Walking Ability and Quality of Life in Subjects With Transfemoral Amputation: A Comparison of Osseointegration With Socket Prostheses.

Abstract

OBJECTIVE: To investigate walking ability and quality of life of osseointegrated leg prostheses compared with socket prostheses. DESIGN: Prospective case-control study. SETTING: University medical center. PARTICIPANTS: Subjects (N=22) with transfemoral amputation (1 bilateral) referred to our center because of socket-related skin and residual limb problems resulting in limited prosthesis use. Their mean age was 46.5 years (range, 23-67y) and mean time since amputation was 16.4 years (range, 2-45y). Causes of amputation were trauma (n=20) and tumor (n=2). INTERVENTION: Implantation of an osseointegration prosthesis (OIP). MAIN OUTCOME MEASURES: Global score of the Questionnaire for Persons With a Transfemoral Amputation (Q-TFA), prosthesis use, 6-minute walk test (6MWT), Timed Up & Go (TUG) test, and oxygen consumption during treadmill walking. RESULTS: With the socket prosthesis, the mean +/- SD Q-TFA global score, prosthesis use, 6MWT, TUG, and oxygen consumption were 39+/-4.7 points, 56+/-7.9h/wk, 321+/-28m, 15.1+/-2.1 seconds, and 1330+/-310mL/min, respectively, and significantly improved with OIP to 63+/-5.3 points, 101+/-2.4h/wk, 423+/-21m, 8.1+/-0.7 seconds, and 1093+/-361mL/min, respectively. CONCLUSIONS: Osseointegration is a suitable intervention for persons whose prosthesis use is reduced because of socket-related problems. Subjects with OIP significantly increased their walking ability and prosthesis-related quality of life.