Methods: A literature research was conducted comprising two parts: socket design and suspension. Boolean search terms and truncation were used using relevant keywords in online search engines to obtain precise results.Results: Seventeen articles that met inclusion criteria were reviewed.

Conclusions: A conclusion on whether socket preference is due to the suspension mechanism or socket design itself cannot be drawn. Patellar tendon bearing (PTB) sockets are still successfully used and, in some studies, preferred over total surface bearing (TSB) sockets. Biomechanically, however, TSB sockets allow for a more even weight distribution when combined with suction, particularly vacuum-assisted socket suspension (VASS). Some limited evidence exists to support that such designs may have some effect on wound healing and early ambulation. Further research must be conducted to standardize acclimation periods. Crossover randomized controlled trials with larger sample sizes are required to establish an evidence base to improve clinical practice. (J Prosthet Orthot. 2019;31:224–245)