Durability challenges and mitigation strategies for paediatric prostheses - Cambodian prosthetist experiences and clinical casefile analysis
Author(s)
Edgar, Caitlin
Ghidini, Claudia
Harte, Carson
Kheng, Sisary
Bull, Anthony MJ
Type
Journal Article
Abstract
Purpose
Prosthetic component durability challenges can form a significant barrier to the successful rehabilitation of children with lower-limb absence in low-resource environments. This work aims to define these challenges and understand current mitigation strategies to support improved design and service delivery.
Materials & Methods
A convergent mixed methods approach was employed. Qualitative interviews were conducted through purposive sampling with 6 prosthetists in Cambodia. Thematic analysis was complemented with data from 62 retrospective paediatric clinical casefiles detailing prosthetic component problems, failure points, and repair solutions. Descriptive and inferential statistics were applied with a significance level of p < 0.05.
Results
At interview, 5 themes were identified: the challenge of prosthetic component durability; prosthetic knees; SACH feet; repairs require professional expertise; and local supply/repair of componentry is beneficial. Clinical casefiles revealed component failure points. The distribution of knee problems was design specific and showed significant differences between local polypropylene and donated modular componentry (p < 0.001). Repair solutions are provided for knee and feet designs.
Conclusion
Prosthetists provided critical insight which was supported with clinical evidence. Durability is a significant challenge which can be partially alleviated through inclusion of spare parts and mobile outreach repairs. Clarity on current design shortcomings provides evidence for designers and manufacturers.
Prosthetic component durability challenges can form a significant barrier to the successful rehabilitation of children with lower-limb absence in low-resource environments. This work aims to define these challenges and understand current mitigation strategies to support improved design and service delivery.
Materials & Methods
A convergent mixed methods approach was employed. Qualitative interviews were conducted through purposive sampling with 6 prosthetists in Cambodia. Thematic analysis was complemented with data from 62 retrospective paediatric clinical casefiles detailing prosthetic component problems, failure points, and repair solutions. Descriptive and inferential statistics were applied with a significance level of p < 0.05.
Results
At interview, 5 themes were identified: the challenge of prosthetic component durability; prosthetic knees; SACH feet; repairs require professional expertise; and local supply/repair of componentry is beneficial. Clinical casefiles revealed component failure points. The distribution of knee problems was design specific and showed significant differences between local polypropylene and donated modular componentry (p < 0.001). Repair solutions are provided for knee and feet designs.
Conclusion
Prosthetists provided critical insight which was supported with clinical evidence. Durability is a significant challenge which can be partially alleviated through inclusion of spare parts and mobile outreach repairs. Clarity on current design shortcomings provides evidence for designers and manufacturers.
Date Issued
2026-06-01
Date Acceptance
2025-10-17
Citation
Disability and Rehabilitation, 2026, 48 (12), pp.3913-3928
ISSN
0963-8288
Publisher
Taylor and Francis Group
Start Page
3913
End Page
3928
Journal / Book Title
Disability and Rehabilitation
Volume
48
Issue
12
Copyright Statement
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
License URL
Identifier
10.1080/09638288.2025.2578428
Subjects
Paediatric
prosthetic
durability
low-resource environment
prosthetist
Publication Status
Published
Date Publish Online
2025-10-30