CAD/CAM Versus Conventional Prosthetic Sockets for Transtibial Amputees

Abstract

Abstract Background: Traditionally, the prosthetic socket was handmade, which involved several different stages that might not be ideal initially. However, over the past 15 years, there have been multiple attempts to use computer-aided design/manufacturing (CAD/CAM) technologies to manufacture prosthetic sockets for transtibial amputees. Objectives: To critically appraise and analyse the use of CAD/CAM techniques for manufacturing prosthetic sockets compared with traditional methods for transtibial amputees to meet their expectations of structural integrity, trust, reliability and high-quality. Study design: Literature review that followed the principal of systematic review. Methods: MEDLINE, PubMed, Scopus, CINAHL Plus, Web of Science, OVID Database and Google Scholar were systemically searched for studies that compared CAD/CAM prosthetic sockets and conventional sockets for transtibial amputees. Results: A total of nine articles met the inclusion criteria and were included in the review. The articles were rated according to their level of evidence. All nine papers were small, non-randomized controlled trials. Four studies showed positive outcomes for using CAD/CAM: three were based on 3D printing and one used a computer numerical control (CNC)-milled prosthetic socket. Conclusion: CAD/CAM technologies provide exciting new opportunities for the field of prosthetic sockets. In the next few years, CAD/CAM technologies might be more accessible, cheaper and more advanced, which might lead to the manufacturing of high-quality prosthetic sockets. However, further high-quality studies and validation are required for evidence-based practice to evaluate the clinical efficiency and effectiveness of CAD/CAM sockets.