PROSTHETIC CPM 2026 TEST PAPER QUESTIONS AND
ANSWERS GRADED A+
✔✔TT Interfaces - ✔✔Socks: also for volume management
Foam/pelite liner: custom, easily adjustable, durable
Gel liners: cushion/flow, hot, prevents shear
Flexible inner socket: reduce edge pressure, reliefs in outer
✔✔Waist belt (TT) - ✔✔Pros: secure, historic, knee extension assist
Cons: bulky, ugly, pistoning
✔✔Supracondylar (TT) - ✔✔pelite liner with wedge, can have removable brim (ML-PML
>=12)
Pros: knee stability (ML), simple, short limbs, good for pts with upper limb involvement,
low maintenance, don't need good hygiene, good for less active, easy donning
Cons: higher trimlines, bulkier (thicker), restrict knee ROM
✔✔SC-SP (TT) - ✔✔Supracondylar with suprapatellar bar (quad bar), easy donning
Pros: knee stability (AP and ML), simple, short limbs, good for pts with upper limb
involvement, low maintenance, don't need good hygiene, good for less active, easy
donning
Cons: higher trimlines, bulkier, less cosmetic, restrict knee ROM
✔✔Supracondylar cuff/strap (TT) - ✔✔Pros: Simple, suprapatellar suspension, low
maintenance, don't need large PML-ML difference, adjustable
Cons: Higher trimlines, ugly, bulky, pistoning, may impair circulation
✔✔Sleeve (TT) - ✔✔Pros: minimizes pistoning, can be cosmetic by masking trimlines,
can be used as auxiliary suspension, can be used for lots of patients
Cons: hot, doesn't last very long, can reduce ROM, large thighs may cause it to roll
down
✔✔Liner w/ Lock or Lanyard (TT) - ✔✔Pros: positive lock, lower profile, liner protects
against shear, increased ROM
Cons: can get pistoning/milking, must have full function of upper extremities for liner
use, need good subcutaneous tissue,
✔✔Seal-in suction (TT) - ✔✔Pros: one way valve, solid connection, no pistoning, active
patients, very secure
Cons: little tolerance for volume fluctuation, must have good hygiene
✔✔Elevated vacuum (TT) - ✔✔mechanical or electric pump
Pros: Good for volume management, increased control/proprioception, wound care
advantages
Cons: requires sleeve, cognitive ability, pump adds weight, precise fit needed
, ✔✔Clues: bilstering/discoloration of distal limb (socket fit is correct) - ✔✔Problem:
milking on the limb due to donning the liner incorrectly
Solution: don liner without air at distal end
✔✔Clues: Upper extremity terminal device opening with elbow flexion - ✔✔Problem:
EFA too proximal
Solution: move EFA distal
✔✔Clues: Upper extremity terminal device will not open all the way - ✔✔Problem:
housing is impacting, crosspoint incorrect location, CAS too loose
Solution: check housing, move crosspoint distal to C7 and slightly to sound side, tighten
CAS
✔✔Clues: TF pain and redness on lateral distal femur - ✔✔Problem: lack of ML stability
in the socket
Solution: ensure ischial containment, pad just proximal to distal lateral femur, adduct
socket slightly
✔✔Clues: Symes pain on medial/lateral malleolus - ✔✔Problem: too much pressure?
Not in socket all the way?
Solution: Make sure malleoli are reaching the appropriate reliefs, relieve area if
necessary
✔✔Clues: Transtibial pain/redness on distal end, distal patella, and fib head -
✔✔Problem: bottoming out
Solution: add sock(s)
✔✔Clues: Knee disarticulation using excessive amount of socks - ✔✔Problem: Volume
too large?
Solution: pad socket
✔✔Clues: Anterior proximal redness - ✔✔Problem: excessive pressure
anterior/proximal
Solution: socket too extended (dynamic) flex socket
✔✔Clues: Anterior distal pressure - ✔✔Problem: too much pressure
Solution: pretibial pads, extend socket
✔✔Clues: Lateral distal pressure - ✔✔Problem: Foot too inset
Solution: outset foot
✔✔Clues: Symes pediatric redness on malleoli after growth spurt - ✔✔Problem:
increased pressure due to growth
Solution: onion layer socket to allow room for relieving
ANSWERS GRADED A+
✔✔TT Interfaces - ✔✔Socks: also for volume management
Foam/pelite liner: custom, easily adjustable, durable
Gel liners: cushion/flow, hot, prevents shear
Flexible inner socket: reduce edge pressure, reliefs in outer
✔✔Waist belt (TT) - ✔✔Pros: secure, historic, knee extension assist
Cons: bulky, ugly, pistoning
✔✔Supracondylar (TT) - ✔✔pelite liner with wedge, can have removable brim (ML-PML
>=12)
Pros: knee stability (ML), simple, short limbs, good for pts with upper limb involvement,
low maintenance, don't need good hygiene, good for less active, easy donning
Cons: higher trimlines, bulkier (thicker), restrict knee ROM
✔✔SC-SP (TT) - ✔✔Supracondylar with suprapatellar bar (quad bar), easy donning
Pros: knee stability (AP and ML), simple, short limbs, good for pts with upper limb
involvement, low maintenance, don't need good hygiene, good for less active, easy
donning
Cons: higher trimlines, bulkier, less cosmetic, restrict knee ROM
✔✔Supracondylar cuff/strap (TT) - ✔✔Pros: Simple, suprapatellar suspension, low
maintenance, don't need large PML-ML difference, adjustable
Cons: Higher trimlines, ugly, bulky, pistoning, may impair circulation
✔✔Sleeve (TT) - ✔✔Pros: minimizes pistoning, can be cosmetic by masking trimlines,
can be used as auxiliary suspension, can be used for lots of patients
Cons: hot, doesn't last very long, can reduce ROM, large thighs may cause it to roll
down
✔✔Liner w/ Lock or Lanyard (TT) - ✔✔Pros: positive lock, lower profile, liner protects
against shear, increased ROM
Cons: can get pistoning/milking, must have full function of upper extremities for liner
use, need good subcutaneous tissue,
✔✔Seal-in suction (TT) - ✔✔Pros: one way valve, solid connection, no pistoning, active
patients, very secure
Cons: little tolerance for volume fluctuation, must have good hygiene
✔✔Elevated vacuum (TT) - ✔✔mechanical or electric pump
Pros: Good for volume management, increased control/proprioception, wound care
advantages
Cons: requires sleeve, cognitive ability, pump adds weight, precise fit needed
, ✔✔Clues: bilstering/discoloration of distal limb (socket fit is correct) - ✔✔Problem:
milking on the limb due to donning the liner incorrectly
Solution: don liner without air at distal end
✔✔Clues: Upper extremity terminal device opening with elbow flexion - ✔✔Problem:
EFA too proximal
Solution: move EFA distal
✔✔Clues: Upper extremity terminal device will not open all the way - ✔✔Problem:
housing is impacting, crosspoint incorrect location, CAS too loose
Solution: check housing, move crosspoint distal to C7 and slightly to sound side, tighten
CAS
✔✔Clues: TF pain and redness on lateral distal femur - ✔✔Problem: lack of ML stability
in the socket
Solution: ensure ischial containment, pad just proximal to distal lateral femur, adduct
socket slightly
✔✔Clues: Symes pain on medial/lateral malleolus - ✔✔Problem: too much pressure?
Not in socket all the way?
Solution: Make sure malleoli are reaching the appropriate reliefs, relieve area if
necessary
✔✔Clues: Transtibial pain/redness on distal end, distal patella, and fib head -
✔✔Problem: bottoming out
Solution: add sock(s)
✔✔Clues: Knee disarticulation using excessive amount of socks - ✔✔Problem: Volume
too large?
Solution: pad socket
✔✔Clues: Anterior proximal redness - ✔✔Problem: excessive pressure
anterior/proximal
Solution: socket too extended (dynamic) flex socket
✔✔Clues: Anterior distal pressure - ✔✔Problem: too much pressure
Solution: pretibial pads, extend socket
✔✔Clues: Lateral distal pressure - ✔✔Problem: Foot too inset
Solution: outset foot
✔✔Clues: Symes pediatric redness on malleoli after growth spurt - ✔✔Problem:
increased pressure due to growth
Solution: onion layer socket to allow room for relieving
