Adjustable prosthetic sockets: a systematic review of industrial and research design characteristics and their justifications.
Michael Baldock, Nicolaas Pickard, Michael Prince and 7 others
PMID 37926807WHAT IT FOUND
Adjustable prosthetic sockets split into four design types: inflatable bladders, moveable panels, circumferential adjustment, and variable length.
Commercial devices mostly use panels or circumferential straps, while research favours bladders. Most commercial designs lack published clinical evidence.
Key findings
01The review classifies adjustable sockets by four principles of adjustability: inflatable bladders, moveable panels, circumferential adjustment, and variable length.
02There is a distinct gap between research and industry, with commercial designs often using panels or circumferential adjustment, while research focuses on bladder-based concepts.
03Most clinically available adjustable socket designs are not supported by published clinical studies, with 68.75% of identified commercial designs lacking associated research.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review only included papers available in English or French. No physical inspection of sockets was performed; categorisation relied on descriptions and images. Most clinical studies in the literature were small case or cohort studies with low participant numbers (median 10). There is a significant lack of published evidence supporting the majority of commercially available designs. The patent search may have missed some active products, and some patents were not linked to current companies.
Declared interests
Funded by the Engineering and Physical Sciences Research Council. The authors state they have no competing interests.
The easy way to misread this
Do not assume that commercially available adjustable sockets have been proven effective or safe in clinical trials. The review found that nearly 70% of commercial designs identified had no associated published research, and safety reporting in the existing literature was very low.