Management of an above-knee amputee with complex medical problems using the CAT-CAM prosthesis

The purpose of this case report is to 1) briefly describe the traditional above-knee (AK) quadrilateral socket, 2) describe the contoured adducted trochanteric-controlled alignment method (CAT-CAM) socket, 3) describe the management of a patient with a temporary CAT-CAM prosthesis, and 4) explain how the CAT-CAM prosthesis approach has resolved a medically complex clinical problem. The 49-year-old patient in this case study received a left AK amputation in 1984 and was provided with a quadrilateral socket. She abandoned this prosthesis after 2 years because of her dissatisfaction with the device (ie, poor fit, awkwardness, excessive energy expenditure) and because of her compromised cardiac condition. The patient was fitted with a CAT-CAM prosthesis in 1988 and reported increased comfort, ease of donning and doffing, and increased gait efficiency with the CAT-CAM prosthesis as compared with the quadrilateral socket. The patient required 19 days of prosthetic training and was discharged independent in ambulation and transfers using two straight canes. We consider the CAT-CAM prosthesis an improvement over the quadrilateral socket for increasing ambulation independence in the individual with AK amputation and other medical complications.