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Journal of NeuroEngineering and Rehabilitation
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Open Access 01-12-2024 | Research

A one-year follow-up case series on gait analysis and patient-reported outcomes for persons with unilateral and bilateral transfemoral amputations undergoing direct skeletal fixation

Authors: Diana Toderita, Tiereny McGuire, Alice M. Benton, Charles Handford, Arul Ramasamy, Paul Hindle, Anthony M. J. Bull, Louise McMenemy

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2024

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Abstract

Background

Direct skeletal fixation, a surgical technique enabling the attachment of an external prosthesis directly to the bone through a percutaneous implant, offers an enticing solution for patients with lower limb amputations facing socket-related issues. However, understanding of its impact on musculoskeletal function remains limited.

Methods

This study compares pre- and 1-year post-osseointegration surgery outcomes, focusing on patient-reported measures and musculoskeletal system function during level-ground walking. Two participants with unilateral transfemoral amputations and two participants with bilateral transfemoral amputations completed the questionnaire for transfemoral amputations (Q-TFA) and underwent gait analysis. Musculoskeletal modelling simulations were conducted.

Results

Results showed improved Q-TFA scores for all participants. Participants showed reduced amputated limb peak hip extension angles, flexion torques and contact forces at the push-off phase of the gait cycle. Post-operatively, hip adduction angles and abduction moments increased, indicating more natural gait patterns. Whilst one participant demonstrated increased post-operative walking speed, others walked more slowly.

Conclusions

The study revealed diverse adaptation patterns after one year in individuals with transfemoral amputations transitioning to bone-anchored prostheses. Additional longer-term data is necessary to enable generalization and clinical implications of these results.
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Metadata
Title
A one-year follow-up case series on gait analysis and patient-reported outcomes for persons with unilateral and bilateral transfemoral amputations undergoing direct skeletal fixation
Authors
Diana Toderita
Tiereny McGuire
Alice M. Benton
Charles Handford
Arul Ramasamy
Paul Hindle
Anthony M. J. Bull
Louise McMenemy
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2024
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-024-01509-4

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