Prosthetic Limb Process

You’ve had an amputation, your residual limb is healing, and it’s time to start thinking about a prostheses. Here are some answers to questions new amputees frequently ask:

What happens after the amputation?

A prosthesis  is an artificial replacement for a missing limb or part of a limb. Although a prosthesis is never as natural as your own limb, it can help you to do many things quite effectively if you are willing to combine your energy and willpower into learning how to use it. The most important aspect of success is working with your prosthetist and therapist to address all of your concerns, and then to work with them on the processes of design, fitting and training, which are required to be a successful user.

How long should I wait after my amputation before I can see the Prosthetist at the Ledbrook Clinic?

First the residual limb wound must heal properly. The actual rehabilitation phase starts after a few weeks when this healing process is finished. As a rule, it lasts up to half a year. Your treatment team will decide when you can start with intensive rehabilitation based on how your recovery progresses.

Prosthetic RehabilitationDuring the rehabilitation phase you are specifically prepared for wearing a prosthesis. The goal is to provide you with the highest possible degree of mobility and independence so that you can live your life as normally as possible in the future. However, your active participation is the decisive factor for a successful rehabilitation. Your motivation and a high degree of self-confidence can also make an important contribution.

During rehabilitation you will learn how to care properly for your residual limb, the scar, and your sound leg and what you should pay attention to.
Before you can wear a prosthesis, your residual limb must be healed and have attained the proper shape. This means that all fluids which accumulated through the operation have been removed through compression therapy and that the residual limb edema has subsided.
Once your residual limb has been formed properly and can bear weight, you may be fitted with an early or interim prosthesis. Then you will practice using your prosthetic leg: first how to put the prosthesis on and take it off, followed later by gait training. Have your prosthetist show you how to care properly for your prosthesis.

Can I bring someone with me to my prosthetic appointment?

We encourage you to bring your family to an appointment. It is important for all family members to be involved in the fitting process, and to have an opportunity to ask questions. If your child is missing a limb, we also feel it is important for siblings to take part in certain appointments.

What will happen at my first appointment?

During the first initial appointment at the Ledbrook Clinic, you will be seen by the Clinical Team who will assess you for the best prosthesis suited to your lifestyle and level of fitness. We will discuss the best type of socket and if you are a below knee amputee, the best type of prosthetic foot suited to your activity levels.

If you are an above knee amputee, we will also discuss the best type of prosthetic knee suited to your activity level. We will then put together a quotation for you based on your needs and budget. If you decide to proceed with treatment, then we will take a cast of your residual limb, and our highly skilled technicains witll manufacture a test socket from this cast. You will then attend for a further appointment for the test socket fitting, then we will proceed to manufacture the prosthesis.

Can you tell me more the fitting process for a prosthesis?

It can take several fittings to produce a well-fitting, well-functioning artificial limb. The Prosthetist at the Ledbrook Clinic will normally focus on the fit of the socket first. A clear plastic test socket may be fitted so that the Prosthetist can actually see where the socket fits well and where modifications are needed. Your Prosthetist will ask for your feedback regarding comfort and fit.

What does the prosthesis look like? How will it stay on?

Depending on the level of your amputation, physical ability and functional needs, each prosthesis will be somewhat different. If you desire a “cosmetic look,” prosthetic supplements are available. But, for most standard prostheses, they are comprised of conventional component parts attached to a socket that fits over your residual limb.

How does a prosthesis work? Will I be able to do all the things I did before I lost my limb?

The majority of people who lose a limb can get back to a normal mode of functioning within a few to several months, depending on the location of the amputation as well as physical ability. How well they function depends primarily on their goals along with timely, comfortable prosthetic fitting, good follow-up care, and a “can do” attitude from themselves as well as their medical team.

When will I be ready for my prosthesis?

Generally, you should be ready for prosthetic measurements and fitting a few weeks after surgery, when the wound is healed and the tissue swelling is decreased. Then you will be ready for prosthetic measurements and fitting. This process can be easily attained with exercise and rehabilitation. During this stage, your  team also will be concerned with maintaining proper shape of the residual limb, as well as increasing overall strength and function. Fitting is usually stress-free and involves several steps to create a unique prosthesis for you.

What if my prosthesis doesn't fit correctly?

Follow-up is as important as the initial fitting. You may need to make several visits for adjustments with the prosthetist as well as training with a therapist. They can help you ease pressure areas, adjust alignment, work out any problems, and regain the skills you need to adapt to life after limb loss. Tell your Prosthetist if the manufactured limb is uncomfortable, too loose or too tight. Ask questions about things you need or want to do. Communicate honestly about your needs. The more you communicate with your Prosthetist and therapist, the better you will be able to succeed with a prosthesis.

How long will my prosthesis last?

Depending on your age, activity level and growth, the prosthesis can last anywhere from several months to several years. In the early stages after limb loss, many changes occur in the residual limb that can lead to shrinking of the limb. This may require socket changes, the addition of liners, or even a different device. Later on, increased activity level and desire for additional function can necessitate a change in the prosthesis or its parts. Once you are comfortably adjusted and functioning at the desired level of activity, the prosthesis needs only minor repairs or maintenance and can last for an average of three years.

Is it learning to use a prosthesis difficult?

Learning to use a prosthesis is a tough job. It takes time, great effort, strength, patience and perseverance. You will do best to work with a physiotherapist while learning how to handle the new device. Much like learning how to operate a car, you will need guidance on how to:

  • Take care of the prosthesis.
  • Put on (don) and take off (doff) the prosthesis.
  • Walk on different types of surfaces including stairs and uneven surfaces.
  • Handle emergencies safely, including falling down and getting back up again.
  • Perform daily activities at home, at work and even in the car.
  • Investigate new things you may be uncertain of, including sports and recreational activities.

Do you offer Prosthetic Therapy?

We are able to offer the services of experienced professional physiotherapists to ensure you receive optimum rehabilitation.

At The Ledbrook Clinic, our patients are our focus and we deliver these services to a very high clinical standard so that you can be confident of the best possible care. Following an assessment and close working with your prosthetist, an initial programme of postural training and good basic exercises will help manage gait and muscle imbalance that may occur with a new prosthesis.

Finally we are able to demonstrate and teach methods regarding functional tasks such as ascending and descending stairs and ramps or getting on and off the floor, walking outdoors and in a range of different every day settings, along with other specific tasks needed to get you back to a safe, independent functioning status. At the Ledbrook Clinic we can also offer by appointment visits to your home. These can be arranged in the evening or on weekends when we can look at your function in your own environment to again allow for more specific task training.

Will I need to use a wheelchair or crutches following my prosthesis?

Some people elect not to use a prosthesis, relying exclusively on mobility devices. However, with a prosthesis, the use of crutches or a wheelchair depends on several factors including level of amputation, whether you have a single or bilateral amputation, and your level of balance and strength. Most amputees have a pair of crutches for times when the limb is off, including night-time trips to the bathroom, showering, participating in certain sports, and to help if problems arise that may require leaving the prosthesis off for any length of time.

If you are a person who has lost both legs, you will probably use a wheelchair at least some of the time. Unilateral amputees may find it helpful to use a cane or crutches for balance and support in the early stages of walking or just to have a break from the prosthesis. This is an individual decision based on factors such as age, balance, strength and sense of security.

Once I have been fitted and feel comfortable with my prosthesis, what will happen next?

Plan on making follow-up visits to the Prosthetist at the Ledbrook Clinic a normal part of your life. Proper fit of the socket and good alignment will insure that the prosthesis is useful to you. Prostheses, like cars, need regular maintenance and repair to continue efficient functioning. Small adjustments can make a big difference.

Can a prosthetic limb break down or fail?

Yes, things can happen that will require repair or replacement, so it’s a good idea to know about warranties. Get small problems with your prosthesis taken care of promptly. There is no benefit to waiting until something falls apart or causes you serious skin breakdown. If you wear a prosthesis too long when it needs repairs or replacement, you can do harm, not only to your residual limb, but also to other parts of your body. Strain on other muscles, especially in your back and shoulders, will affect posture in addition to performance of the device and energy needed to use it. Early prevention is more valuable than long-term treatment.

Follow up care for your prosthesis

Once your device is complete, your Prosthetist will set up a free of charge recheck appointment within 3 months to monitor the fit and function of your device. We want to be sure that your prosthesis continues to fit comfortably and that it remains in good mechanical condition. If we find anatomical changes (body size or volume) or changes in your functional ability, we will adjust the device and/or recommend changes to the device.

We recommend that you return at least every six months for follow-up care, or sooner if you notice changes in your weight or activity level. Your clinician will let you know if your device requires more frequent follow-up care or specific maintenance.

Follow-up is a lifelong activity

It is important to allow your limb to adapt to your new prosthesis. A gradual increase in your wearing time can make the difference between a comfortable and painful transition. Your residual limb volume may reduce during the first few weeks of wearing a new prothesis, especially if this is your first prosthesis.

Check your skin every time you take off your prosthesis:

  • With your eyes and your hands (especially if you have altered sensation from a neuropathy, poor circulation, or diabetes) to avoid blisters and skin damage.
  • If your skin is broken, do not wear the prosthesis until it is completely healed.
  • Many prosthetic users also find it necessary to add or change socks throughout the day. This is common.

How much will it cost?

  • Prosthetic care can be expensive and every amputee or their providers are concerned about the cost. It’s difficult to tell someone how much their prosthesis is going to cost without a consultation.  Once the assessment is done, we will then be able to provide you with an itemised cost for your treatment. We will also advise you on future cost and warranties.
  • Prices start from £3,000 for a below-knee low activity limb to a maximum of £25,000 for above- knee high specification limb with a silicone cover.
  • If clients are travelling from abroad or from a distance in the UK, we will be happy to give some idea of costings over the phone or by email.
  • We accept credit and debit cards as well as bank transfer.