How to Choose A Prosthetist: An Open Letter to Amputees

Dear Patients:

Choosing the best prosthetist and components for your prosthesis can be tricky decisions. A successful outcome of designing and fitting a new prosthesis is very subjective. As a practicing prosthetist for more than 30 years I’ve seen that each person has unique factors that are theirs alone, as well as other aspects that pertain to many amputees. Many practitioners are locked into a comfort level with certain manufactures and utilize the same feet and knees on everyone. Additionally, some prosthetists implement new technology randomly, since it is easy to market, and often they are well compensated for it. Although there are times when state-of-the-art technology is the best choice, there are other occasions where more established technology and parts might be more conducive to a better outcome for your specific needs.

As an amputee how does one determine how to choose the prosthetist who will help them fulfill their potential? Certifications are necessary to guarantee a minimum standard, yet certifications alone are not sufficient. Credentials in conjunction with experience are essential in this profession. A prosthetist’s experiences are invaluable in choosing componentry and design for each patient. Although every manufacturer of knees and feet has a great deal of literature expressing why theirs is the best, it’s just marketing! An experienced practitioner, however, has firsthand knowledge of what has worked well in the past and which components, although tempting to utilize, probably will not achieve the desired outcome.

When visiting your prosthetist, ask to see the lab. You’ll want to choose a facility that has onsite manufacturing. This enables your prosthetist to have eyes on your prosthesis during all aspects of its creation. Additionally, your prosthetist should sculpt the model himself that will be used to manufacture your prosthetic socket. This allows for the most individualized design and provides the greatest likelihood for a comfortable fit.

When you inspect your prosthetist’s lab, you will likely see a wall of used parts for emergency repairs as well as new componentry in stock. Do you notice mostly a repetition of parts? This could indicate that lab is not always considering a wide variety of designs. Every lab’s used and new parts wall should contain: 
C-leg by Ottobock
Rheo microprocessor Knee by Ossur
Vari-Flex Foot and Pro-Flex XC by Ossur
as well as an Elan computerized foot and ankle by Endolite, also known as Blatchford 
Is there an Avalon K2 Foot or Triunph K3 Foot?  
There also ought to be several different suspension systems. You want the best system for you, not for the prosthetist.  Are there shuttle locks, elevated vacuum systems like the Unity System by Ossur?  Does your prosthetist make both KISS-Suspension sockets as well as suction sockets? 

There are so many factors in choosing the best prosthetist for you. Hopefully, I have added to your process and given you more food for thought as you make this important decision. I appreciate your taking the time to read my posting. This enables me to begin to introduce myself, and gives me the opportunity to share my thoughts and a bit of myself with you.

Thank you for taking the time. I hope to meet you soon.

Sincerely,
Bruce

Bruce Goodman, CO, BOCP
Certified Prosthetist / Orthotist
President