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Above knee amputee

Christian Wied, Nicolai B Foss, Morten T Kristensen, Gitte Holm, Thomas Kallemose, Anders Troelsen
AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013 and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion...
December 18, 2016: World Journal of Orthopedics
Peter Ladlow, Rhodri Phillip, Russell Coppack, John Etherington, James Bilzon, M Polly McGuigan, Alexander N Bennett
BACKGROUND: Medical practitioners face difficult decisions over whether to amputate or to salvage a lower limb that has undergone trauma. To our knowledge, there has been little evidence reporting the impact of different surgical decisions on functional and mental health outcomes following intensive rehabilitation that might inform decision-making. METHODS: This study is a retrospective, independent-group comparison of rehabilitation outcomes from a U.K. military complex trauma rehabilitation center...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
Steffen Willwacher, Volker Herrmann, Kai Heinrich, Johannes Funken, Gerda Strutzenberger, Jan-Peter Goldmann, Björn Braunstein, Adam Brazil, Gareth Irwin, Wolfgang Potthast, Gert-Peter Brüggemann
The purpose of this study was to explore the relationship between the forces applied to the starting blocks and the start performances (SPs) of amputee sprinters (ASs) and non-amputee sprinters (NASs). SPs of 154 male and female NASs (100-m personal records [PRs], 9.58-14.00 s) and 7 male ASs (3 unilateral above knee, 3 unilateral below knee, 1 bilateral below knee; 100 m PRs, 11.70-12.70 s) with running specific prostheses (RSPs) were analysed during full-effort sprint starts using instrumented starting blocks that measured the applied forces in 3D...
2016: PloS One
Andreas Hahn, Michael Lang, Claudia Stuckart
The objective of this work is to evaluate whether clinically important factors may predict an individual's capability to utilize the functional benefits provided by an advanced hydraulic, microprocessor-controlled exo-prosthetic knee component.This retrospective cross-sectional cohort analysis investigated the data of above knee amputees captured during routine trial fittings. Prosthetists rated the performance indicators showing the functional benefits of the advanced maneuvering capabilities of the device...
November 2016: Medicine (Baltimore)
R A Weinert-Aplin, M Twiste, H L Jarvis, A N Bennett, R J Baker
Amputees are known to walk with greater metabolic cost than able-bodied individuals and establishing predictors of metabolic cost from kinematic measures, such as centre of mass (CoM) motion, during walking are important from a rehabilitative perspective, as they can provide quantifiable measures to target during gait rehabilitation in amputees. While it is known that vertical CoM motion poorly predicts metabolic cost, CoM motion in the medial-lateral (ML) and anterior-posterior directions have not been investigated in the context of gait efficiency in the amputee population...
January 2017: Gait & Posture
Viviana Rota, Maria Grazia Benedetti, Yusuke Okita, Marco Manfrini, Luigi Tesio
Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion...
December 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Aaron Plauche, Dario Villarreal, Robert D Gregg
Persons with amputations lack important senses from the amputated limb. With the absence of proprioception in the amputated leg, amputees have far more difficulty maintaining a natural gait with balance and stability. The biggest determinant of temporal limb behavior during locomotion is the phase in the gait cycle, which can be estimated using the center of pressure (COP) under the feet. We hypothesize that feedback from the COP of the prosthetic foot can help restore a more robust sense of phase in transfemoral (above-knee) amputees...
July 2016: IEEE Transactions on Haptics
Isabel Font-Jiménez, Mireia Llaurado-Serra, Montserrat Roig-Garcia, Belen De Los Mozos-Perez, Sagrario Acebedo-Urdiales
AIM: Describe the incidence of non-traumatic amputation in a Spain region and identify the risk factors associated with the level of amputation and reamputation. METHODS: Retrospective study on non-traumatic lower-extremity amputees in a Spanish region between 2007 and 2013. A descriptive, bivariate and multivariate analysis was performed using bivariate logistic regression. Statistical significance p≤0.05, SPSS V.21. RESULTS: 495 amputations were carried out in 353 patients...
December 2016: Primary Care Diabetes
Govindarajan Narayanan, Saraswathy Gnanasundaram, Mohan Ranganathan, Rajaraman Ranganathan, Gautham Gopalakrishna, Bhabendra Nath Das, Asit Baran Mandal
PURPOSE: In the Indian scenario, the Jaipur foot is a low-cost breakthrough that enabled the disabled person to adapt to the Indian environment. The aim of this study is to modify the present foot in terms of ankle support design and method of fabrication, foot moulds profile and the inner core material in order to improve the performance and durability. METHOD: The optimized design of ankle support and flat foot profile moulds suitable for both left and right foot were developed through CAD/CAM and prosthetic feet were fabricated using ethylene vinyl acetate (EVA) foam as an appropriate alternative core material for microcellular rubber (MCR)...
2016: Disability and Rehabilitation. Assistive Technology
Andrea Giovanni Cutti, Emanuele Lettieri, Martina Del Maestro, Giovanni Radaelli, Martina Luchetti, Gennero Verni, Cristina Masella
BACKGROUND: The fitting rate of the C-Leg electronic knee (Otto-Bock, D) has increased steadily over the last 15 years. Current cost-utility studies, however, have not considered the patients' characteristics. OBJECTIVES: To complete a cost-utility analysis involving C-Leg and mechanical knee users; "age at the time of enrollment," "age at the time of first prosthesis," and "experience with the current type of prosthesis" are assumed as non-nested stratification parameters...
March 29, 2016: Prosthetics and Orthotics International
Umesh Meena, Ramesh Meena, Balaji S, Sahil Gaba
The treatment of an above knee amputee who has sustained a fracture of the femoral neck is a chal- lenging situation for both the orthopedic surgeon and the rehabilitation team. These fractures may be managed acutely either by reduction and internal fixation or by endoprosthetic replacement based on the same criteria as in any other patient with otherwise intact limbs.We present a neglected case treated successfully with valgus osteotomy. We conclude that these fractures should be treated with the same urgency and expertise as similar fractures in non-amputees as long-term survival and good quality of life can be expected...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
David Quintero, Anne E Martin, Robert D Gregg
This paper presents a novel control strategy for an above-knee powered prosthetic leg that unifies the entire gait cycle, eliminating the need to switch between controllers during different periods of gait. Current control methods divide the gait cycle into several sequential periods each with independent controllers, resulting in many patient-specific control parameters and switching rules that must be tuned by clinicians. Having a single controller could reduce the number of control parameters to be tuned for each patient, thereby reducing the clinical time and effort involved in fitting a powered prosthesis for a lower-limb amputee...
August 2015: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
Abdullah Bin Saeed, Usama Bin Saeed, Muhammad Zain-Ur-Rehman, Rana Dawood Ahmad Khan, Ajmal Yasin
BACKGROUND: More than 100,000 major lower extremity amputations -- amputations at the metatarsal, below-knee or above-knee level -- are performed yearly in the United States. Despite improvements in long-term outcome, operative mortality following such amputations has remained stable at 9% to 10% over the last 20 years. Several predictors for functional outcome of amputee patients are mentioned in the literature. OBJECTIVES: The current study was planned to assess the impact of comorbidities on functional status after lower extremity amputations...
November 2015: JPMA. the Journal of the Pakistan Medical Association
Davide Croci, Javier Fandino, Serge Marbacher
BACKGROUND: Phantom radicular pain is very uncommon. To the best of our knowledge, only 14 cases have been described in the literature. A review of the literature revealed the most common cause of phantom radicular pain to be lumbar disc herniation and, furthermore, that treatment with epidural steroid injection or surgical decompression relieves pain in almost all cases. A significant number of patients with superimposed phantom radiculopathy may be missed because of the high incidence of degenerative lumbar spine diseases in the adult population, as well as the fact that amputee patients very often present with mixed stump and phantom pain...
June 2016: World Neurosurgery
Morten Tange Kristensen, Gitte Holm, Peter Gebuhr
INTRODUCTION: The successful outcome of a major amputation depends on several factors, including stump wound healing. The purpose of this study was to examine the criteria upon which the index amputation was based and to identify factors associated with early amputation failure after major non-traumatic lower-extremity amputation. METHODS: We studied a consecutive one-year series of 36 men and 34 women with a median (25-75% quartiles) age of 72 (63-83) years who were treated in an acute orthopaedic ward; 44 below-knee and 26 above-knee amputees of whom 47 had an American Society of Anesthesiologists rating above two...
December 2015: Danish Medical Journal
S Arun, S Kanagaraj
Trans femoral amputation is one of the most uncomfortable surgeries in patient׳s life, where the prosthesis consisting of a socket, knee joint, pylon and foot is used to do the walking activities. The artificial prosthetic knee joint imitates the functions of human knee to achieve the flexion-extension for the above knee amputee. The objective of present work is to develop a light weight composite material for the knee joint to reduce the metabolic cost of an amputee. Hence, an attempt was made to study the mechanical properties of multi walled carbon nanotubes (MWCNT) reinforced Poly (methyl methacrylate) (PMMA) prepared through melt mixing technique and optimize the concentration of reinforcement...
October 2015: Journal of the Mechanical Behavior of Biomedical Materials
Derek F Amanatullah, Robert T Trousdale, Rafael J Sierra
There are approximately 1.6 million lower extremity amputees in the United States. Lower extremity amputees are subject to increased physical demands proportional to their level of amputation. Lower extremity amputees have a 6-fold higher risk of developing radiographic osteoarthritis in the ipsilateral hip and a 2-fold risk of developing radiographic osteoarthritis in contralateral hip when compared with the non-amputee population. Additionally, there is a 3-fold increased risk of developing radiographic osteoarthritis in the ipsilateral hip after an above knee amputation when compared with a below knee amputation...
May 2015: Orthopedics
Chunhui Ma, Qi Lv, Chengqing Yi, Jinzhong Ma, Libo Zhu
There is limited literature about the outcomes of total hip arthroplasty (THA) as a surgical option for above-knee amputees. Here, we described one case of femoral neck fracture with above-knee amputation. Two-year follow-up revealed an excellent clinical and radiological outcome. The main challenge of THA posed by the amputation was control of the lower extremity. We recommend inserting a pin at the greater trochanter of the femur to improve control of traction or rotation.
2015: International Journal of Clinical and Experimental Medicine
Kemin Liu, Tao Tang, Anqin Wang, Shouchang Cui
BACKGROUND: Stump problems (SPs) secondary to traumatic lower limb amputation had a crucial influence on amputees' ability to return to living and work. The purpose of this study was to investigate the surgical management strategies of the SPs after above-ankle amputation of the lower limb secondary to trauma. METHOD: A cohort of clinical cases, who were troubled by SPs after above-ankle amputation following trauma, had undergone revision surgery of the stump and was analyzed retrospectively...
2015: BMC Musculoskeletal Disorders
E Kolossváry, T Ferenci, T Kováts, L Kovács, Z Járai, G Menyhei, K Farkas
OBJECTIVES: To assess the trends of peripheral arterial disease associated major lower limb amputation in Hungary over a 9 year period (2004-2012) in the whole Hungarian population. METHODS: This was a retrospective cohort study employing administrative health care data. Major amputations were identified in the entire Hungarian population during a 9 year period (2004-2012) using the health care administrative data. Direct standardization was used to eliminate the potential bias induced by the different age and sex structure of the compared populations...
July 2015: European Journal of Vascular and Endovascular Surgery
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