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Updated: Feb 11, 2026

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Development and preliminary evaluation of a new anatomically based prosthetic alignment method for below-knee

Nahid Tafti1, Masoud Karimlou2, Mohammad Ali Mardani1

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Assistive Technology : the Official Journal of RESNA
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Summary

This study found significant correlations in the sagittal plane between lower limb measurements in unilateral transtibial amputees. A new anatomical prosthetic alignment method was developed and shows promise for improving prosthetic fitting.

Keywords:
anatomical landmarksanthropometrylaser instrumentprosthetic alignmenttranstibial prosthesis

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Area of Science:

  • Biomechanics
  • Prosthetics and Orthotics
  • Human Anatomy

Background:

  • Unilateral transtibial amputees often face challenges with prosthetic alignment.
  • Existing methods may not fully utilize anatomical relationships between limbs.
  • A standardized, anatomically based approach could improve prosthetic outcomes.

Purpose of the Study:

  • To analyze similarities and relationships of lower limb anatomical landmarks in unilateral transtibial amputees.
  • To develop and evaluate a novel static prosthetic alignment methodology based on anatomical principles.

Main Methods:

  • Photographic assessment of anthropometrical differences and relationships between sound and amputated lower limbs.
  • Paired t-tests and regression analyses were used for data interpretation.
  • A new alignment method was developed and tested in a single-subject case study comparing experienced and inexperienced prosthetists.

Main Results:

  • No significant anthropometrical differences were found between limbs in the frontal and transverse planes.
  • Significant correlations were observed in the sagittal plane between the amputated and sound limbs.
  • The new method demonstrated potential for consistent prosthetic alignment, particularly in the sagittal and frontal planes.

Conclusions:

  • Anatomical measurements of the sound limb can inform prosthetic alignment in unilateral transtibial amputees, especially in the sagittal plane.
  • The developed anatomically based static prosthetic alignment method offers a reproducible approach.
  • Further validation with larger sample sizes of amputees and prosthetists is recommended.