M. and Wurdeman, S.R., 2020. The Role of Earlier Receipt of a Lower Limb Prosthesis on Emergency Department Utilization. PM&R. Oct 3.

During these challenging times patients should not have to wait longer for a prosthesis.  Fit with minimal visits, and fully adjustable by the patient the iFIT prosthesis is perfect post amputation.  During the first year, drastic reductions in volume occur as the limb matures. The iFIT system helps shrink the limb down and maintain a secure fit.

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Give those with limb loss the mobility they deserve and the freedom they expect.

 

• Aligned quickly: Can be fit in under 1 hour
• Lighter weight: Making mobility easier
• Eliminate visits: The user can adjust their own setting
• No socks: Not required to accommodate limb changes
• Reduced socket rotation: More secure gait