Non-Cochrane · intervention · PM42390277
Clinical Outcomes of Bone-Anchored Versus Socket-Suspended Prostheses in Individuals With Transfemoral Amputation: A Systematic Review and Meta-Analysis of Two-Arm Comparative Studies.
Tan Sue Wei Janice, Low Wen Xian, Bretherton Chris · Orthopaedic surgery · 2026 · PubMed · doi:10.1111/os.70369
Findings
Population Individuals with transfemoral amputation (TFA)
13 findings
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Hip range of motion: flexion-extension Cross-sectional (single time point) | MD 16.95 Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 100 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Hip range of motion: abduction-adduction Cross-sectional (single time point) | MD 4.1 Very low Downgraded: risk of bias, imprecision 2 studies · 100 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Quality of life: Q-TFA global health Cross-sectional (single time point) | MD 1.14 [-22.02, 24.30] Very low Downgraded: risk of bias, imprecision, inconsistency 3 studies · 96 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Mobility: 6-Minute Walk Test (6MWT) Cross-sectional (single time point) | MD -65 Very low Downgraded: risk of bias, imprecision 2 studies · 53 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Quality of life: Q-TFA prosthesis use Cross-sectional (single time point) | MD 1.18 [-2.36, 4.71] Very low Downgraded: risk of bias, imprecision 4 studies · 112 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Gait: gait speed Cross-sectional (single time point) | MD -0.03 [-0.31, 0.25] Very low Downgraded: risk of bias, imprecision 3 studies · 77 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Quality of life: Q-TFA problems Cross-sectional (single time point) | MD -6.29 [-18.77, 6.19] Very low Downgraded: risk of bias, imprecision, inconsistency 3 studies · 96 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Mobility: Prosthetic Limb Users Survey of Mobility (PLUS-M) Cross-sectional (single time point) | MD 0.34 Very low Downgraded: risk of bias, imprecision 2 studies |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Mobility: Activities-specific Balance Confidence (ABC) scale Cross-sectional (single time point) | MD 0.05 [-22.19, 22.29] Very low Downgraded: risk of bias, imprecision 3 studies · 58 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Quality of life: Q-TFA prosthetic mobility Cross-sectional (single time point) | MD 0.37 [-9.93, 10.68] Low Downgraded: risk of bias, imprecision 3 studies · 96 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Hip range of motion: rotation Cross-sectional (single time point) | MD 24.3 Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 100 participants |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Complications and infection Cross-sectional (single time point) | no estimate extracted No studies found 0 studies |
| Bone-anchored prostheses (BAP) | Socket-suspended prostheses (SSP) | Mobility: Timed Up and Go (TUG) test Cross-sectional (single time point) | MD 0.16 [-2.09, 2.41] Very low Downgraded: risk of bias, imprecision 3 studies · 79 participants |
Included primary studies 12
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Gailey 2023 Comparison of prosthetic mobility and balance in transfemoral amputees with bone-anchored prosthesis vs. socket prosthesis. PMID:36701197 | 2023 | this review only | not stated | not extracted yet |
| Hagberg 2005 Socket versus bone-anchored trans-femoral prostheses: hip range of motion and sitting comfort. PMID:16281724 | 2005 | this review only | not stated | not extracted yet |
| Haggstrom 2013 Comparison of prosthetic costs and service between osseointegrated and conventional suspended transfemoral prostheses. PMID:22907950 | 2013 | this review only | not stated | not extracted yet |
| Haggstrom 2014 Vibrotactile evaluation: osseointegrated versus socket-suspended transfemoral prostheses. PMID:24699977 | 2013 | this review only | not stated | not extracted yet |
| Kooiman 2023 Oxygen consumption and gait dynamics in transfemoral bone-anchored prosthesis users compared to socket-prosthesis users: A cross-sectional… PMID:37075553 | 2023 | this review only | not stated | not extracted yet |
| Kooiman 2024 The influence of prosthetic suspension on gait and cortical modulations is persons with a transfemoral amputation: socket-suspended versus… PMID:38454427 | 2024 | this review only | not stated | not extracted yet |
| Moller 2024 Cognitive load in individuals with a transfemoral amputation during single- and dual-task walking: a pilot study of brain activity in… PMID:39175448 | 2024 | this review only | not stated | not extracted yet |
| Orgel 2022 Comparison of functional outcome and patient satisfaction between patients with socket prosthesis and patients treated with transcutaneous… PMID:35717545 | 2022 | this review only | not stated | not extracted yet |
| Orgel 2023 Osseoperception in transcutaneous osseointegrated prosthetic systems (TOPS) after transfemoral amputation: a prospective study. PMID:34345935 | 2023 | this review only | not stated | not extracted yet |
| Pospiech 2021 Quality of life of persons with transfemoral amputation: Comparison of socket prostheses and osseointegrated prostheses. PMID:33834741 | 2021 | this review only | not stated | not extracted yet |
| Ranaldi 2023 Walking ability of individuals fitted with transfemoral bone-anchored prostheses: A comparative study of gait parameters. PMID:37350084 | 2023 | this review only | not stated | not extracted yet |
| Welke 2023 Comparison of conventional socket attachment and bone-anchored prosthesis for persons living with transfemoral amputation - mobility and… PMID:37075546 | 2023 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Humans over 18 years with unilateral or bilateral transfemoral amputation | Individuals with transfemoral amputation (BAP n=200; SSP n=244) |
| Intervention | Any bone-anchored prosthesis (OPRA, OIP, TOPS, ILP) | BAP: OPRA (n=5 studies), TOPS (n=3), ILP (n=1), OIP (n=1) |
| Comparison | Socket-suspended prosthesis users | SSP users |
| Outcomes | Quality of life, mobility, gait analysis, hip range of motion, osseoperception, cost analysis, infection | Mobility (6 studies), quality of life (5), gait (4), hip ROM (2), osseoperception (2), cost (1); no infection or complications studies |
| Study designs | Two-arm comparative studies only (cross-sectional, prospective cohort, retrospective, RCT or NRCT) | 12 cross-sectional two-arm comparative studies (non-randomized) |
| Timing | Single time point or follow-up periods | Cross-sectional; time with BAP 2 to 16 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | Yes | no |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: Yes · RCT: N/A | NRSI: Yes · RCT: N/A | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: No · RCT: N/A | NRSI: No · RCT: N/A | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |