Design and Preliminary Field Validation of a Fully Passive Prosthetic Knee Mechanism for Users With Transfemoral Amputation in India

An estimated 230,000 above-knee amputees in India are currently in need of prosthetic devices, a majority of them facing severe socio-economic constraints. However, only a few passive prosthetic knee devices in the market have been designed for facilitation of normative gait kinematics and for meeting the specific daily life needs of above-knee amputees in the developing world. Based on the results of our past studies, this paper establishes a framework for designing a potentially low-cost, fully passive prosthetic knee device, which aims to facilitate able-bodied kinematics at a low metabolic cost. Based on a comprehensive set of functional requirements and biomechanical analysis from our past work, we present an early prototype mechanism for the prosthetic knee joint that is primarily focused on enabling able-bodied kinematics. The mechanism is implemented using two functional modules: an automatic early stance lock for stability and a differential friction damping system for late stance and swing control. For preliminary, qualitative validation of the knee mechanism, we carried out a field trial on four above-knee amputees in India, which showed satisfactory performance of the early stance lock. The prototype enabled smooth stance-to-swing transition by timely initiation of late stance flexion. Possible methods of incorporating an additional spring module for further refinement of the design are also discussed, which can enable flexion-extension during the early-stance phase of the gait cycle and potentially reduce the metabolic energy expenditure of the user further.