Ab0186 the Effect of Knee Joint Loss on Prosthesis Awareness in Lower Limb Amputees

Abstract

BackgroundIn knee disarticulation, transfemoral and hip disarticulation amputations, unlike transtibial amputations, the anatomical knee joint is replaced by a prosthetic knee joint. In amputations where the natural knee joint is not preserved, compared to transtibial amputations; It has been stated that it is difficult to reach the normal functional level and more energy is spent [1]. The closer the amputation level is to the proximal, the more restrictions the amputee has in activities of daily living [2].ObjectivesIn this study, we compared the ability of forgetting the prosthesis, which is an indicator of adaptation with the prosthesis, of amputees with and without an anatomical knee joint in daily life activities. The aim of this study is to examine the effect of loss of the knee joint on the ability to forget the prosthesis in daily life in amputees.MethodsLower limb amputees aged 18-65 years, who used prosthesis for at least 6 months were included in this study. Prosthesis awareness was evaluated with the Forgotten Joint Score-12 (FJS-12) amputee version [3]. The FJS-12 amputee version consists of 12 questions about awareness of the artificial limb during daily living activities. The raw scores are transformed to range from 0 to 100 points, with high scores indicating as a percentage (%) the extent to which the patient can forget the artificial limb, that is, adapt them to their lives. Amputees were divided into two groups as with and without knee joint loss. The prosthetic awareness scores of the two groups were compared. Independent sample t-test was used to compare the data.Results29 transtibial amputees (mean age: 37.17 ± 11.05 years; Body Mass Index: 25.21 ± 3.02 kg/m2) were included in the knee joint group. A total of 26 amputees (mean age: 35.07 ± 10.29 years; Body Mass Index: 23.77 ± 3.59 kg/m2) were included in the group without knee joint, including 5 knee disarticulations, 18 transfemoral and 3 hip disarticulations. The groups were similar in terms of mean age, body mass index, and years of prosthesis use (respectively p=0.470;p= 0.143; p=0.980) When the FJS-12 total score means of the groups with and without knee joint were compared, there was a statistically significant difference between the two groups (p=0.017; Z=-2.337).ConclusionThis study showed that loss of the knee joint affects the way amputees perceive their prosthesis. In the absence of a anatomical knee joint, amputees’ attention to their prosthesis is increasing. Amputees with a knee joints focus less on their prostheses in daily life activities. Our study revealed that the knee joint, which is frequently used in activities of daily living, is also a determining factor in the adaptation of amputees to the prosthesis.References[1] Davis AJ, Kelly BM, Spires MC. Prosthetic restoration and rehabilitation of the upper and lower extremity: Demos Medical Publishing; 2013.[2] Kowal M, Starczewska A, Rutkowska-Kucharska A. Biomechanical Parameters of Gait after Unilateral Above-knee Amputation. Current State of Research. Ortopedia, traumatologia, rehabilitacja. 2018;20(4):245-56.[3] Karakaş G, Özçadirci A, Topuz S. A Modified Version of the Forgotten Joint Score–12 in Lower Limb Amputees: Validity and Reliability Study. OTJR: Occupation, Participation and Health. 2022: DOI: 10.1177/15394492221123521Acknowledgements:NIL.Disclosure of InterestsNone Declared.