A one-year follow-up case series on gait analysis and patient-reported outcomes for persons with unilateral and bilateral transfemoral amputations undergoing direct skeletal fixation.

Autor: Toderita D; Department of Bioengineering, Imperial College London, London, UK. diana.toderita15@imperial.ac.uk., McGuire T; Department of Bioengineering, Imperial College London, London, UK., Benton AM; Department of Bioengineering, Imperial College London, London, UK., Handford C; Department of Bioengineering, Imperial College London, London, UK.; Academic Department of Military Trauma and Orthopaedics, Birmingham, UK., Ramasamy A; Department of Bioengineering, Imperial College London, London, UK.; Academic Department of Military Trauma and Orthopaedics, Birmingham, UK., Hindle P; St. Paul's Hospital, Vancouver, Canada.; University of British Columbia, Vancouver, Canada., Bull AMJ; Department of Bioengineering, Imperial College London, London, UK., McMenemy L; Department of Bioengineering, Imperial College London, London, UK.; Academic Department of Military Trauma and Orthopaedics, Birmingham, UK.
Jazyk: angličtina
Zdroj: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2024 Nov 29; Vol. 21 (1), pp. 208. Date of Electronic Publication: 2024 Nov 29.
DOI: 10.1186/s12984-024-01509-4
Abstrakt: Background: Direct skeletal fixation, a surgical technique enabling the attachment of an external prosthesis directly to the bone through a percutaneous implant, offers an enticing solution for patients with lower limb amputations facing socket-related issues. However, understanding of its impact on musculoskeletal function remains limited.
Methods: This study compares pre- and 1-year post-osseointegration surgery outcomes, focusing on patient-reported measures and musculoskeletal system function during level-ground walking. Two participants with unilateral transfemoral amputations and two participants with bilateral transfemoral amputations completed the questionnaire for transfemoral amputations (Q-TFA) and underwent gait analysis. Musculoskeletal modelling simulations were conducted.
Results: Results showed improved Q-TFA scores for all participants. Participants showed reduced amputated limb peak hip extension angles, flexion torques and contact forces at the push-off phase of the gait cycle. Post-operatively, hip adduction angles and abduction moments increased, indicating more natural gait patterns. Whilst one participant demonstrated increased post-operative walking speed, others walked more slowly.
Conclusions: The study revealed diverse adaptation patterns after one year in individuals with transfemoral amputations transitioning to bone-anchored prostheses. Additional longer-term data is necessary to enable generalization and clinical implications of these results.
Competing Interests: Declarations. Ethical approval, consent to participate and for publication: Ethical approval was obtained from the Imperial College Science, Engineering and Technology Research Ethics Committee (Reference 22IC7601, 20IC6268). Written informed consent for publication was obtained from all study participants. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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