t-t liner answers

Monica Motloch

Description

Title:

t-t liner answers

Creator:

Monica Motloch

Date:

6/29/2002

Text:

I have a bilateral trans-tibial patient who is not comfortable with the amount of pressure at her patella's from the silicone liners (with pin suspension).
Monica Motloch, CO, Prosthetic Resident

ANSWERS:

The Aegis liner is preflexed, but it tends to 'milk' the distal end more so than others. You didn't mention how thick of liner you are using, but the
thinner the liner, the easier it will stretch around the knee.
Marcus Boren, CP

One of my patients uses second skin gel pads to protect his patella from the friction of the alpha liner. This is not an inexpensive solution.
Bobby Leaber, CP

I've had some trouble with the same thing. Often times correcting the
donning method helps. Have your pt roll on the liner as usual, but as they
roll over the patella have them bend their knee. This takes some tension
off the patella. Personally, I don't like cut outs, due to window edema.
John Warren CP, LP

Take a look at the Agis ultimate liner it is pre flexed and they have
imperial data that show there is a reduction in patella pressure or the
Angle socks from Comfort Products both systems can be used with a valve and suspension sleeve instead of a pin. You can get them from Southern or PEL or the manufacture
Richard Hughes
Comfort Products


Provide her with a donut pad to place around her patella.
Ted A. Trower C.P.O.
A-S-C Orthotics & Prosthetics


Tec liners (sorry, don't know suppliers in US) are preflexed as you suggested, they are also made from urethane, which disperses better than silicone and often feels a lot different to patients. One drawback is that they are a heavier than other liners. Tec will also custom make liners to a cast, so this may also be helpful if she is still experiencing problems.
Vicky Jarvis CPO


You may want to try soft liners, like Dermo and Comfort and stay away from stiff ones like the clear and similars!
Jairo Blumenthal P.O
Ortopedia Correto- Brazil

 
Go with a 3mm liner, if possible, as they stretch more and if sized
correctly, exert less stress on the patellar region. Consider the 'Plus'
shape from Alpha or Ossur, as they are more conical (most appropriate where there is a large thigh circumference vs distal circumference). Your client could also use lubricant directly over their patella before rolling the
liners over that region of their limb.

 
We have had this complaint a few times and it weems it's more the tackiness of the liner causing the problem.; Before you cut anything try some non-absorbing lubrication (vasaline) and see if that helps


Very helpful information and Thank You to everyone who responded!

                          

Citation

Monica Motloch, “t-t liner answers,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/219175.