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If the fitting was modified from a previous knee joint generation such as the 3B1-2, 3B1-3, 3B5-2, 3B5-3; 3C98-*, 3C88-* to a Genium X4 knee joint (3B5-4=P/3B5-4=ST) without fabricating a new socket, the changed position of the pyramid/threaded connector has to be taken into account since the pyramid/threaded connector is no longer angled (0°). Use intermediate adapters (e.g. 4R47=*, 4R48=*) to adjust the position if necessary.