Prosthetic Leg

What is a prosthetic leg?

A prosthetic leg, or lower limb prosthesis, is an artificial replacement for part or all of your leg. If you can’t use your leg, either because of a birth defect or amputation, you might use a prosthetic leg to walk.

A leg prosthesis can replace as much of your leg as you need, from your foot, ankle and shin to your knee, thigh and hip. It can offer you greater mobility and the chance to live a more active lifestyle.

What is the purpose of a prosthetic leg?

Prosthetic limbs are assistive devices to enhance your mobility and independence. They mimic the functions of a human limb to help you do certain things better than you could without them.

Using a prosthetic limb can also help you maintain your overall musculoskeletal health. Making your different side more usable allows you to distribute your body’s workload more evenly across both sides.

What are prosthetic legs made of?

Modern prosthetic legs are made of strong but lightweight materials, like carbon fiber or fiberglass, titanium or aluminum. They also have some softer parts, like foam cushioning and silicone sleeves.

The moving parts at the joints might include mechanical springs and gears or computer microprocessors. Some prosthetic legs include hydraulic or pneumatic cylinders, which make movement smoother.

What do prosthetic legs look like?

Prosthetic legs can look different ways. Some are high-tech and look like robot limbs. Others are more low-tech and skeletal-looking. You can also get different types of “skins” to cover your prosthesis.

Some people customize their prosthetic legs with fun fabrics, logos or tattoos. Others prefer a low-profile look that’s custom-painted to look like their natural legs. Most cosmetic covers are removable.

What are the different types of prosthetic legs?

Different types of prosthetic legs replace different parts of your leg. You might need a prosthesis with an ankle joint, a knee joint and/or a hip joint. Different types also have different mechanisms at the joints.

Some prosthetics are purely mechanical, while others have computerized parts. Some move in limited ways, and others move in many ways. Some are designed for particular sports or other activities.

Amputation levels

Different types of prostheses are available for different types of lower limb amputations, including:

• Transtibial amputation: Amputation through your lower leg.
• Knee disarticulation: Amputation at your knee joint.
• Transfemoral amputation: Amputation above your knee and through your femur.
• Hip disarticulation: Amputation at your hip joint.
• Hindquarter amputation (external hemipelvectomy): Removal of your whole leg and part of your pelvis.

Above-the-knee and below-the-knee prosthetic legs

Your limb deficit or amputation level will determine the level of prosthesis you need. In general, an above-the-knee prosthetic leg is a more complex device than a below-the-knee prosthetic leg.

One difference is the knee joint. If your prosthesis is below the knee, it only needs a shin, ankle and foot, which may or may not be flexible. If it’s above the knee, it’ll need to include a functioning knee joint.

Your knee joint is central to the mechanics of walking. It bears much of your weight and affects your stability and balance on various terrains. It also determines whether your leg can run, bike or swim.

The attachment part of the prosthesis also needs to be more sophisticated, as the prosthesis must attach to a shorter lever arm. Generally, the higher the amputation level, the trickier it is to attach the prosthesis.

Mechanical and bionic legs

The joints in your prosthetic leg may be mechanical or bionic, which means they include computer microprocessors. These microprocessors enable the joints to automatically adjust to different terrain.

Both types have pros and cons. Mechanical legs tend to be more durable, lightweight and affordable than bionic legs. They aren’t “smart,” but you can use them for basic walking and sitting down.

Bionic legs use microprocessors to provide real-time feedback about how you’re using them. They adjust to different activities and environments more like a natural leg would. Some are also programmable.

Both mechanical and bionic legs may include pneumatic or hydraulic components (compressed air or water). These provide adjustable resistance while walking, which allows for a more natural gait pattern.

What are the components of a prosthetic leg?

Prosthetic legs have several components, which are sometimes interchangeable. When you and your prosthetist design your custom prosthesis, you’ll discuss each of these components.

• Socket. The socket is the part that connects your prosthesis to your existing limb. It’s custom-made to fit your existing limb, and you’ll have several fitting appointments to perfect the fit. You’ll usually wear a changeable liner or “sock” between your limb and the socket.
• Suspension. The prosthesis connects to the socket by some type of suspension system. There are many types of prosthesis suspension systems, including straps or belts, suction liners, pin-locking liners, electric vacuum pumps and neoprene sleeves that “grip” the prosthesis.
• Skeleton. This is the “bone” part of a prosthetic leg, which connects the socket with the joint components. It’s also called the connector, adapter or frame. It’s often a type of metal pipe, or pylon, with connecting parts. Sometimes, it’ll have a softer, limb-shaped material over it.
• Joints. An above-the-knee prosthesis will need a knee joint, and sometimes a hip joint. These might be mechanical, pneumatic or hydraulic, and/or powered (bionic). Different types may be better for different people. You’ll also need an ankle joint, but this is usually part of the foot.
• Foot. The prosthetic foot is the terminal device at the end of your prosthetic leg. It may or may not resemble a human foot. Prosthetic feet can be low- or high-tech, with ankles that move in a variety of ways. Special feet can accommodate swimming, running, skiing or other sports.

Who can benefit from a prosthetic leg?

You might benefit from a prosthetic leg if you’ve had a lower limb amputation or have a congenital limb difference that makes walking difficult. However, not everyone benefits equally from a prosthetic leg.

Many factors can influence how much you’re likely to benefit from a prosthetic leg, and what complications you may face along the way. Before recommending one, your provider will want to know:

• Is your existing limb in good condition to use with a prosthesis?
• Do you have much pain in your existing limb or phantom limb?
• How much range of motion does your existing limb have?
• What’s the condition of your other leg?
• What are your mobility goals?
• How much rehabilitation and training can you commit to?
• Do you have insurance coverage or other funding for the type of prosthesis you want?
• What kind of moral support system do you have?

What are the steps involved in getting a prosthetic leg?

Getting a new prosthetic limb and learning to use it is a huge undertaking. It will take time, patience and practice on your part. It may be frustrating at times, and you’ll need to manage your expectations.

Here’s a brief breakdown of the steps involved:

• Consultation and assessment. You’ll begin the process with a consultation and assessment with your healthcare provider. They’ll assess your physical condition and fitness to use a prosthesis, then discuss your lifestyle, needs and goals to determine the best type of prosthetic leg for you.
• Fitting. When you’re ready, you’ll see your prosthetist to begin taking measurements for the fitting. They might take a cast or a 3-D scan of your different limb and your opposite limb. They’ll also need to determine which muscle groups you’ll need to use to operate the prosthesis.
• Basic training. When your prosthesis is ready for you, your prosthetist will show you how to put it on and take it off, how it works and how to take care of it. You’ll learn how to clean it, how to operate the mechanical parts and how to charge the electrical parts, if you have any.
• Physical and occupational training. Next, you’ll work with a physical therapist and/or occupational therapist to learn how to use your prosthetic leg for your specific activities. You’ll practice exercises to strengthen your muscles and drill different movements and actions.
• Mental health care. While you’re working hard to rehabilitate your body, you’re also processing a major psychological event. Don’t underestimate this part. Mental health professionals and peer support groups can help support this part of your journey.

What can you do with a prosthetic leg?

Your physical condition, the type of prosthesis you have and your ability to adapt to it may limit what you can do with it. But barring these factors, you may be able to do everything you could do before.

People with prosthetic legs run marathons, go on ski holidays and take part in the Paralympics. Your healthcare team will work with you to set realistic goals for you and tackle them one at a time.

What are the possible complications of using a prosthetic leg?

Possible obstacles include:

• Chafing or pressure sores due to an improper fit.
• Excess sweating under the prosthesis, which can lead to skin irritation.
• Residual limb pain or phantom limb pain causing difficulties with use.
• Cost and funding issues or insurance complications.
• Mechanical failures and breakdowns requiring repairs or replacement.
• Technical difficulties with the type of prosthesis you have.

These risks are mostly avoidable with proper fitting, training and maintenance.

How long does it take to adapt to a prosthetic leg?

Many variables can affect how long it takes to adapt to your new prosthesis, including what you want to use it for, the type you have, how you practice and any complications you might be having.

Your physical therapist and/or occupational therapist will design a customized plan to train you to use your prosthesis. Training happens in stages. This part of your rehabilitation can take up to a year.

Learning to use your muscles in new ways to achieve specific actions with your prosthetic leg takes time. Learning to program a bionic leg and toggle between different movement patterns can take even longer.

While you’re physically learning to use your prosthetic leg, you’ll also be adapting to it mentally and emotionally. Remember to practice patience and self-compassion. This process has its own timeline.

What happens after rehabilitation?

When you and your healthcare team feel you’ve adapted to your prosthetic leg, you may not need to continue with physical therapy. But your relationship with your prosthetist is likely to be a long-term one.

As your physical and practical needs change over the years, you’ll need repairs, adjustments and replacements for your prosthesis. Be sure to consult your prosthetist if discomfort or complications develop.

How long does it take to get a prosthetic leg?

Many variables can affect how long it takes to get your prosthetic leg. But on average, it takes three to six months to receive your prosthetic leg and begin the training process. This includes:

• Two to three months of recovery after an amputation before you’re ready for fitting.
• Several appointments with your prosthetist to take measurements and discuss your needs.
• One to two months to make your custom prosthesis (or custom socket for a prefabricated one).
• Several appointments with your prosthetist after the prosthesis arrives to fine-tune the fit.

How long will my prosthetic leg last?

Most artificial legs last three to five years, depending on the type and how much you use them. Your prosthetist can give you a more specific estimate based on your lifestyle and the model you have.

Is it hard to walk on a prosthetic leg?

Different things may be hard to navigate with different types of prosthetic legs. For example, a mechanical leg may be relatively simple to operate but may require more muscle work to control.

Bionic legs require less muscle work because the microprocessors help keep your balance automatically. But there’s a learning curve to figuring out how to use them to walk, especially if they’re programmable.

Is a prosthetic leg painful to use?

The prosthesis itself shouldn’t be painful. If it is, consult your prosthetist. It might be a fit issue, or skin irritation related to sweat. If your muscles are sore from using your prosthesis, you might be overusing them.

Some people also have phantom limb pain or pain in their residual limb. These aren’t related to the prosthesis, but they can make it uncomfortable to use. Consult your healthcare provider if you feel pain.

Mirror therapy is one method that’s proven successful in relieving phantom limb pain for amputees. Targeted muscle reinnervation, a surgical technique, has been helpful in preventing nerve-related pain.

Will I still need to use a wheelchair or crutches with a prosthetic leg?

Some people do. It depends on your mobility with the prosthesis you have. Some people have a more limited type of prosthesis, and some people have more limited mobility goals and expectations.

Depending on your condition, you might only use your prosthetic leg for limited purposes, like walking to the bathroom or transferring from a wheelchair to a vehicle. Some people might still use a crutch.

This doesn’t mean that you aren’t successful in using your prosthesis. It’s there to serve you in whatever way you need it to. How long you wear it or what you do with it doesn’t define your success.

A note from Cleveland Clinic

Prosthetic limbs have come a long way from the clunky wooden legs of old, and so has public sentiment about them. A fake leg that might’ve once seemed like a burden might be a bragging point today.

Modern prosthetic legs do more than just help you walk. Whether you hope to run, swim or ski, or join your family and friends in more of the everyday activities they enjoy, a prosthetic leg can help you get there.