A New Implant for Transfemoral Amputation: Improved Gait and Comfort

Abstract

Introduction: Transfemoral amputation results in a prosthesis which bears weight on the ischium. Gait disturbance, lack of an end-bearing stump and discomfort in the groin from the socket even while sitting, are important issues. Methods: This is a pilot report of an ongoing randomized blind clinical trial of a new intramedullary implant post transfemoral amputation. Here, we describe a single case illustrating the surgical technique and clinical outcome of a dysfunctional post-traumatic transfemoral amputation addressed with this implant. Clinical gait analysis, SF-12 and VAS were assessed pre-and post-intervention at 6 months of follow-up. Results: An improved stump control is accomplished by means of myoplasty and myodesis through an end-cap. Stride width improved from 0.21 m pre-op to 0.13 m post-op, and more symmetrical stride length (∆0.21 m pre-op vs. ∆0.06 m post-op) was noted, indicating improved gait quality and stability. Gait velocity increased (0.51 ± 0.04 m/s pre-op vs. 0.64 ± 0.02 m/s post-op). Conclusion: This technique reveals improvements in gait parameters in a transfemoral amputee treated with a new procedure. Improved prosthesis control, sitting comfort, greater hip range of motion, better gait stability, and enhanced walking abilities were noted.