Above knee prosthetic socket fitting.

The key to a good prosthetic leg is proper fit of the prosthetic socket. Which depends first and foremost on the expertise of your prosthetist. Therefore it is difficult to say if your prosthetic socket fit is good or if you could have a better one. I have seen many prosthetists and more than once I had to change my prosthetist because the prosthetic socket I got was uncomfortable or even painful.

The prosthetic socket I am demonstrating in this video is unconventional because I hold this socket purely with muscle contraction in my residual limb. I do not need a silicone liner or a donning aid (to pull the stump skin into the socket). This might not work for all above knee amputees. However, the precise fitting of this socket is a demonstration of what is possible even with a short stump. This should give hope to amputees who are struggling with their current prosthetic leg. See my video to understand why this above-knee prosthetic socket is exceptional.

I give credit to my prosthetist Alexander Schwarz from Schwarz Beinprothetik in Hamburg, Germany, whose expertise, commitment and patience in finding the optimal socket fit for his above knee amputee customers is unparalleled. For me as an above knee amputee a prosthetic socket that is both functional and comfortable is a major factor for my quality of life!

Also see this video in which I show how I don my above-knee prosthesis:

Easily Donning my Above Knee Prosthetic Leg

In the following video I am testing my socket on difficult terrain, requiring a maximum of stability in the socket. See how it works, even with a short stump:

Also see my post on my flexible prosthetic socket.

9 thoughts on “Prosthetic Socket Fit

  1. Hi Karl
    I did contact you last year and appreciated your response.
    I changed fro the NHS prosthetist to a private one. I have I have had an Ottobock C-Leg 4 for some 5 months
    I made good progress initially and although my leg was amputated in October 1016 my stump has continued to shrink. Therefore I have a suction socket. Air has started get into the socket and causing all kinds of problems (including producing some unpleasant noises which means I get some strange looks). However a new socket is currently being made and I will make sure that I am 100% happy with it and will keep returning to the prosthetist until it is.
    You are so right it doesn’t matter what knee you are fitted with. It is the socket that is crucial to gaining maximum mobility.


  2. Hi Karl,

    Great blog!!! Your family is lovely!!! My name is Carlos and I’m from Ecuador, I use a prosthetic leg for almost 18 years and it has been very difficult specially in my country where you don’t have many economical possibility to afford a good prosthetic leg.

    Anyway, throught these years I’ve used diferent types of prosthetic legs and in my case, liners of ossur are the best and I’ve recover my mobility in a high level. I can walk for 10 kilometers without problems and climb mountains. The system is awesome but it’s expensive especially here in South America.

    You can see some pics of my travels in my Instagram account cjjurado97 ???

  3. Hi, I have been above knee amputee for 22 years and have always had problems. With pin socket the only socket I have ever been given. I have been told to ask for suction socket that the fit a lot better. I have a c-leg which is great. Any help on best above knee socket would be very helpful.


    • Hi Mark,
      I agree that a suction socket is best for us above knee amputees (unless there are skin or scar complications with the stump). However, a pin socket is easier for the CPO. Because a pin socket always fits „somehow“, whereas a suction socket needs a precise socket shape.
      In other words: I think you should change your prosthetist! I my case, with my short stump, my CPO takes a lot of time, sometimes days, to optimize my socket fit. Usually the first check socket is already very good, however, it takes a lot of testing and adjustments to further perfect the socket shape such that I can walk basically unlimited distances, without the skin getting sore. That requires expertise and dedication by the prosthetist. I have seen prosthetists give you a socket, maybe do some minor initial adjustments, and send the amputee away, assuming that this is now the final product. With a pin socket, yes, it will hold somehow. But a precise socket shape (which is a requirement for a suction socket) requires a lot of testing and -in my case- adjustments.
      Hope that helps,

  4. I am new to this and feel I need a lot of input . I am an above the knee amputee of 6 months currently in a rehabilitation in Vancouver BC . There are other amputee here besides myself , the are below the knee . It would be great to hear from others on different sockets . I am not comfortable wearing my new leg a lot as I do not like the way it feels my leg feels pain and it is hard to describe to the guys who are making it possible for me to walk .

    Thanks for letting me share


    • Hi Donna,
      prosthetic socket fit and socket comfort is NOT JUST about the socket type, be it M.A.S., direct skin contact or silicone liner, flexible or rigid. Let 3 different prosthetists each make, say, a M.A.S. type socket for you. Probably each will be different. Some may be good, some not. I depends on the prosthetists skills, experience and dedication. Therefore, try to find a good prosthetist. Try to find other amputees and see how well they are walking (not just what they are talking…). I can truly recommend the prosthetists who had helped me so much. Amputees are coming from all over the world now to have socket made by him.

  5. I am pleased to see that you can hold your socket on with your well developed muscles.
    I cannot do this even if I wanted to, because my quad muscles were badly damaged at the time of my accident and had to be totally removed, so I have to put up with a rigid external socket with a roll on silicone inner with a screw like pin on the end which clicks into the rigid outer socket. The problem is they always rub and pinch making me very sore and generally uncomfortable.
    The knee I have stabilises to a point but should it bend beyond that point with any weight on it there is only one place you are going and that is “down”
    I m going to see if I can be prescribed the VGK, it does seem to be revolutionary, the knee I have is useless, I would also like a foot with some flexion on it,
    Do you have any suggestions?

    • Dear Sue,
      a prosthetic socket should never be rubbing and pinching, regardless of whether it’s a suction socket or with a silicone liner. It is a matter of precise socket shape, or, in other words, the expertise of your prosthetist. It is very important that you give precise feedback to your prosthetist: where exactly does it hurt or feel uncomfortable, in which situations, etc. The problem is, you never know if your socket is „right“ unless you’ve seen a difference. The only way to find out is trying with an other (hopefully better) prosthetist. That’s what I have been doing for 20 years, until finally I found a prosthetist whose expertise, skills and compassion for his amputee patients exceeded everything I have seen before.
      Wishing you luck, Karl

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