Total Surface Bearing Socket for a Transtibial Prosthesis: Preference, Satisfaction, and Clinical Implications

ABSTRACT

OBJECTIVE: To evaluate the preference of transtibial amputees for the total surface bearing (TSB) socket versus the patellar tendon bearing (PTB) socket, to examine the reasons for their preferences and to determine the clinical indications of each socket. METHOD: We investigated fifty five subjects who could walk with the TSB silicon liner socket and had already used the PTB socket with supracondylar suspension. The subjects responded to a questionnaire of the 19 items. RESULTS: 67.3% (37/55) of the subjects preferred the TSB silicon liner socket over the PTB socket. More than 60% of the respondents regarded the wearing, appearance, donning & doffing, weight and noise positively. However, knee flexion, walking on an uneven surface, amount of perspiration, heating and odor were regarded negatively by more than 50% of respondents. When we compared the satisfaction scores of 37 respondents who preferred TSB socket and 18 respondents who did not, the two groups showed significant differences in the level of satisfaction for wearing appearance, walking, pistoning, donning & doffing, adaptation, perspiration, heating, odor, skin disorder, stump pain, tightening feeling, and noise (p<0.05). CONCLUSION: The TSB silicon liner socket was preferred by many transtibial amputee patients. TSB silicon liner socket showed positive effects on comfort, donning & doffing and cosmesis. Also it improved prosthetic suspension as a decrease in pistoning compared to the PTB socket with supracondylar suspension. However the TSB silicon liner socket has some problems such as causing excessive perspiration, heating and odor etc.