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Analysis of Four-bar Linkages Suitable for

Above-knee Prosthesis
Shailendra Singh Chauhan
Babu Banarsi Das Institute of Technology and Management

Avadhesh Kumar Khare

Babu Banarsi Das Institute of Technology and Management

https://doi.org/10.5109/4843107

出版情報：Evergreen. 9 (3), pp.737-744, 2022-09. 九州大学グリーンテクノロジー研究教育センター

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 EVERGREEN Joint Journal of Novel Carbon Resource Sciences & Green Asia Strategy, Vol. 09, Issue 03, pp737-744, September 2022

Analysis of Four-bar Linkages Suitable for Above-knee

Prosthesis
Shailendra Singh Chauhan* Avadhesh Kumar Khare**
*
Babu Banarsi Das Institute of Technology and Management, Lucknow,(U.P.) India
**Quantum University, Roorkee,

E-mail:sschauhan3456@gmail.com, khareavadhesh@gmail.com

(Received January 27, 2022; Revised June 8, 2022; accepted July 19, 2022).

Abstract: Four-bar linkage above-knee prosthesis provide a greater toe clearance in the swing
phase and stability in the stance phase in comparison to the single-axis knee joint. Just because of
its simplicity, the four-bar linkage is still the most commonly preferred mechanism because it
permits the prosthesis to be sufficiently stable and replicates the natural movement of the joint. The
authors present a basic/simple kinematic model using a four-bar knee prosthesis. In all eight
different configurations are evaluated and examined using a program with the use of the
arrangement. These configurations of the four-bar linkage mechanism will enable the prosthetist to
assess the mechanical advantage of different four-bar designs. Also, plots of the angle of flexion vs.
increase of toe clearance of these eight configurations is provided to enable comparative advantage
for the user. It was noticed that the entire length of the prosthesis gets shortened while moving
from the extension to the flexion phase. This aspect minimizes energy consumption during the
initial phase of motion. All configurations of four-bar knee linkages have been examined and the
results show that they have nearly the same energy conservation.

Keywords: Four-bar linkage knee, Prosthesis, Amputation, mobility, Knee stability

1. Introduction designers have considered four-bar linkage mechanisms

for the knee joint to ensure stability in the stance phase
Many people in the world have lost their natural lower and toe clearance in the swing phase of the normal gait in
limbs due to some major disease or accident. This may comparison to the single-axis knee9, 10). An amputee has
result in a disturbed normal gait. To restore the mobility, a better voluntary control of the entire prosthesis while
a lower limb prosthesis is very suitable and is usually using a four-bar knee mechanism because of the change
selected by the level of amputation. Mainly two types of in the position of the instantaneous centre of rotation (IC).
amputation are commonly encountered; one is One of the major advantages of the four-bar mechanism
below-the-knee (B-K) amputation and the second is is that an amputee has to apply less effort as compared to
above the knee (A-K) amputation or transfemoral the single-axis knee to initiate the motion and control the
amputation. Transfemoral amputation is one of the motion in the stance phase. A polycentric knee can fulfill
common types of lower limb amputations and involves the requirements of an amputee, particularly extra toe
the femur. In case an amputee has to apply a force with clearance for uneven terrain, provided it is suitably
his/her residual limb to initiate the motion and control it designed.
the entire prosthesis is involved in the process. On the Four bar linkage knee mechanism has to satisfy two
cantrary, in the case of a below-knee prosthesis, there is functional requirements for the user; the first is the
no problem in the design. However, in the above-knee kinematic motion of the knee and the second is the
prosthesis, the designer has to consider a more position of the load line, and the mechanism must be
complicated joint, where enough care is required to taking care of these two requirements together 11).
ensure stability during the stance phase and toe clearance However, an amputee with weak hip muscle can only
during the swing phase of the gait cycle, which are the maintain their stability during the stance phase by
two major criteria for the consideration 1). In prosthesis shifting the knee centre behind the load line. With the
industry two types of prosthesis are commonly available; increase in flexion angle, the instantaneous centre of the
one is the single-axis prosthesis and the other is four-bar linkage knee should quickly move downwards.
polycentre Single-axis prosthesis2). The single-axis knee It is reported that a higher knee center can give a good
is used to support the residual limb but has a poor stability in the standing phase 12). A person has to apply
functional quality to satisfy normal walking3-8). Mostly,

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 EVERGREEN Joint Journal of Novel Carbon Resource Sciences & Green Asia Strategy, Vol. 09, Issue 03, pp737-744, September 2022

more effort to initiate the motion if the knee centre is low, obtained from the biomechanics and knee stability
which is so difficult for the person having weak muscles. equation of the polycentric knee mechanism 20).
The effect of design variables in lower limb prosthesis on a. Effort required from the hip muscles is
normal gait was analyzed in detail 13). With weak reduced when the knee center is high during the early
muscles, the higher the location of the instantaneous stance phase nearly about 150 of knee flexion.
centre the lesser will be the effort required. A new b. The knee center should be well behind the
four-bar knee prosthetic was developed by Jaipur load line during the initial stance phase.
artificial limb center, India 14). An external four-bar knee
prosthetic mechanism was also developed for persons c. The instantaneous center curve should be
having pelvic limb amputations to the transfemoral level behind the load line and should be continuous for
15)
. It is reported that a six-bar linkage has more design about 150 to 200 of knee flexion.
flexibility and has more instant inactive joints resulting Lower limb knee prostheses should be so designed in
into zero relative velocity as compared to a four-bar such a way so that they can restore stability during
linkage, thus a six-bar linkage knee is found to be more walking and voluntary control of the prosthetic knee in
stable in the stance phase of the walking cycle 16). the stance phase. Redcliffe 11) derived the Eq. 1 used for
Redcliff investigated the knee stability during the stance deciding the stability of the knee joint during the stance
phase of the gait and derived the stability equation for a phase, Hip moment can be calculated to stabilize the
four-bar mechanism 17). A four-bar knee model was joint by the following equations.
developed with the application of a magneto-rheological L
M H = ( PX − M K )
(MR) damper for the use of the A-K Prosthesis 18). It is Y (1)
investigated that there is a correlation between ankle and
hip joint range of motion if the knee joint is not In the above equation
functioning well due to knee osteoarthritis (OA) 19). In
MH =Moment exerted by the muscles at hip joint.
such a case the walking patterns are adversely affected
due to the affected limb. Still, the four-bar linkage knee MK= Knee moment created by mechanical or
mechanism is the first preference of many designers for hydraulic controller
above-knee joint prosthesis because of its simplicity and
functional advantages. The different type of the four-bar L=the overall length of the prosthesis.
mechanisms studied in this paper, namely, 3R32, 3R30, P= the load passing through the load line as shown in
3R46, 3R55, 3R70, 3R72, and Hosmer knee. The main figure 1(a).
objective of this study is to compare different four-bar
configurations which are suitable for above-knee Y= the vertical height measured from the heel to the
prostheses and to examine their performance on stability instantaneous centre.
and toe clearance with the view to help decision making X = the distance of the instant centre of the knee from
for the proper choice. the load line.
Therefore, in equation no 1 the knee stability is
2. Methodology
governed by three independently parameters: MK, Y and
2.1 General Concept X.
To analyze different types of four-bar configurations MH can be reduced to zero if the mechanism is
for the knee joint, some important parameters need to be capable of developing a brake moment:
understood. These parameters are well discussed in this
study and also described in the literature. The selection MK =P.X (2)
of parameters for the designing of a four-bar knee
MH= (P.L) X/Y (3)
mechanism is an open choice for the designers, and we
have selected increasing the toe clearance during swing
and knee stability during the stance phase of the walking
cycle as the deciding criteria for choosing the mechanism.
Knee stability during the stance phase of the walking
cycle is derived by locating the knee center behind the
load line (i.e. line joining hip to foot) and is based on the
weight-bearing criterion when the knee is fully extended.
In addition to that, an amputee applies hip extension
moments with the help of a group of muscles to stabilize
the joint.
The instantaneous centre curve traced for the
mechanism should have the following characteristics as

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 Analysis of Four-bar Linkages Suitable for Above-knee Prosthesis

2.2 Kinematic arrangement of four-bar knee

prosthesis:
Using a four-bar mechanism with elevated IC, a
prosthetic knee has been designed for many years and is
presented in figure 2. In this arrangement socket or thigh
portion of the prosthesis is connected with the coupler of
the four-bar mechanism, while the fixed link is
connected to the shank 18). The other two moving links of
the mechanism will be creating a polycentric movement
of the knee joint. These links are called anterior and
posterior links. It has been observed that the anterior link
is long whereas the posterior link is short. The extended
lines passing through anterior and posterior links
intersect at a point which is known as IC. When the knee
flexes this IC generates a curve that is called centrode.
Many combinations of link lengths, pivot locations, and
adjustment of extension stop can be taken to fulfill the
Fig. 1: Knee stability equation functional requirements. Further, the lower limb
(Where, K=either single axis or instant centre of four-bar prosthesis kinematics can be obtained by the combined
linkage, S=Share force, P=Ground reaction force) motion of the hip joint and thigh motion. The load line
passing through the hip joint and the ankle joint forms a
A four-bar linkage typically does not incorporate a significant line in the design. This line is also known as
brake mechanism hence the simplified eqn. 3 can be used the load-bearing line and its direction and location can be
in place of eqn. 1 to estimate the hip extension moment measured with the help of force plate during walking. Its
required as the position of the instant centre changes direction and location are constantly changing with
during heel contact and push up of the gait cycle. respect to the axis of the prosthesis. The load line
A typical link arrangement of single axis is shown in direction can be observed from the medial side for a
fig.1 and four-bar knee is in fig 2. The stance and swing trans-femoral amputee and is directly concerned with the
phase characteristics of the knee have been selected to prosthetic knee stability. The knee stability equation is
compare the different four-bar configurations. The first derived in figure 1. An amputee can control the direction
parameter in the stance phases, the knee stability, is one of the load line, which has been observed in the
of the important critical factors where a prosthesis user mediolateral view with the use of his active
has to prevent any type of buckling. In Eq.3, the x/y ratio flexion-extension musculature about the hip joint of the
at the heel strike is an important parameter, which varies residual stump. This is the leading the concept of the
for different knee configurations. A negative heel strike voluntary control of knee stability and forms the main
ratio x/y results in an ample advantage for the user to interest of the polycentric prosthetic knee designers. The
control the knee without applying any hip moment, and elevated IC improves the stability during the stance
is desirable. The second parameter is in the swing phase phase and allows an amputee to initiate the motion with
when the knee has to push off while a prosthesis using
less energy. Another requirement of the knee is a
person has to apply a moment through the hip to shift the
cosmetic appearance at 900 flexion. However, while
load line behind the instant centre of rotation. Further,
sitting it is required to move the knee center quickly
from equation 3, if the x/y ratio is close to the load line
then an easy push-off can be performed at this stage of downward with knee flexion. The designer has to keep a
walking. The third parameter the toe clearance, is to be consideration for the initial stance phase of the gait cycle,
maximized which again depends upon the configuration which is 10-150 of initial knee flexion. After the stance
of the four-bar mechanism. To maximize toe clearance as phase, the amputee has to initiate the knee flexion in the
the knee passes from flexion to extension, the overall swing phase of the gait and apply the hip moment to lift
length of the prosthesis will be shortened 10). It is not the prosthesis from the ground.
possible in the case of a single axis knee, while in a
four-bar mechanism the striking length of the prosthesis
decreases. Since an amputee consumes energy during
walking, therefore the shortening of the prosthesis length
results into minimization of the energy consumption
during walking. The prosthesis designer has to consider
this factor to reduce the unproductive effort applied by
the user for the motion.

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 EVERGREEN Joint Journal of Novel Carbon Resource Sciences & Green Asia Strategy, Vol. 09, Issue 03, pp737-744, September 2022

Fig. 3: Kinematic arrangement and path of instantaneous

centre of the four-bar knee mechanism

The loop closer equations for the coordinates of B1 of

four bar mechanism in the clockwise and
Fig. 2: Relative motion analysis of thigh and shank 18)
counterclockwise sense are written as follows:
XB1 = XBO+ L4Cosθ4
2.3 Synthesis of the four-bar linkage
=XAO+L2Cosθ2+L3Cosθ3(3)
For synthesis purposes, an initial four-bar YB1 = YBO+ L4 Sin θ4
configuration suitable for the knee joint has been =YAO+L2Sinθ2+L3Sinθ3(4)
selected as shown in fig. 3. This configuration is just In this application, through the knee block (ie coupler)
similar to the configuration used by Radcliffe 20) the the input is given. So that the coupler angle θ3 is
shank is connected with the link CDF and the socket is considered as independent variable. Therefore, Eq.3 and
connected with the coupler link ABE. In fig 3 a 4 are modified with one dependent variable θ2, by taking
coordinate system is used as a reference line at any to the left side; and the remaining parameters on the right
suitable location in the frame link. The knee block is side.
connected with the coupler link via crankpins A1 and B1 L2 Cos θ2 = L4 Cos θ4+ C1 (5)
on the knee. It rotates about crank centers Ao and Bo L2 Sin θ2 = L4 Sin θ4+ C2(6)
respectively. The link AoA1 is considered as link 2, the Where,
coupler A1B1 as link 3. The second crank BoB1 is C1 = XBO — XAO — L3 Cos θ3,
considered as link 4. The links have respective lengths L1, C2 = YBO — YAO — L3 Sin θ3
L2, L3, and L4 and respective angles θ1 θ2, θ3, and θ4. The For any input angle θ3 these values are constants.Then,
link angles are measured in a counterclockwise sense Squaring and adding Eq.5 and Eq. 6we get equation 7,
from the positive direction of the Y-axis. Each joint is L2 2 =L42 +C12 +C22 +2C1L4 Cos θ4 + 2 C2 L4 Sin θ4 (7)
represented in the X-Y frame by a vector containing its The equation of motion is obtained by rearranging and
elements as shown in figure 2. collecting these terms.
A Sin θ4 + B Cos θ4 = C, (8)
Where;
A = 2 C2L4,
B = 2C1L4,
C = L22 – L42 – C12- C22
These are the constants for any input value of θ3.
Also, C1 and C 2 are defined in eq. 5 and eq. 6.
Eq.8 is not of much direct use because it is contained
moving function of θ4. Following substitution is made to
get definite equation:

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 Analysis of Four-bar Linkages Suitable for Above-knee Prosthesis

 θ
 IC changes and it traces a curve as shown in fig.3. This
θ
 
2 tan 4  1 − tan 2  4  curve called corrode, is very important to decide the
 2   2 
Sinθ =   Cosθ =   stability, hip moment requirement, and speed of the
4 θ  4  θ
 shank in the walking cycle. Maximum knee flexion of
1 + tan 2  4  1 + tan 2  4 
 2   2  the different commercially available knee joints is
  ,   (9) presented in Table 1 for comparison. Each knee
θ  mechanism has certain advantages depending upon its
tan 4  configuration and has improved knee stability against a
 2 
Eq.8 reduces to a quadratic in   with the single-axis knee without a knee break. Depending upon
the requirement of the amputee and maximum knee
solution: flexion a suitable type of knee mechanism has been
suggested.
A ± A2 + B 2 − C 2
θ 4 = 2 tan −1
B+C Table 1. Maximum Knee Flexion of different four-bar linkage
At this mo me n t, θ 3 has been stated and θ4 has been knee
calculated. The coordinates of point B1 and point A1are Types of Description Max. Knee
determined as follows. Four-bar Flexion
X B 1 = X B 1 O + L 4 Co s θ 4 linkage knee
YB1 = YB1O + L4 Sin θ4 T1 3R32 Modular polycentric 1100
X A 1 = X B 1 – L 3 Co s θ 3 “Four-bar Knee”
YA1 = YB1 – L3 Sin θ 3 T2 3R30 Modular polycentric 1100
The angle θ2 is computed by knowing the “Four-bar Knee”
coordinates of A1 and Ao. T3 3R46 Modular polycentric 1100
(𝑌𝑌𝐴𝐴1 − 𝑌𝑌𝐴𝐴𝐴𝐴 ) “Four-bar Knee”
𝜃𝜃2 = tan−1 T4 3R60 Modular EBS Knee with 1400
(𝑋𝑋𝐴𝐴1− 𝑋𝑋𝐴𝐴𝐴𝐴 )
hydraulic swing phase Control
In figure 3 from the geometry of the four bars T5 3R55 Modular polycentric knee 1120
mechanism and the crank centers coordinates and the with hydraulic swing phase
crank angles, the coordinates of the instant center, IC, Control
can be evaluated. After rearranging the equations, the x- T6 3R70 Modular Polycentric knee 1350
and y- coordinates of the instant center can be evaluated joint with pneumatic swing
from Eq. 10 and Eq. 11 as given below: phase control
 Y  T7 3R72 Modular Polycentric knee 1400
Y +x −x − OA  tan θ (10) joint with pneumatic swing
OB  OA OB tan θ  4
Y =  2 phase control
I tan θ T8 Hosmer Knee 1550
1− 4
tan θ
2

And Y −y
x =x + I OA (11)
I OA tan θ
2
Further, a detailed synthesis procedure, as explained
for the evaluation of a four-bar knee mechanism, was
used for the four-bar linkage mechanism A-K knee
prosthesis21, 22). Once the four-bar knee mechanism is
designed kinematically, it should also be checked under
its structural strength before its actual application to meet
the ISO 10328 standards for load bearing.23, 24)

3. Four-bar knee joint configurations

In the four-bar linkages configurations under study the
position of IC was traced graphically by extending two
vertical links and obtaining their intersection.
Mathematically the position of IC can be easily
determined with the help of eq. 10 and eq.11 for any type
of four-bar mechanism. As the knee flexes the position of

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Table 2. Position of Instantaneous Centre (IC) of four bar knee

configurations
Four Instantaneous Centre Position (IC)
Bar
Knee
Type
IC At 90 degree At 65 degree
flexion flexion
X Y X Y X Y
(mm) (mm) (mm) (mm) (mm) (mm)
T1 -49.2 299 2.1 -4.83 7.21 4.94
T2 -0.00 -89.05 24.93 -13.22 31.86 27.42
T3 22.56 -183.47 -21.44 -45.42 -13.99 -51.43
T4 -20.0 128.33 11.76 5.05 19.68 18.87
T5 -53.6 123.85 0.07 5.82 3.60 6.85
T6 -8.74 93.34 8.10 -2.39 13.65 8.17
T7 -9.04 87.24 9.81 -2.17 15.92 8.88
T8 7.27 8.63 1.77 -6.79 4.84 -4.70

In table 2 the position of the instantaneous centre is

compared for all the eight knee configurations where a
Fig. 4: Four-bar knee configurations negative value represents the shortening of the leg length
as compared to the single-axis knee prosthesis. The
4. Results and discussion minimum toe clearance observes at 230 hip flexions and
490 knee flexion in the normal walking cycle. 25) The
4.1 Stability of four bar linkage knee in stance phase maximum height of the IC Should not be more than
In the lower limb kinematic frame the hip, the heel, 400mm to avoid hyperstablize the knee joint and the
the toe, and the knee are taken as hip (0mm, 400mm), minimum value is 100mm because it has been examined
knee (-10mm, 0mm), heel (-50mm, -500mm), and toe that a high IC has higher toe clearance. 26)
(200mm, -500mm). Table 1 presents the position of the
Instantaneous center of different four-bar linkage
configurations in the mid-swing position i.e. 650 flexions
and at 900 flexion to satisfy the sitting cosmetic
appearance. It has been found that, the position of IC has
to maintain the requirement as discussed earlier to ensure
the stability criteria. Also, to maintain its cosmetic
feature the knee centre moves quickly when the knee
flexes towards the anatomical knee.
The results of Increased toe clearance (in mm) vs the
angle of flexion (in degrees) of four-bar knee
configurations are presented in figure 5. Using the
program developed by Professor Charles W. Redcliffe,
University of California at Berkeley, these configurations
were analyzed. The centrode curve can be compared by
using this program, and toe clearance between a specific
four-bar and single-axis knee prosthesis. This graph
offers a comparative representation of the toe clearance
for the selection of a type of four-bar knee configuration.
Through the software, the variation between the single
axis and four-bar linkage knee was evaluated.

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 Analysis of Four-bar Linkages Suitable for Above-knee Prosthesis

Fig 5: Graph showing Toe Clearance variation vs Angle of stability, whereas type 2 and type 3 configurations are
Flexion for Eight Polycentric Four-Bar Knee Configurations. having poor stability. Increased toe clearances of the
configurations are very suitable for transfemoral
4.2 Energy consumption prosthesis users. With the help of configurations
The length shortening of the prosthesis is directly presented in this paper, a prosthetic designer can take
proportional to the energy consumption. 10) An amputee need-based decisions and fabricate a new model for the
requires energy while moving with a prosthesis through above-knee prosthesis.
muscular activity. A Group of muscles develops the
necessary force required for the movement of the body. Statements and Declarations
The ultimate aim of the prosthesis designer is to
This has been declared that no funds, grants, or other
minimize this energy consumption rate during movement.
support were received during the preparation of this
It was examined that the four-bar knee prosthesis length
manuscript.”
is reducing while it passes from extension to flexion
The authors have no relevant financial or non-financial
phase. Therefore, the energy consumption will be less in
interests to disclose.”
such a case. Energy consumption in the swing phase of
eight different knee configurations was examined and the
result is presented in figure 6. It is also noted that in Ethical statement
comparison to a single-axis knee the four-bar knee
This article does not contain any studies with human
prosthesis shortens its length while moving from
participants or animals performed by any of the authors.
extension to flexion and therefore it requires lesser
energy consumption.
Results show that all configurations of four-bar knee References
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