More and Less Lead to Good DESIGN

Less is more.
More or less.
Why choose? Can’t you have both more and less?

Yes! Alpha DESIGN® Liners, prosthetically speaking, eliminate the need for clinicians to choose between more and less.

With the release of Alpha DESIGN Liners in 2005 more control was put in the hands of clinicians to design liners from the inside out. The result is that more gel in some areas and less gel in other areas of a liner yielded total contact between a liner and a residual limb for greater comfort, improved limb health, higher quality of life, and happy amputees.

Since coming to the market a decade ago, clinicians have been getting more and more savvy in how to ‘construct’ custom liners. Creative clinical thinking now has Alpha DESIGN Liners being used for amputees who may only be able to “get by” with prefabricated liners, but who would ultimately benefit more from a liner with localized customization.

More: Applications of designing liners using ‘more’ gel includes:

• Fill deep invaginations with gel (up to 25 mm thick) in a residual limb to ensure the residual limb and liner have total contact.
• Instead of building a relief within a socket, design a relief directly in the liner to off-load sensitive areas and bony prominences with gel build-ups [see figures 1 & 2]. An added bonus is liner life may be extended by eliminating wear on a liner due to it continually rubbing against a built-in socket relief.
• Build up gel distally to provide extra protection and comfort. Distal gel build up can also eliminate the need for using gel cups.
• When working with an asymmetrical shape such as a large thigh that tapers to a narrow residual limb, add gel proximally to build substance and support to aid in liner fit and to prevent the liner from rolling down due to an amputee’s anatomy [figure 3]. An excellent companion to this design is choosing the one-way stretch Select fabric to help the liner stay in place yet provides for easy donning due to its circumferential stretch.
• Add gel to the medial side of the knee to allow for some weight transfer for increased comfort over the bone structure.

Figure 1

Figure 2

Figure 3

Less: Applications of using ‘less’ gel in a custom liner include:

• Upper extremity amputees or amputees coping with medical issues resulting in low energy can benefit from thinning gel throughout the liner to reduce the overall weight.
• For added knee flexion and comfort, thin the gel over the patella [figure 4]. This trick reduces the risk of the liner uncomfortably pulling on the knee cap when the residual limb is bent and relieves hamstring pressure.
• For patients who almost have complete comfort from a prefabricated liner, modify a ‘standard’ Alpha Liner profile. Clinicians can thin the gel in a specific, localized area to optimize a liner’s fit and comfort.
• Patients who struggle with getting their liners on and off may benefit from having less gel throughout a custom liner to enable easier donning and doffing.
• For amputees desiring less bulky prosthetic, a liner may be designed with less gel in order to reduce ‘bulk’ and achieve a more cosmetically appealing liner.

Figure 4 – Gel thinned over patella, medial view