Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction

Area of Science:

• Biomedical Engineering
• Prosthetics and Orthotics
• Rehabilitation Medicine

Background:

• The human-prosthesis interface remains a significant challenge in prosthetics.
• Prosthetics and Orthotics International has extensively documented advancements in this field.
• This review commemorates 50 years of the International Society for Prosthetics and Orthotics.

Purpose of the Study:

• To review the evolution of human-prosthesis interfaces over the last five decades.
• To examine research contributions to interface mechanics and their impact on clinical practice.
• To explore future directions in prosthetic interface technology and application.

Main Methods:

• Narrative review of studies on lower limb prosthetic sockets and osseointegration.
• Consideration of research on socket comparison, design, manufacturing, and evaluation.
• Analysis of advances in sensing, soft tissue quantification, computing, and additive manufacturing.

Main Results:

• Significant improvements in understanding socket designs and their effects over 50 years.
• Development of volume and thermal control mechanisms with potential clinical applications.
• Osseointegration offers a functional alternative for non-socket users, with potential for neuromuscular integration.

Conclusions:

• While clinical research has enhanced socket design knowledge, high-quality studies are still required.
• Technological advances are enabling data-driven, automated socket manufacturing.
• Osseointegration presents a viable solution, but implant mechanics and infection control need further refinement.