Monitoring the Residual Limb-Socket Interface: A Perspective on Clinical Needs and Challenges.

Skin-related complications are among the most common secondary conditions experienced by lower limb amputees. Besides connecting the prosthetic legs, the residual limb-socket interface (RLSI) plays a crucial role in maintaining skin health for prosthesis users. However, RLSI evaluation typically relies on subjective feedback from amputees, who may have difficulty accurately assessing the condition of the interface-particularly those with sensory impairments. RLSI monitoring systems have the potential to improve care by providing objective, real-time, and quantitative feedback to amputees, prosthetists, and clinicians. Despite advancements in sensing technologies, most RLSI monitoring research has focused on technical development, with limited attention to clinical integration. As a result, there is a lack of clinical evidence demonstrating improved outcomes from using these monitoring systems. This perspective aims to help researchers align their sensing technologies with current clinical practices so that RLSI monitoring data can support evidence-based medical decision-making. We begin by reviewing RLSI manufacturing and maintenance procedures, followed by an overview of common clinical strategies used to optimize RLSI performance. Next, we discuss the challenges of incorporating RLSI monitoring systems into existing clinical workflows. Finally, we identify key clinical needs and highlight several promising monitoring technologies that could address those needs.