International prosthetists' perspectives on adjustable-volume lower limb prosthetic sockets

Background: Adjustable-volume prosthetic sockets are designed to address residual limb volume fluctuations that temporarily alter socket fit. These systems are relatively new to the market and their global use, and the type of patient they work best for, remains unclear. Objective: This study explored global experiences and perspectives on fitting different styles of commercially available adjustable-volume prosthetic sockets. Methods: An online survey was distributed globally to prosthetists. The survey asked about experiences with adjustable sockets, including successes, challenges, and barriers faced when fitting, and the impact of amputation level on success. Responses were statistically compared between United States (US) and non-US respondents. Results: Of 195 valid responses, 66.7% were from the US. Eighty-five percent of respondents had fit an adjustable socket, with those in the US more likely to fit them than those outside of the US ( p = 0.001). Reported success rates ranged from 40.0% to 75.1% depending on the socket style, with no significant differences between US and non-US respondents or between amputation levels. Open-ended feedback highlighted the importance of patient selection, the timing of use, and differing views on the implications of prefabricated designs for clinical practice and access to care. Conclusions: Globally, prosthetists report moderate success in fitting a variety of lower limb adjustable-volume sockets at different levels of amputation. As the market for adjustable-volume sockets continues to expand, further research is warranted to evaluate long-term outcomes across styles and amputation levels to better inform global prescription practices.