Bone and joint changes in lower limb amputees.

Burke, Matthew J.; Román, Victor Estuardo León; Wright, V.

doi:10.1136/ard.37.3.252

Cited by 206 publications

(151 citation statements)

References 6 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…For example, a group of athletes with unilateral lower leg amputation was shown to have a higher incidence of radiographic OA of the "normal" (nonamputated) knee compared with age-matched healthy controls (22). Furthermore, results of gait evaluation in patients who had undergone lower leg amputation suggested that the patients place relatively higher loads on the nonamputated extremity compared with a normal control population (23). This was assumed to be a result of increased magnitude and duration of functional loading of the nonamputated extremity during day-to-day activities.…”

Section: Discussionmentioning

confidence: 99%

Asymmetric knee loading in advanced unilateral hip osteoarthritis

Shakoor¹,

Hurwitz²,

Block³

et al. 2003

Arthritis & Rheumatism

127

108

View full text Add to dashboard Cite

Objective. Subjects with unilateral end-stage hip osteoarthritis (OA) who undergo total hip replacement (THR) preferentially require subsequent replacement of the contralateral knee compared with the ipsilateral knee. We investigated whether this nonrandom, preferential evolution of lower extremity OA from the hip to the contralateral knee joint may be related to asymmetries in dynamic joint loading at the knees, particularly the peak external knee adduction moment, which has been associated with the progression of knee OA.Methods. Gait analysis was performed on 50 subjects who were preoperative for unilateral THR. Twenty-two of these subjects were reevaluated postoperatively 10-23 months after undergoing successful THR. At each analysis, dynamic joint loads in the contralateral knee were compared with those in the ipsilateral knee.Results. Prior to THR, the peak external knee adduction moment and peak medial compartment load were significantly higher in the contralateral knee. This asymmetry persisted after THR.Conclusion. Subjects with unilateral end-stage hip OA preferentially require subsequent replacement of the contralateral knee, as compared with the ipsilateral knee. Among patients with unilateral end-stage hip OA, the contralateral knee is subjected to higher dynamic joint loads than is the ipsilateral knee, and this asymmetric loading persists long after subjects have undergone successful THR. Biomechanical factors appear to be involved in the multiarticular evolution of OA of the lower extremities.

show abstract

Section: Discussionmentioning

confidence: 99%

Asymmetric knee loading in advanced unilateral hip osteoarthritis

Shakoor¹,

Hurwitz²,

Block³

et al. 2003

Arthritis & Rheumatism

127

108

View full text Add to dashboard Cite

show abstract

“…Despite common reductions in physical activity levels after lower limb loss [23], recent advances in rehabilitation methods and prosthetic technologies facilitate participation in recreational activities for these individuals. Continued prosthetic use, however, has been associated with an increased presence of joint pain and arthritis [3,11], and the demographics of these injured servicemembers likely increase the risk for arthritis compared with older and less active populations with lower limb loss.…”

Section: Introductionmentioning

confidence: 99%

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Pruziner

Werner

Copple

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background The initiation and progression of knee and hip arthritis have been related to limb loading during ambulation. Although altered gait mechanics with unilateral lower limb loss often result in larger and more prolonged forces through the intact limb, how these forces differ with traumatic limb loss and duration of ambulation have not been well described.Questions/purposes The purpose of this study was to determine whether biomechanical variables of joint and limb loading (external adduction moments, vertical ground reaction force loading rates, and impulses) are larger in the intact limb of servicemembers with versus without unilateral lower limb loss and whether intact limb loading differs between shorter (B 6 months) versus longer (C 2 years) durations of ambulation with a prosthesis. 4.45-16.79; 10.18-12.81] 4.64-14.47; 8.26-9.74 82-19.51; 12.98-15.05]; ES = 0.43; p = 0.001), respectively. Intact limb mean and peak vertical ground reaction force loading rates were also larger in subjects with transfemoral limb loss with B 6 months and C 2 years of experience ambulating with a prosthesis versus control subjects .68] versus 9.03 BW/s [4.64-14.47; 8.26-9.74]; ES C 0.53; p \ 0.001;.05]; ES C 0.68; p \ 0.001, respectively). Similarly, intact limb vertical ground reaction force impulses ; ES C 0.53, p \ 0.001) were also larger among both groups of transfemoral subjects versus control subjects, respectively. Limb loading variables were not statistically different between times ambulating with a prosthesis within groups with transtibial or transfemoral limb loss. Conclusions Larger intact limb loading in individuals with traumatic transtibial loss were only noted early in the rehabilitation process, but these variables were present early and late in the rehabilitation process for those with transfemoral limb loss. Such evidence suggests an increased risk for early onset and progression of arthritis in the intact limb, especially in those with transfemoral limb loss. Clinical Relevance Interventions should focus on correcting modifiable gait mechanics associated with arthritis, particularly among individuals with transfemoral limb loss, to potentially mitigate the development and progression in this population.versus 9.03 BW/s [

show abstract

“…These asymmetries have been reported to contribute to secondary injuries such as osteoarthritis, joint degeneration, and low-back pain [7,[9][10][11][12][13][14][15]. Servicemembers with trauma, including amputation, to one or both lower limbs may be at a greater risk for secondary injuries because of additional physical compensations during ambulation.…”

Section: Introductionmentioning

confidence: 99%

Assessment of transfemoral amputees using C-Leg and Power Knee for ascending and descending inclines and steps

Wolf

Everding

Linberg

et al. 2012

JRRD

View full text Add to dashboard Cite

Abstract-Adding active power to a prosthetic knee unit may improve function and reduce the potential for overuse injuries in persons with transfemoral amputation (TFA). Servicemembers who have sustained a TFA are often young and motivated to perform at high functional levels. The goal of this article is to compare the biomechanics of ramp and stair descent and ascent for participants using the C-Leg and the Power Knee (PK). Subjects were asked to ascend and descend an instrumented staircase and 12 degree ramp at their comfortable pace while equipped with retroreflective markers. Temporal-spatial and kinetic data were collected. Knee power generated by the nondisabled limb during stair ascent for subjects wearing the C-Leg was significantly greater than for those wearing the PK. Knee power generated by prosthetic knee units was significantly greater for subjects while wearing the PK. Although the PK reduced the power required from the nondisabled knee during stair climbing, it does not appear to be superior to the CLeg for other tasks. Adding power to a prosthetic knee may reduce wear on the nondisabled limb; however, there are still limitations that require improvement.

show abstract

Bone and joint changes in lower limb amputees.

Cited by 206 publications

References 6 publications

Asymmetric knee loading in advanced unilateral hip osteoarthritis

Asymmetric knee loading in advanced unilateral hip osteoarthritis

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Assessment of transfemoral amputees using C-Leg and Power Knee for ascending and descending inclines and steps

Contact Info

Product

Resources

About