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Clinical Evaluation of the Access Socket Flexible Socket for Transtibial Prosthesis
Sponsor: Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est
Summary
Transtibial amputation significantly impacts patient autonomy and quality of life, primarily due to the limitations of conventional rigid sockets, which restrict comfort and joint range of motion. The Access Socket (AS) is an innovative prosthetic socket combining a rigid carbon-fiber structure in key load-bearing areas with flexible urethane-resin (ProtheFLEX®) zones in regions typically rigid in conventional sockets. This hybrid design aims to improve comfort and pressure distribution while preserving the mechanical properties required for ambulation. The AS has already demonstrated benefits in transfemoral amputees and is now reimbursed in France for that population. A preliminary uncontrolled study in 12 transtibial amputees suggested significant improvements in perceived function, comfort, satisfaction, and mobility. This multicenter, randomized, open-label, two-arm crossover study aims to compare the (AS) with the standard rigid socket (RS) in 25 adults with transtibial amputation. Participants will wear each socket for approximately 4 weeks (after a 1-2 week adaptation period) in a randomized order. The primary outcome is the Patient Specific Functional Scale (PSFS). Secondary outcomes include comfort (SCS), satisfaction (OPUS), psychosocial adjustment (TAPES-R), mobility (PLUS-M), prosthesis utility (PEQ-U), and the proportion of patients electing to keep the AS at study completion.
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
25
Start Date
2026-04-27
Completion Date
2027-10-30
Last Updated
2026-05-18
Healthy Volunteers
No
Interventions
Access Socket (AS)
Hybrid prosthetic socket combining a rigid carbon-fiber structure in load-bearing areas (lateral, postero-inferior, inferior) with flexible urethane-resin (ProtheFLEX®) zones in regions typically rigid in conventional sockets. Manufactured from the same plaster mold as the rigid socket to ensure identical internal geometry.
Rigid Socket (RS)
Conventional definitive carbon-fiber rigid socket, currently the only socket type reimbursed in France for transtibial amputation (LPPR-listed). Standard of care comparator.
Locations (5)
Hôpital National d'Instruction des Armées (HNIA) Percy
Clamart, France
Hôpital Filieris de Freyming-Merlebach
Freyming-Merlebach, France
CHU Grenoble Alpes - Hôpital Sud
Grenoble, France
Institut Régional de Médecine Physique et de Réadaptation (IRR) - Filière Locomoteur
Nancy, France
Insititution Nationale des Invalides
Paris, France