Converting a Quad socket wearer to Ischial Containment (case

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case study

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I am currently a prosthetic resident at JFK/JRI P&O Lab in Edison , NJ an
d
recently had the opportunity to work on an interesting case that I would 
like
to share with this forum and recieve feedback.
I have  a 56 year old, black male with a right AKA secondary to trauma in
1956.
He has a medium length residual limb with firm residual limb musculature,
 full
ROM, and fair + hip abductor strength. He is a community ambulator withou
t
assistive devices and exhibits a prominent lateral lean to the prosthetic
 side
durring ambulation.
Pt is in need of a new AK prosthesis and has been wearing an exoskeletal
prosthesis with a  quadrilateral socket for 42 years (full suction for th
e
past 10 years).  I would like to convert my patient to endoskeletal
componentry and an Ischial containment socket design (full suction) to
decrease the weight of the new prosthesis, and make good use of the
biomechanical advantages of ischial containment.
Would you do it?
What has been your experience converting long time Quad socket wearers to
Ischial containment with respect to comfort, compliance, function, and
reduction of gait deviations ?
What are some problems you have encountered ?
Do you have any helpful tips or techniques to help make a conversion of t
his
nature a success, or do you feel  a conversion would become a disaster ?
I would greatly appreciate your response on this matter.
Thank You in advance,
Robert Austin,  Prosthetic Resident

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