Improvements in hip- and pelvic motion for patients with osseointegrated trans-femoral prostheses

This study describes the changes in hip and pelvic kinematics in 19 trans-femoral amputees, who were treated with an osseointegrated trans-femoral prosthesis. Patients were studied with 3-dimensional gait analysis, walking with socket prosthesis within two days before the osseointergration procedure. The post-operative gait analysis was carried out at the 2 year follow-up visit. Fifty-seven; age-, side- and gender-matched healthy subjects served as controls. Post-operative data showed that patients who had an osseointegrated transfemoral prosthesis increased their hip extension by 7.3 degrees (p = 0.007), changing from -2.6 degrees (range -13.4 degrees to 10.7 degrees) to -9.9 degrees (range -29.4 degrees to 5 degrees). Moreover, the pre-operative anterior pelvic tilt was reduced by 4.0 degrees (p = 0.016), changing from 21.7 degrees (range 11.9-34.8 degrees) to 17.7 degrees (range 5.5-25.7 degrees). Values for hip extension and pelvic tilt changed toward those of controls. These results confirm that patients treated with osseointegrated trans-femoral prosthesis encounter significant changes of their kinematic pattern in terms of hip extension and anterior pelvic tilt. Even though the changes were moderate they may, in the long-term have a positive influence on low-back biomechanics and could contribute to reducing the risk of further problems with low back pain. (C) 2010 Elsevier B.V. All rights reserved.