The entire prosthesis is controlled via the pelvis or pelvic shaft.
We train you in the daily use of your hip disarticulation prosthesis
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In a hip disarticulation, the entire leg is amputated by a disarticulation (=surgical removal of the entire lower limb by transection through the hip joint). This removes the femoral head from the acetabulum, usually preserving the pelvis and ischium. In a hemipelvectomy, the leg and parts of the pelvis are amputated. Hip disarticulation is necessary in cases such as tumors, severe trauma and infections.
Hip disarticulation poses a major challenge for prosthetic treatment – a leg prosthesis is usually controlled by the user’s lower leg stump or thigh stump. In the case of hip disarticulation, on the other hand, there is no corresponding stump. Control is taken over exclusively by the pelvis. This special situation makes the manufacture of a hip disarticulation prosthesis (HDP) an absolute specialty in leg prosthetics, which requires a high level of expertise.
The pelvis is embedded in an HTV silicone contact socket called the “pelvic socket”. It makes up the connection between the prosthesis and the body. The design of the socket has a significant influence on the comfort and operability of the prosthesis.
You can choose between three concepts:
Hip joint: Both hip and knee joints are used to regulate the swing and standing phase. Among other things, we use the Ottobock hip joints (e.g. 7E10 Helix hip joint, 7E9), which our users were able to be convinced about, thanks to their function.
Knee joint: For safe, dynamic walking and to fully exploit the function of the hip joint, Ottobock’s electric legs (e.g. C-Leg, Genium, Kenevo) are recommended.
Foot: Various carbon spring foot systems are used, depending on the respective mobility.
Cosmetically, there are two options:
a split variant that keeps the joints free and therefore has little influence on the function of the prosthesis. This cosmetic is popular with users who are actively engaged with the prosthesis.
Guiding a hip disarticulation prosthesis requires a great deal of concentration and energy on the part of the user. With the limited control of the pelvis, it must be possible to coordinate the movement of the mechanical ankle joint, knee joint and hip joint fitting parts.
The prosthetic socket plays a central role here. Its fit must be as close as possible to the body and free of pressure points, with little restriction of movement in the lumbar region and an option for direct control. We have risen to this challenge and have been able to develop new materials and working techniques that significantly improve socket comfort. Our innovative socket concept envisages the use of individual silicone hip pants.
By closing the silicone pants, the user compresses all soft tissues and thus prevents their uncontrolled movement. This means that the stump in the pants is compressed over a large area. This compression creates a strong, firm (stump) surface that provides the pelvic socket with the necessary support. The stump is therefore put into good condition by the silicone pants in order to absorb the socket and to create the smoothest possible adaptation between stump and prosthesis.
The silicone pants form a clear separating layer to the pelvic harness. The material silicone is used in various shore hardness grades. Thus, the HTV silicone blends used for the pants can be adjusted softer or harder depending on the fabric condition and sensitive skin areas.
In developing the pelvic socket, we have set ourselves the goal of reducing the fixed portions of the shaft in order to achieve greater freedom of movement. We also wanted to optimize the control of the prosthesis. The two-part pelvic socket with silicone inlays meets these requirements.
A special locking technique opens and closes the two-part socket. The silicone pants can be easily closed with a velcro fastener. The velcro fastener can be retightened even after the pelvic harness has been put on.
With the implementation of our innovative socket concept, it was possible to optimize both socket functionality and comfort:
1. Improved control of the prosthesis:
2. Hygienic and skin-protecting stump bed
And what are the alternatives?
Of course, we also provide conventional pelvic harnesses, although from a functional point of view there are no reasons to deprive new users of modern treatment technologies. Experienced users who do not wish to expend extra effort with closures – or who have high demands when it comes to cosmetic appearance and volume in the pelvic area – can alternatively choose a pelvic socket made of carbon with a semi-flexible proportion in the back area and individual silicone hip pants. After several years of experience, the use of a socket system in combination with silicone pants is the method of choice and brings a great advantage in the quality of care for hip prosthetics.