Walking Ability and Quality of Life in Subjects With Transfemoral Amputation: A Comparison of Osseointegration With Socket Prostheses

Objective: To investigate walking ability and quality of life of osseointegrated leg prostheses compared with socket prostheses. Design: Prospective case-control study. Setting: University medical center. Participants: Subjects (N=22) with transfemoral amputation (1 bilateral) referred to our center because of socket-related skin and residual limb problems resulting in limited prosthesis use. Their mean age was 46.5 years (range, 23-67y) and mean time since amputation was 16.4 years (range, 2-45y). Causes of amputation were trauma (n=20) and tumor (n=2). Intervention: Implantation of an osseointegration prosthesis (OIP). Main Outcome Measures: Global score of the Questionnaire for Persons With a Transfemoral Amputation (Q-TFA), prosthesis use, 6-minute walk test (6MWT), Timed Up & Go (TUG) test, and oxygen consumption during treadmill walking. Results: With the socket prosthesis, the mean +/- SD Q-TFA global score, prosthesis use, 6MWT, TUG, and oxygen consumption were 39 +/- 4.7 points, 56 +/- 7.9h/wk, 321 +/- 28m, 15.1 +/- 2.1 seconds, and 1330 +/- 310mL/min, respectively, and significantly improved with OIP to 63 +/- 5.3 points, 101 +/- 2.4h/wk, 423 +/- 21m, 8.1 +/- 0.7 seconds, and 1093 +/- 361mL/min, respectively. Conclusions: Osseointegration is a suitable intervention for persons whose prosthesis use is reduced because of socket-related problems. Subjects with OIP significantly increased their walking ability and prosthesis-related quality of life. (C) 2013 by the American Congress of Rehabilitation Medicine