The prevalence of osteoarthritis: Higher risk after transfemoral amputation?—A database analysis with 1,569 amputees and matched controls

Abstract

BackgroundSeveral studies have shown that patients with a unilateral amputation have an increased risk of developing osteoarthritis (OA) in the knee of their sound leg. OBJECTIVE: The first objective was to investigate whether amputees are more frequently affected by gon-, cox- or polyarthritis as well as back pain or spinal disorders. We hypothesized that mobile and active transfemoral amputees more often experience OA and spinal disorders than non-amputees. The second objective was to compare the mean age of the patients with OA.PatientsPatients with a unilateral transfemoral amputation (n = 1,569) and five abled-body control groups (each n = 1,569) matched in terms of age and gender resulting in total of 9,414 participants.MethodsGroups were analyzed regarding the prevalence of six selected diagnoses regarding musculoskeletal disorders.ResultsA significantly decreased prevalence of OA and specific disorders of the spine in transfemoral amputees compared to a control group was found. The amputees with OA are significantly younger than patients with OA in the control group.ConclusionThe results from the presented study contradict previously published literature. Apparently circumstances of life play an important role, like physical work and strenuous activities which are likely to be underrepresented in the amputee group. The results of the study need to be used cautiously due to the major limitation of the study which is the lack of detail in individual patients caused by the methodology.

Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee

“…However, our research shows that the gait of people with MicPK might be more similar to the correct gait in the frontal plane, whereas the degree of asymmetry in the transverse plane is greater Table 5 The mean, minimum, maximum, and range values of the variability of the symmetry function (relative to the norm) characterizing pelvic movements in frontal (POBLI), sagittal (PTILT), and transverse (PROT) plane as well as hip joint movements in frontal (HPAA), sagittal (HPFE), and transverse (HPROT) plane and knee joint movements sagittal plane (KEF) of an amputated limb (in) and an intact limb (un) than that of people with MechPK. This also influences an uneven load distribution, which results from an asymmetrical gait pattern regardless of module type [33]. Luetmer et al [8] and Devan et al [34] state that the type of prosthetic does not reduce the frequency of LBP, confirming this idea.…”

“…However, our research shows that the gait of people with MicPK might be more similar to the correct gait in the frontal plane, whereas the degree of asymmetry in the transverse plane is greater than that of people with MechPK. This also influences an uneven load distribution, which results from an asymmetrical gait pattern regardless of module type [ 33 ]. Luetmer et al [ 8 ] and Devan et al [ 34 ] state that the type of prosthetic does not reduce the frequency of LBP, confirming this idea.…”

Redefining Safety in Light of Human-Robot Interaction: A Critical Review of Current Standards and Regulations

“…This extension provides an instance of the temporal dimension of safety: it is no longer reserved for an immediate physical impact/harm, but such harm, such consequence, can appear at a later stage in time. This relates to the fact that, sometimes, harm appears after the continuous use of a device [in the case of wearable walking exoskeletons, abnormal muscle activation could cause a problem at a later stage causing what is called prospective liability, (Fosch-Villaronga and Özcan, 2020) or in the case of unilateral transfemoral amputation the intact limb joints have a higher prevalence of osteoarthritis, due to amputees not interacting optimally with their artificial limb (Welke et al, 2019)].…”

More than half of persons with lower limb amputation suffer from chronic back pain or residual limb pain: a systematic review with meta-analysis

“…Three authors responded to our request and their data were processed in the analyses [5,26,27]. Five studies used a retrospective cohort design [11,[31][32][33][34], three studies a prospective cohort design [25,35,36], one study was a secondary analysis of a randomized clinical trial (Table 1) [25]. All other studies were cross-sectional in design.…”

“…In most studies, questionnaires were sent to participants to gather the necessary data. Two studies used International Classification of Diseases Ninth or Tenth Revision codes (ICD-9 or ICD-10) [33,34].…”