Background: Advances in prosthetic technology, especially microprocessor-controlled knees (MPKs), have helped enhance gait symmetry and reduce fall risks for individuals who have undergone transfemoral amputation. However, challenges remain in walking in constrained situations due to the limitations of passive prosthetic feet, lacking ankle mobility. This study investigates the benefits of SYNSYS^®, a new microprocessor-controlled knee–ankle–foot system (MPKA_NEW), designed to synergize knee and ankle movements. Methods: A randomized crossover trial was conducted on 12 male participants who had undergone transfemoral amputation who tested both the MPKA_NEW and their usual MPK prosthesis. Biomechanical parameters were evaluated using quantitative gait analysis in various walking conditions. Participants also completed self-reported questionnaires on their quality of life, locomotor abilities, and prosthesis satisfaction. Results: The MPKA_NEW showed a significant reduction in the risk of slipping and tripping compared to standard MPK prostheses, as evidenced by increased flat-foot time and minimum toe clearance during gait analysis. The MPKA_NEW also improved physical component scores in quality-of-life assessments (Short-Form 36 General Health Questionnaire), suggesting enhanced stability and reduced cognitive load during walking. Conclusions: The MPKA_NEW offers significant improvements in gait safety and quality of life for people who have undergone TFA, particularly in challenging conditions. Further studies are needed to assess the long-term benefits and adaptability across diverse amputee populations.

Background/Objectives: Lower-limb amputation significantly impacts autonomy and daily functioning. Microprocessor-controlled prosthetic knees (MPKs) improve mobility, safety, and quality of life compared with non-microprocessor prosthetic knees (nMPKs). Despite general benefits, differences among MPK models remain unclear. The goal of this investigation was to evaluate functional mobility and patient-reported outcomes in active transfemoral amputees using a new MPK (PROTEOR QUATTRO) compared with existing MPKs. Methods: In this multicenter cross-over clinical trial, active transfemoral amputees were assessed using patient-specific functional scales (PSFS), standardized locomotor capacity tests (6MWT, 10mWT, HAI, SAI) and satisfaction and quality-of-life questionnaires (PEQ-A, SF-36, ESAT). Biomechanical data collection was performed during walking test, to examine gait symmetry indices. Results: The QUATTRO MPK was associated with significantly higher PSFS scores, reflecting higher self-rated ability in performing chosen daily life activities compared with patient’s current prosthesis. Standardized locomotor tests revealed comparable performance between devices. Biomechanical analyses showed similar symmetry indices for QUATTRO and other MPKs. Patient-reported outcomes showed an improvement in physical health with QUATTRO, while overall satisfaction remained similar. Conclusions: QUATTRO improved patient-perceived ability to perform meaningful daily-life activities while maintaining comparable performance on standardized locomotor tests. These results highlight the importance of patient-centered assessments in identifying functional benefits that may guide individualized prosthetic prescriptions for active transfemoral amputees.

Background: Various socket designs exist, linking the residual limb together with the prosthetic components to restore the ability to walk; however, lack of socket comfort is a frequent complaint. Objective: To evaluate the impact of socket design on end-user comfort and mobility. Methods: A randomized crossover trial was set to compare comfort and mobility of above-knee amputees (AKAs) wearing an ischial containment (IC) or subischial (I-SUB) socket. Patients actively wearing IC sockets were recruited from 10 rehabilitation centers across the country. They were then fitted for an I-SUB socket by Certified Prosthetists (CPs) as an alternate socket. Participants were randomly assigned to start with one or the other socket. After a minimum of 2 weeks, each participant evaluated the Socket Comfort Score (SCS) (primary outcome) in various situations, performed the 2-min walk test, and answered the PLUS-M questionnaire (secondary outcomes). Results: A total of 25 participants were included, of whom 23 completed the study with full (n = 21) or partial data (n = 2). SCS were improved with I-SUB compared with IC in all situations, with significant differences in general, when sitting on a rigid chair, sitting in a car, and standing. The differences in self-reported mobility and walking distance at the 2-min walk test were not significant. At the end of the study, more than 80% of the participants chose to keep the I-SUB socket for their daily use. Conclusions: For the first time, this study supports that the subischial suction socket improves comfort in daily life without negatively impacting user mobility in a group of individuals with AKA.