For many leg amputees, it can be hard coming to terms with the realities of losing a limb. The life they once knew in many cases is now gone, but that doesn’t mean they have to live with discomfort and pain anymore. A new innovation in prosthetics has surpassed years of practices and principles that many Certified Prosthetists and Orthotists have relied upon.
German entrepreneur Andreas Radspieler introduced the groundbreaking Symphonie Aqua System in 2015, the world’s first system for hydrostatic plaster impressions for accurately fitting prosthetic sockets.
“The benefit of the Symphonie Aqua System is it’s a stainless steel pressure tank that has a very thin membrane on the inside and it’s connected to a water source,” Radspieler said. “The patient is technically shaping their own socket. We calculate how tight that specific socket has to be. The rules of physics can’t be disputed.”
For years, CPO’s have varied in their techniques for fitting prosthetics and have often taken pride in their own unique way of conducting their practice.
“This was a process that stayed the same since the last, probably, 250 years,” Radspieler said. “It’s very traditional. We skip decades of trial and error learning processes from a CPO. This is not replacing a job, it’s a very valuable tool to skip the process and the time for a patient waiting to get the best socket they can possibly have.”
Local CPO and owner of Maughan Prosthetic and Orthotic, Justin Maughan provided a great analogy to what this new innovation will do for the industry.
“If you drew a circle every day for 20 years, your circle would get better,” he said. “You’d get to the point where you could draw a pretty good circle. If you gave everybody a compass, everybody would be able to draw a perfect circle. There was no tool in prosthetics to draw a perfect circle.”
The MPO Silverdale branch adopted Radspieler’s innovation around two years ago when Maughan saw the system at an annual meeting. Radspieler’s idea has spread like wildfire, with SAS’s in use all around the world. 50,000 patients are currently using the system worldwide, according to Radspieler.
“It’s going to level the whole playing field,” Maughan said. “When you see that many people in this small field jumping on something, it’s because it works. There’s only about three or four of these [systems] in the U.S. One day this may be in every prosthetic facility in the United States.”
In general, the SAS makes it possible to accurately capture a limb’s anatomy under full weight-bearing conditions. The hydrostatic cylinder replicates the exact forces one would experience while standing in a prosthetic socket. Using hydrostatic pressure, the exact anatomy of a patient’s stump can be reproduced before the trial socket is made. At the same time, scarred and sensitive areas, pressure and pain points, as well as prominent locations on the bone are clearly recognized.
The accuracy of the weight-bearing impression eliminates the need for cast modifications, which was a common problem before, and enables the practitioner to efficiently provide the patient with a comfortable, well-fitting socket.
At MPO Silverdale, the specific system used is the Symphonie Aqua System VC. The accessories used in this system include casting lubricant, aqua pad, distal cup, silicone pads, Symphonie replacement membrane, reservoir bag, and an aqua liner. The plaster impression thus produced enables patients and technicians to capture the pressure situation in the negative cast under full weight-bearing load.
The patient also is able to provide valuable information on the socket volume and the load distribution on bony structures and any painful areas. Tedious adjustments to the socket are no longer necessary, as the VC application calculates the recommended pressure in the cylinder for every case. The frugality of the system is another benefit for the patient, as it is taking less time to get fitted, according to Radspieler.
“We apply plaster bandage, which is wet and soft for about three to five minutes,” Radspieler said. “[The patient] stands up in the system, apply the pressure, and wait those three to five minutes until it sets and captures the shape. You make the socket out of the material you like and you can assemble the leg and they’re ready and good to go.”
“The app that’s calculating runs on body weight, size of the residual limb, the density of your soft tissue, and your mobility level.”
Radspieler said the most rewarding aspect of his hard work comes from the reactions of patients who immediately gain a new jolt of life after being fitted.
“We have seen tears of joy because we changed their life and it means so much for them,” he said. “They get the feeling that life is now coming back.”
When asked if this is just the beginning of new prosthetic technology and innovations, Radspieler didn’t hesitate to confirm that the SAS is the new standard for practitioners.
“We just entered a new level of technology,” he said. “We are now able to look into the future of how we can actually make those limbs stronger. To me, this is just the beginning to standardize socket manufacturing worldwide. I want to see three million people a year in that machine. This is just the entrance.”