Functional performance and safety of bone-anchored prostheses in persons with a transfemoral or transtibial amputation: a prospective one-year follow-up cohort study
| Autor: | Ruud A. Leijendekkers, Femke Atsma, Maria W.G. Nijhuis-van der Sanden, Thomas J. Hoogeboom, Jan Paul M. Frölke, Gerben van Hinte, Hendrik van de Meent |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
safety
Adult Male 030506 rehabilitation medicine.medical_specialty One year follow up Lower extremity amputation artificial limbs Physical Therapy Sports Therapy and Rehabilitation Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Cohort Studies 03 medical and health sciences 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Quality of life Amputees Transtibial amputation medicine Humans Muscle Strength Bone-Anchored Prosthesis business.industry Rehabilitation Evaluative Studies osseointegration Middle Aged Physical Functional Performance Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] Artificial limbs functional outcomes Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] Patient Satisfaction Physical therapy Quality of Life Female 0305 other medical science business 030217 neurology & neurosurgery Cohort study Follow-Up Studies |
| Zdroj: | Clinical Rehabilitation Clinical Rehabilitation, 33, 3, pp. 450-464 Clinical Rehabilitation, 33, 450-464 |
| ISSN: | 1477-0873 0269-2155 |
| Popis: | Objectives: (1) To compare level of function, activity, health-related quality of life (HRQoL) and satisfaction in persons with a lower extremity amputation before surgery and 6- and 12-months after implantation of an osseointegration implant and (2) to report adverse events. Design: Prospective cohort study. Setting: University medical centre. Subjects: A total of 40 consecutive persons (median age: 56 years) who received a transfemoral (31) or transtibial (9) osseointegration implant, between April 2014 and March 2016. Intervention: Osseointegration implant surgery followed by a predefined rehabilitation programme. Main measures: Hip abductor strength, prosthetic use, back pain frequency, postoperative pain, mobility level (Timed-Up and Go (TUG) and wheelchair-boundedness), walking ability (6 minute walking test (6MWT) and walking distance in daily life), HRQoL, satisfaction regarding the prosthesis, and adverse events. Results: Strength, prosthetic use, walking distance, HRQoL, and satisfaction level increased significantly at 6- and 12-month follow-up compared to baseline ( P ⩽ 0.002). The TUG showed no change at 6-month follow-up ( P = 0.420) but improved significantly at 12-month follow-up compared to baseline ( P = 0.005). Wheelchair-boundedness decreased from 12/40 participants at baseline to 0 at follow-ups. The 6MWT ( P ⩾ 0.038) and back pain ( P ⩾ 0.437) did not change over time. Stump pain was present in 28/39 and 22/40 of the participants at 6-and 12-month follow-up, respectively. The major adverse events were managed successfully and included three dual-cone breakages and four bone fractures. An uneventful course was completed by 19/31 transfemoral and 4/9 transtibial bone-anchored prostheses users. Conclusion: Bone-anchored prostheses lead to improved performance and appear to be safe, so they might be considered for persons with socket-related problems. |
| Databáze: | OpenAIRE |
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