Effect of Amputation Level on Energy Expenditure During Overground Walking by Children with an Amputation

Jeans, Kelly A.; Browne, Richard; Karol, Lori A.

doi:10.2106/jbjs.i.01557

Cited by 62 publications

(41 citation statements)

References 18 publications

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“…28 Thus, amputation may not unavoidably increase the cost of walking and pre-amputation metabolic costs of walking may be achieved with passive prostheses. Similar findings of equivalent metabolic costs between individuals with and without TTA when walking at the same speed occur infrequently in the literature but have been reported in children with traumatic amputations or congenital limb absences 29,30 and other cohorts of Service Members. 12 Although the equivalent metabolic costs between individuals with TTA and controls were promising, it was not expected that individuals with more proximal amputations (e.g.…”

Section: Introductionsupporting

confidence: 82%

The influence of traumatic transfemoral amputation on metabolic cost across walking speeds

Esposito

Rábago

Wilken

2018

Prosthetics &Amp; Orthotics International

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Although the transfemoral amputation group was relatively young, physically fit, and had extensive access to rehabilitative care, the metabolic cost of walking fell within the ranges of the literature on older or presumably less fit individuals with transfemoral amputation. Clinical relevance Developments in prosthetic technology and/or rehabilitative care may be warranted and may reduce the metabolic cost of walking in individuals with a transfemoral amputation.

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Section: Introductionsupporting

confidence: 82%

The influence of traumatic transfemoral amputation on metabolic cost across walking speeds

Esposito

Rábago

Wilken

2018

Prosthetics &Amp; Orthotics International

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“…The level of lower extremity amputation is directly proportional to the increase in oxygen consumption required for ambulation. 2,3 Retrospective studies found a wide range, from 5% to 61%, of either the ipsilateral or contralateral hip osteoarthritis after a lower extremity amputation. 4,5 Kulkarni et al 5 retrospectively evaluated 44 lower extremity amputees and found that 24 (55%) of the ipsilateral hips and 8 (18%) of the contralateral hips had osteoarthritis.…”

mentioning

confidence: 99%

Total Hip Arthroplasty After Lower Extremity Amputation

2015

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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. The authors retrospectively reviewed 35 total hip arthroplasties after lower extremity amputation. The mean clinical follow-up was 5.3±4.0 years. The mean time from lower extremity amputation to total hip arthroplasty was 12.2±12.8 years after a contralateral amputation and 5.4±6.0 years after an ipsilateral amputation (P=.050). The mean time to total hip arthroplasty was 15.6±15.4 years after an above knee amputation and 6.4±6.1 years after a below knee amputation (P=.021). There was a statistically significant improvement in the mean Harris Hip Score from 35.9±21.8 to 76.8±12.8 with total hip arthroplasty after a contralateral amputation (P<.001). There also was a statistically significant improvement in the mean Harris Hip Score from 25.4±21.7 to 78.6±17.1 with total hip arthroplasty after an ispilateral amputation (P<.001). Three (17.7%) total hip arthroplasties after a contralateral amputation and 2 (11.1%) total hip arthroplasties after an ipsilateral amputation required revision total hip arthroplasty. Patients with an ipsilateral amputation or a below knee amputation progress to total hip arthroplasty faster than those with a contralateral amputation or an above knee amputation, respectively. Lower extremity amputees experience clinically significant improvements with total hip arthroplasty after lower extremity amputation.

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“…6 Although these functional results are sobering, it needs to be borne in mind that disarticulation of the hip is a major undertaking with a significant associated mortality rate 16,17 Disarticulation is difficult to manage with a prosthesis, which is cumbersome and physically demanding. 18 In addition, Chin et al 19 have shown that the mobilisation of elderly patients following disarticulation of the hip is very limited, and that wheelchair use represented an alternative and realistic goal. There may also be significant psychological sequelae.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary and total femur replacement in revision arthroplasty as a last limb-saving option

Hoell

Butschek

Gosheger

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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There has been a substantial increase in the number of hip and knee prostheses implanted in recent years, with a consequent increase in the number of revisions required. Total femur replacement (TFR) following destruction of the entire femur, usually after several previous revision operations, is a rare procedure but is the only way of avoiding amputation. Intramedullary femur replacement (IFR) with preservation of the femoral diaphysis is a modification of TFR. Between 1999 and 2010, 27 patients with non-oncological conditions underwent surgery in our department with either IFR (n = 15) or TFR (n = 12) and were included in this study retrospectively. The aim of the study was to assess the indications, complications and outcomes of IFR and TFR in revision cases. The mean follow-up period was 31.3 months (6 to 90). Complications developed in 37% of cases, 33% in the IFR group and 4% in the TFR group. Despite a trend towards a slightly better functional outcome compared with TFR, the indication for intramedullary femur replacement should be established on a very strict basis in view of the procedure's much higher complication rate.

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Effect of Amputation Level on Energy Expenditure During Overground Walking by Children with an Amputation

Abstract: Children with an amputation through the knee or distal to the knee were able to maintain a normal walking speed without significantly increasing their energy cost. Only when the amputation is above the knee do children walk significantly slower and with an increased energy cost.

Cited by 62 publications

References 18 publications

The influence of traumatic transfemoral amputation on metabolic cost across walking speeds

The influence of traumatic transfemoral amputation on metabolic cost across walking speeds

Total Hip Arthroplasty After Lower Extremity Amputation

Intramedullary and total femur replacement in revision arthroplasty as a last limb-saving option

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