What is a fix for an excessive varus moment noted at midstance?

In addressing an excessive varus moment observed at midstance, the most effective solution is to adduct the socket. Adduction of the socket modifies the alignment of the prosthetic limb relative to the body. This adjustment helps to reduce the varus moment by improving the alignment of the center of pressure over the base of support, thereby promoting a more stable stance phase.

When the socket is adducted, it encourages a lateral shift of the ground reaction forces, which counteracts the tendency for the knee and foot to rotate inward excessively. This realignment leads to improved weight distribution and a more natural gait pattern, ultimately enhancing the overall function of the prosthetic limb.

The other interventions may provide benefits in specific scenarios but do not directly address the excessive varus moment as effectively as socket adduction does. Outsetting the foot, for example, might help in some instances but can also lead to other alignment issues if not paired correctly with socket adjustments. Widening the socket mediolaterally could increase stability but might not specifically counteract the varus moment. Instruments to assess limb length are necessary for ensuring proper fit and functionality but don’t directly rectify the varus moment issue at midstance.