fig1 is a perspective illustration of a sure - fit prosthetic anchoring system 2 . the anchoring system 2 is adapted for a patient that has undergone a limb reduction surgery resulting in an above - the - knee amputation . in a preferred embodiment , the anchoring system 2 generally includes a commercially - available liner 10 equipped with upper and lower strap - anchors 4 , 6 , respectively . the upper strap anchor 4 is pivotally attached at one end by grommet - post 24 to a reinforcement plate 23 , plate 23 being a plastic member that is sewn , bonded and / or attached with hook and loop peripherally onto the liner 10 at an upper outside position as shown . in a preferred embodiment the grommet - post 24 comprises two screw - together sections having 1 ′ flanges which sandwich the plate 23 and upper strap 4 together . the other end of upper strap 4 bears a buckle 14 with a short length of extension strap past the buckle 14 to provide a finger - grip . the extension strap past the buckle 14 may be a short length of strap or plastic attached to the buckle itself , a slightly longer length sewn to the upper strap 4 , or art even longer length of strap / plastic attached by the grommet - post directly to the reinforcement plate 23 , in all cases serving to provide the user with a finger grip to pull the liner 10 down . in addition , a lower strap 6 is attached at one end to the bottom of the liner 10 by a flathead machine bolt 43 as described below . the liner 10 fits within a socket 12 and rests upon a centering cup 33 . in a preferred embodiment , the socket 12 is formed with , at least one slot 16 passing through an upper side ( at the outside of the limb ) for allowing the upper strap 4 and buckle 14 to pass outwardly therefrom . the socket 12 is also formed with one lower slot 17 at the bottom and aligned with the upper socket 16 for allowing the lower strap 6 to pass outwardly therefrom . the lower fastening strap 6 has a section 21 of hook - and - loop material at the distal end , and a mating section 22 of hook - and - loop material running lengthwise along its mid - section . alternately , a single section of hook - and - loop material may run along the entire length of lower fastening strap 6 . the hook and loop is preferably a hybrid weave with hook and loop being mixed together , so there is no distinction between the hook and loop sides . such hook and loop features are commercially available from velcro ® usa . in use , the patient would first apply liner 10 to limb . the liner 10 is then inserted into the socket with lower fastening strap 6 threaded through centering cup 33 out through lower slot 17 , and upper strap 4 with buckle 14 passing out through upper slot 16 . the junction of the upper strap 4 with the liner 10 limits downward insertion of the liner 10 into the socket 12 and seats the liner 10 onto the centering cup 33 as explained below . importantly , this constraint avoids hunching of the liner fabric whilst seating the liner 10 , a very common problem with conventional liners / sockets . the lower fastening strap 6 is then threaded up through the protruding buckle 14 and downwardly , and the strap 6 is pulled tight until the liner 10 is securely seated in the socket 12 atop centering cup 33 . the fastening strap 6 is secured onto itself by joining the two sections 21 , 22 of hook - and - loop material ( or the one continuous section ) in a loop . the foregoing forms a suspension which holds the prosthesis on and absolutely prevents lateral movement , pivotal shifting , and rotation . on the other hand , the simple hook - and - loop - attached strap 6 allows for convenient adjustment of the position of the limb within the socket 12 . thus , if the limb changes position because of volume change and the distal migration of the limb into the socket , the prosthesis can easily be adjusted by adjusting straps 4 , 6 to compensate . in an alternate embodiment , upper strap 4 with buckle 14 is not attached to liner 10 , but is attached directly to the exterior surface of socket 12 above slot 17 for fastening strap 6 . slot 16 may thus be eliminated in this embodiment . as in previous embodiments , strap 4 may be pivotally attached at an upper outside position of socket 12 above slot 17 by a grommet - post to a reinforcement plate , which may be a plastic member that is sewn , bonded and / or attached with hook - and - loop to socket 12 . however , upper strap 4 may also be attached directly to socket 12 using any available means known in the art and capable of providing a secure connection . in the present embodiment , to use the device , the patient would first apply liner 10 to limb . the liner 10 is then inserted into the socket with lower fastening strap 6 threaded through centering cup 33 out through lower slot 17 . the lower fastening strap 6 is then threaded up through buckle 14 , which is attached via strap 4 to an exterior surface of socket 12 above slot 17 , and downwardly , and the strap 6 is pulled tight until the liner 10 is securely seated in the socket 12 atop centering cup 33 . the fastening strap 6 is secured onto itself by joining the sections 21 , 22 of hook - and - loop material . as with the foregoing embodiment , the instant connection system forms a suspension which holds the prosthesis on and absolutely prevents lateral movement , pivotal shifting , and rotation , while the simple hook - and - loop - attached strap 6 allows for convenient adjustment of the position of the limb within the socket 12 . thus , if the limb changes position because of volume change and the distal migration of the limb into the socket , the prosthesis can easily be adjusted by adjusting strap 6 within buckle 14 to compensate . liner 10 is largely a standard transfemoral or transtibial suspension liner designed for amputees with amputations along the length of the tibia or femur . there are a variety of commercially - available suspension liners which will suffice , provided that they afford good suspension independent of volume fluctuations and provide a comfortable anatomical fit . these liners are typically formed of silicone or a gel blend with or without a fabric shell , and they may be equipped with a threaded socket assembly 42 at the bottom end for screw - insertion of flathead machine bolt 43 ( or more conventional locking pin as known in the art ). as disclosed in applicant &# 39 ; s prior u . s . pat . no . 6 , 793 , 682 , the disclosure of which is hereby incorporated by reference in its entirety , the otherwise conventional liner is preferably modified by tethering buckle 14 , via upper strap 4 , on the outwardly facing side of the liner 10 . strap 4 is secured to the liner 10 by first sewing , gluing and / or attaching with velcro the reinforcement plate 23 peripherally to the shell of the lifter 10 , and then passing a grommet - post 24 through the tip of the upper strap 4 and through the plate 23 , thereby pivotally - anchoring strap 4 thereto . in other embodiments , as described above , the strap 4 may be attached directly to an exterior surface of socket 12 . strap 4 may be a short length ( approximately 6 ″) of braided nylon or dacron strap that is looped around one side of a rectangular buckle 14 , thereby suspending buckle 14 approximately 3 - 5 ″ downward from grommet - post 24 on liner 10 or socket 12 . the buckle 14 is a simple rectangular stirrup - type stainless fixture . it should be understood that alternate embodiments are possible without departing from the scope and spirit of the invention , the point being that the tethered buckle 14 must be suspended by a short distance . in a preferred embodiment , a short length ( approximately 1 - 2 ″) of strap material is attached to the opposing side of buckle 14 in a like manner and extends therefrom to provide a finger - grip to facilitate insertion of the strap 4 and buckle 14 through the upper slot 16 in socket 12 . in addition to the upper strap 4 with buckle 14 , in a preferred embodiment the liner 10 is equipped with a lower fastening strap 6 comprising approximately a 2 ′ length of nylon or dacron braided strap attached at one end to , the bottom of liner 10 . as stated previously , liner 10 may be equipped with a threaded socket assembly 42 at the bottom end which includes a threaded metal screw - socket embedded in a concave robber cup which is then epoxied and / or sewn , or otherwise fixedly attached to the lower distal end of the liner 10 . as seen in fig2 , the lower strap 6 is doubled over at one end and a flathead machined hex drive bolt 43 is passed through the strap 6 and is screwed into the threaded socket assembly 42 to anchor the strap 6 to the liner 10 . the flathead hex drive bolt 43 may , for example , be a m10 × 12 12 . 9 thread flat bead stainless bolt having an oversized flat head with diameter at least twice that of the shaft , the head preferably having rounded edges as shown . in accordance - with the invention , bolt 43 not only attaches strap 6 to liner 10 , but also serves as a bearing surface against centering cup 33 as will be described . the lower fastening strap 6 has a section 21 of hook - and - loop material attached to the distal end , and a mating section 22 of hook - and - loop material running lengthwise along its mid - section for attaching strap 6 onto itself around buckle 14 ( see fig1 ). socket 12 is generally a conventional socket formed of flexible plastic that is vacuum formed . the socket 12 made in a custom - fitted component that is made in a conventional manner of a copolymer plastic , plastic polypropylene , polyester , acrylic / epoxy resin . the socket 12 may be vacuum formed or thermoformed by heating the plastic material and forming it over a mold . in a preferred embodiment , socket 12 is formed with an upper pass - through slot 16 along the outside . alternatively , a series of parallel pass - through slots 16 may be provided to facilitate adjustment . the upper slot ( s ) 16 is positioned with respect to the liner 10 inserted therein so that it / they align with the upper strap 4 . specifically , when the liner 10 is fully inserted , the pass - through slot 16 should be even level with the grommet - post 24 on liner 10 . other pass - through slots 16 b , c . . . may be positioned slightly above or below for adjustment . this allows the tethered buckle 14 to be inserted directly through a slot 16 from inside the socket 12 to outside , such that downward tension on strap 4 anchors the grommet - post 24 directly against the slot 16 . in other embodiments , strap 4 with buckle 14 may be attached to the exterior surface of socket 12 via reinforcement plate 23 and grommet 24 as described herein . in addition to the upper slot ( s ) 16 , a lower pass - through slot 17 is positioned downwardly along the same side of the socket 12 in a preferred embodiment . the pass - through slot 17 is spaced in line with a centering cup slot 38 ( described below ) with respect to the bottom of the socket 12 . this way , when the liner 10 is fully inserted , the pass - through slot 17 allows the lower fastening strap 6 to be inserted there through . the outer end of the socket 12 is adapted to be connected to a conventional , bendable knee joint ( a variety of which are presently available ) as seen in fig1 . fig3 - 5 are a top view , side internal diagram , and top internal diagram , respectively , of the centering cup 33 insert as in fig1 which is attached internally to the bottom center of the socket 12 . the centering cup 33 is a puck - like member preferably formed of delrin ®, aluminum , or other sturdy lightweight composite material . in accordance with the invention , centering cup 33 is formed with a concave upper rim 34 leading into a central circular recess 35 . the concave upper rim 34 helps to seat and center the liner 10 . the recess 35 is substantially circular and defined by a perfectly flat floor 36 . the diameter of recess 35 / floor 36 is preferably within a range of from 2 - 4 times that of the oversized flat head hex drive bolt 43 , and most preferably approximately three times the diameter . the floor 36 effectively forms a “ delimited ” bearing surface for the flat head of bolt 43 , e . g ., constraining the bolt 43 to within a circular degree of freedom limited by the walls of recess 35 . the recess 35 is interrupted on one side by a slot 38 through which the lower fastening strap 6 is passed . slot 38 continues out through the side of centering cup 33 and aligns with the lower slot 17 of socket 12 to pass the lower strap 6 outward . a roller pin 39 straddles the slot 38 , and is journaled into the sidewalls of recess 35 suspended slightly above the floor 36 to guide and ease insertion of the strap 6 into slot 38 when the wearer dons the prosthesis . to apply the anchoring system 2 , the patient first applies the liner 10 to his / her residual limb . the liner 10 is then partially inserted into the socket 32 until lower fastening strap 6 can be threaded through the slot 38 in centering cup 33 and on outward through the lower slot 17 through socket 12 . in addition , the upper fastening strap 4 and buckle 14 may be passed outward through slot 16 , in embodiments where fastening strap 4 and buckle 14 are attached directly to liner 10 . the lower fastening strap 6 is then threaded up through the buckle 14 ( strap 6 running upward along the side of the socket 12 ) and is inserted there through . the patient pulls down on the distal end of lower strap 6 which works by pulley action to draw the liner 10 down into the socket 12 until the liner 10 is securely seated in the socket 12 . when fully seated the lower fastening strap 6 is secured to itself by joining the sections 21 , 22 of hook - and - loop material . the lower fastening strap 6 through lower slot 17 forms a first anchoring point , and in a preferred embodiment , upper strap 4 through upper slot 16 forms a second anchoring point , the combination of the two anchoring points serving to reduce lateral movement pivotal and proximal shift , and rotation . when such motion does occur , the delimited bearing surface of floor 36 partially supports the liner 10 on the flat head of bolt 43 yet gives it a lateral degree of sliding freedom ( limited by the walls of recess 35 ) which avoids concentration of lateral forces at the distal end of the liner 10 . this effectively results in a “ modified ” suspension mount , the liner 10 being partially suspended by upper and lower straps 4 , 6 , centered and partially supported by the concave tipper rim 34 of centering cup 33 , yet still being able to articulate therein in a ball - and - socket manner , and partially supported on the flat head of bolt 43 as it hears against floor 36 , yet still being able to shift therein within a limited degree of freedom . importantly , the flat bearing surface of the low profile flat head belt 43 and flat floor 36 of the centering cup 33 combine to create the lowest profile attachment available for a residual - to - prosthetic socket using a gel liner with distal attachment . a primary goal when fabricating a transfemoral prosthesis is to be able to match the height of the anatomical knee center to the prosthetic knee center for a symmetrical gait as well as for cosmetic appearance . this is important during ambulation and when the individual is sitting . the present lower profile design is essential when fabricating a transfemoral prosthesis for an individual with a very long residual limb to obtain the stated results . the resulting modified suspension mount is more fluid and helps to closely mimic the natural movement of the knee , resulting in a more comfortable and natural prosthetic . when desired , the patient need only readjust the hook - and - loop closures to adjust the position of the limb within the socket 12 . thus , if the limb changes position because of volume change and the distal migration of the limb into the socket , the prosthesis can easily be adjusted to compensate . once the limb is properly received within the socket 12 and the straps 6 or 4 and 6 are appropriately adjusted so that a secure fit is achieved . in addition , the fiat - head bolt 43 seated in the shallow disk - shaped recess 35 allows a lighter lower - profile mount . importantly , the modified suspension mount with strap 6 passing directly sideward out through slot 38 across flat floor 36 beneath roller pin 39 also avoids catching and / or entanglement of the strap 6 . if desired , a plurality of through - bores may be formed axially through the upper rim 34 for screw - attachment through the socket 12 into the base of the bendable knee joint ( transfemoral ) or the base of the shaft ( transtibial ), either of which are typically attached directly beneath the socket 12 . alternatively , the through - bores may be eliminated and the centering cup 33 formed instead with a downwardly threaded hub for screw - attachment to the underlying base beneath socket 12 . as an alternative to through - bores / screws , fig6 is a close - up side view of a centering cup 33 with optional crescent grooves 39 designed to fixate the centering cup 33 inside a thermoplastic / laminated socket 12 without need of screws . in this case the peripheral walls of centering cup 33 are indented at a plurality ( preferably four ) evenly - spaced radial locations with fingernail - shaped “ crescent ” notches 39 tapered downward and opening upward toward concave upper rim 34 . the thermoplastic / laminated socket 12 may be formed with conforming outward protrusions keyed thereto , which effectively orient and index the socket 12 and liner 10 . this eliminates the need for without need for screw - fixation . the prosthetic anchoring system 2 described herein increases the stability of the liner anchor using the combined top - side and lower attachments to reduce extraneous up and down motion , pivotal and proximal shift , and rotation . when such motion does occur the specific configuration of the centering cup 33 and flathead bolt 43 comfortably accommodates it . having now fully set forth the preferred embodiments and certain modifications of the concept underlying the present invention , various other embodiments as well as certain variations and modifications of the embodiments herein shown and described will obviously occur to those skilled in the art upon becoming familiar with said underlying concept . it is to be understood , therefore , that the invention may be practiced otherwise than as specifically set forth in the appended claims .
a prosthetic suspension - mounting system which employs an improved flathead bolt and socket centering cup combination for securement of an - amputee - limb enveloping liner within a prosthesis . the liner has a strap fixedly attached on the bottom end of the liner by a flathead bolt . the mounting system also includes a containment socket for seating the liner in the prosthesis using the head of the flathead bolt as a bearing surface against a floor of the socket . the containment socket has a slot there through at a position corresponding to the strap of the liner . the socket is provided with a disk - shaped recess having a flat floor , and the liner is provided with a distal flathead bolt having a flat head to provide a direct bearing surface against the floor of the socket . this provides a delimited bearing surface to keep the liner substantially centered within the prosthesis while still affording a lateral degree of freedom to avoid concentration of lateral forces .