RevoFit Practitioner Education Series
Welcome to the RevoFit Practitioner Education series by Click Medical. We developed
this series to help practitioners learn how to integrate the RevoFit adjustable prosthetic
socket system into their practice. The series is designed to be cumulative in that each
course builds upon the previous. As such we recommend that the courses be taken in
order.
For more information on the RevoFit adjuatable prosthetic socket system please visit
www.ClickMedical.co/revo.
01
Clinical
Considerations
• Identify your patient to match their needs
with the best adjustable socket
• Learn indications and contraindications
for adjustable socket fitting
• Understand design configuration
needs based on the patient evaluation
RevoFit
Education
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1
Optimize
Fit & Function
This course covers the basics of how to fine tune
the adjustable socket fit & the function of the
RevoFit system and how to perform regular
maintenance of the RevoFit reels.
Design
Considerations
This course covers the basics of how to configure
a RevoFit socket & communicate important
information to guide the fabrication process.
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RevoFit
Education
03 - Optimize Fit & Function
for
RevoFit Adjustable Sockets
Introducing the world’s leading adjustable socket solution
Developed by Pam Hale, CPO
Clinical Services, Click Medical
© 2016, Click Medical LLC
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03
Optimize
Fit & Function
This course covers the basics of how to fine tune
the adjustable socket fit & the function of the
RevoFit system and how to perform regular
maintenance of the RevoFit reels.
About This Course
AGENDA
This course will focus primarily on RevoFit fit and function optimization during the fitting and
follow up process.
In this course we will cover:
RevoFit Technology Review
Optimization Procedures
CLINICAL CONSIDERATIONS LEARNING OBJECTIVES
•Understand the optimization process helps you fine tune the fit and function of an adjustable custom fabricated RevoFit socket.
•Learn the basics of how to fine tune the socket of the RevoFit system.
•Learn how to perform regular maintenance and repairs of the RevoFit reels.
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Optimization Fit & Function
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Optimization
The process begins with identification of the purpose of the adjustable system. After fabrication of
the socket, fit and function is optimized by ensuring the RevoFit system functions appropriately.
This means that the reel is functioning efficiently and that the padding on the panels is producing
desired effect of compression without having to “over tighten” the dial and the flexible insert is
flexible enough to move when the panels are compressed without putting undue stress on the reel.
What goes into this is:
•Pad shape, durometer, and thickness
•Flexibility and thickness of the insert
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Optimization Overview
There is a standardized method worth following when fine tuning the fit of
your patient’s adjustable socket.
•Have the patient don the socket with the reel disengaged (pull up on the dial), and do
not push down on the dial until the socket is fully donned.
•Push the dial in.
•Have the patient turn the dial clockwise until they feel tension on their residual limb from
the panel(s) or proximal strap.
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Optimization Overview
If there is no tension or minimal pressure from the panels once the reel is
engaged, make sure to address the following:
1. Ensure that the pad shape is convex
2. Ensure the pad is thick enough
3. Check insert flexibility - if more flexibility is required, you might need to grind the insert
down in the area of the panels to decrease the material thickness.
Optimizing the fit and function of a RevoFit Adjustable Socket involves evaluating pad
shape, thickness and durometer AND evaluating flexibility and thickness of the flexible
insert.
*Review the flow chart on the next slide to walk you through it.
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Optimization Flow Chart
Then check the pad thickness with the “penny chart”
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Penny Test
With the socket on and tension applied (just
enough to start feeling pressure), insert a penny
between the panel and the socket. This is to help
identify appropriate pad thickness.
The panel with the pad should not be
flush to the socket. If it is less than ½ a
penny the pad will not exert pressure
when the reel is tightened, leading to risk
that the reel could be over tightened.
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Penny Test Flow Chart
Check Pad position with
penny test
Arrow are confusing (I know
you didn’t create this)
Ifpanelsurfacedoesnotextendbeyond
thesocketbyatleast5mm,theninstall
thickerordenserpadmaterial
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Ifpanelsurfaceextendsabovesocket
frame½apenny,thensockethascorrect
padthickness
Optimization
•You can adjust the thickness or density of each individual pad to customize the pressure. *Too dense or thick
can lead to discomfort for the patient.
•If using a panel as a “door”, padding may not be necessary, but if pressure is required for volume
management/suspension, a pad should be added to the panel.
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Pad Shape
•Varying pad shape, material/density and thickness are the main methods used for optimizing the fit of the socket.
•Important: create a convex shape on the pads to allow for properly applied pressure as the panels are tightened.
Skive the edges to reduce the potential for excessive “edge” pressure.
•Each panel does not have to have the same pad shape, thickness or density. Work with your patient to customize these
variables to meet their needs.
Recommended Padding Materials:
TF or TT
3/16” thick
Shore 35 Max
Symes
1/8” - 3/16” thick
Shore 35
*Review the illustration below to see a visual representation of pad shape.
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Pad Shape Illustration
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Pad Thickness
•The thicker the pad, the greater the distance the panel can travel to create pressure. If your patient has significant volume loss daily, then consider using a
thicker pad to create a larger range of pressure.
•Choose the best pad material or density to optimize the fit for your patient. More dense pads deliver more direct pressure, less dense pads deliver a more
distributed pressure.
•Note: it is possible to create a pad that is a different thickness from one edge to the other if it is warranted. A thicker pad section will exert more pressure
than a thinner section.
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Replacing Lace
The filament should be checked regularly by your patient to look for areas of wear and tear. Replace immediately if damage is
noticed, and should be replaced at minimum every 12 months. After your socket has been fabricated, you can replace the
filament, dial, and padding.
To
1.
2.
3.
replace the filament, you will need to remove the dial. To do so:
Release the tension on the dial by pulling the dial up
Use a small tool (included in your kit) to press inward on the tab at the pilot hole
As you press in on the tab turn the housing - not the dial - clockwise, then pull the dial out
*Please reference the illustrations on the next slide to show you how to remove the filament.
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Replacing Lace Illustration
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Replacing Lace Continued
•After the dial has been removed, take the lacing out of the tubing and feed new lace into the tubing using the steel lace feeder
•Each RevoFit kit includes 2 sets of lace and a feeder - 1 for initial fabrication and 1 for replacement.
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Replacing Lace Continued
Once the new lace has been fed into the tubing, feed it until it leaves the other side of the reel base.
Considerations and next steps:
•Leave 8cm of lace on each side of the reel to allow the lace to wrap around the spool prior to applying pressure. *This is a
very important safety protocol.
•Tie a knot at the ends of the lace - leaving 1cm of lace after the knot. Then burn the end beyond the knot and pull the lace
through the hole.
•Spectra is slippery, so if the knot is slipping, dab a little super glue on the knot before setting the knot
into the spool.
*Refer to the illustration in the next slide for an overview of these steps.
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Replacing Lace Continued
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Replacing Lace Continued
To finish replacing the lace, the reel must be placed back into the base. To insert the reel
into the socket, follow these steps:
•Pull the panel out to remove the slack, then re-insert the reel and lock into position.
•Wind the reel tight, release the reel and pull out the panel (repeat 3 times)
•Make sure that the lace is moving freely through the system, if it binds at all then release the reel from the panel and ensure the
lace has not been pinched
• Pull the panel out to remove slack, then re-insert the reel and wind (repeat 3 times)
*Refer to the illustration in the next slide for an overview of this process.
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Replacing Lace Continued
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Empowering Your Patient Through Education
For your patient to be a successful user of the RevoFit Adjustable Socket, it is imperative to instruct them
on use, function, and maintenance.
•Function of the reel - user controlled micro and macro adjustment of 1mm of movement for compression and tension without the friction of
“pushing through.”
•Donning/Doffing - completely donning the socket prior to applying tension is very important — otherwise the residual limb might be raised up
out of the socket.
•Socket fit - through adjustable multi-panel sockets.
•Global volume management - can accommodate up to 10 ply.
•Targeted volume management - also can be accomplished through use of adjustable multiple panels.
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Empowering Your Patient Through Education
Continued…
•Release for seated comfort - all without having to remove the socket.
•Controlled release - tension might not need to be fully released but the compression reduced. To control the release of tension the patient would pull up
on the dial and while holding on to the dial allow a small amount of lace to unwind. Then push the dial back in to engage and turn clockwise to
apply tension. If the patient cannot feel pressure from the pad — an adjustment to the padding may be necessary.
•Use with impaired strength and/or dexterity - the dial is easy to turn with one hand. It may be necessary to add a loop to the dial to allow the patient
to pull up on the dial.
•Inspection of lace and reel - this must happen on a regular basis, and have it changed at minimum once per year. The patient should also be
instructed to report any impact or damage to the dial or reel and have the prosthetist inspect for damage.
•Review instructions with your patient and give them the booklet included with each RevoFit kit.
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CONGRATULATIONS! YOU’RE FINISHED!
Take the next course:
Design Considerations
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