title: Transfemoral prosthesis suspension systems: a systematic review of the literature.
abstract: The purpose of this study was to find the scientific evidence pertaining to various transfemoral suspension systems to provide selection criteria for clinicians. To this end, databases of PubMed, Web of Science, and ScienceDirect were explored. The following key words, as well as their combinations and synonyms, were used for the search: transfemoral prosthesis, prosthetic suspension, lower limb prosthesis, above-knee prosthesis, prosthetic liner, transfemoral, and prosthetic socket. The study design, research instrument, sampling method, outcome measures, and protocols of articles were reviewed. On the basis of the selection criteria, 16 articles (11 prospective studies and 5 surveys) were reviewed. The main causes of reluctance to prosthesis, aside from energy expenditure, were socket-related problems such as discomfort, perspiration, and skin problems. Osseointegration was a suspension option, yet it is rarely applied because of several drawbacks, such as extended rehabilitation process, risk for fracture, and infection along with excessive cost. In conclusion, no clinical evidence was found as a "standard" system of suspension and socket design for all transfemoral amputees. However, among various suspension systems for transfemoral amputees, the soft insert or double socket was favored by most users in terms of function and comfort.
authors.affiliation: From the Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Hossein
authors.initials: H
authors.lastname: Gholizadeh
authors.forename: Noor Azuan
authors.initials: NA
authors.lastname: Abu Osman
authors.forename: Arezoo
authors.initials: A
authors.lastname: Eshraghi
authors.forename: Sadeeq
authors.initials: S
authors.lastname: Ali
mesh_terms: D000672:Amputation Stumps; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D006801:Humans; D007866:Leg; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D019919:Prosthesis Implantation / Q000295:instrumentation