I think the biggest factors are going to be activity level and cost, but I would recommend carbon fiber because it is lightweight and high stiffness. Most amputees complain about socket fit, so using a material with high stiffness will help create the feeling of a better attachment.

I agree with the carbon fibre, but the issue is more about the age of the people wearing the sockets. We think at old age we should see where it is appropriate to put flexibility in the socket rather than stiffness. The gate cycle for old people is slow and socket wear and friction will increase. Therefore in my study of below knee amputees socket we find out that optimised holes at the FH and PT will be more comfortable for patient age 55 and over. Optimisation here is very important and you should follow patient range of motion.

Ischial containment with soft inner socket and rigid outer frame socket fits for above knee amputee. Other alternative could be silicon liner with locking mechanizm provides sufficient suspension.

Even if you have soft liner and rigid outer, the swing phase in the old age people will be affected at some critical areas and you should take care of the reliefs at these areas.

I agree with the comments by the other individuals that the type of material to use for socket in a lower limb amputee depends upon the functional goals of the patient (high activity, ballistics, jumping, running, walking, standing, etc.), activity level and physical/mental capabilities (i.e,. ability to don/doff, ability to understand use of the technology, etc.).

For highly active persons that understand technology and have the capabilities to don/doff complex designs, then likely greater stiffness and suspension systems. For less active persons that are technology challenged and possess limited capabilities to don/doff, then likely less stiffness and simpler suspension systems.

What was not discussed and needs to be factored is the body mass of the individual as well. If low activity but large body mass, then certainly need greater stiffness to overcome larger loading forces during stance phase.

I agree here that large body mass need more stiffness to conform with the structural integrity of the socket. We can increase overall stiffness but we can implement certain holes on the FH and PT sides specially for heavy weight and old people to improve the stress distribution without compromising the structural integrity of the sockets. It is important to understand these processes and use DOE optimization to avoid random design and non beneficial trials

Thanks For all above answers( Alexander Steele , Gabi Nehme , Salih Angin , Christopher F. Hovorka )

the best type of socket lamination to be used in the prosthetic lower limb depend on factors such as weight of apmutee

Again increasing stiffness of socket in relation to weight is important. But above all you should maintain flexibility specially at Mt and Fh area to avoid discomf

Thanks Dr. Kahdim, Dr. Gabi

Flexibility at FH for people older than 55 is ve Important