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

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 i...

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Main Authors: Diana Toderita, Tiereny McGuire, Alice M. Benton, Charles Handford, Arul Ramasamy, Paul Hindle, Anthony M. J. Bull, Louise McMenemy
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Journal of NeuroEngineering and Rehabilitation
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Online Access:https://doi.org/10.1186/s12984-024-01509-4
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author Diana Toderita
Tiereny McGuire
Alice M. Benton
Charles Handford
Arul Ramasamy
Paul Hindle
Anthony M. J. Bull
Louise McMenemy
author_facet Diana Toderita
Tiereny McGuire
Alice M. Benton
Charles Handford
Arul Ramasamy
Paul Hindle
Anthony M. J. Bull
Louise McMenemy
author_sort Diana Toderita
collection DOAJ
description 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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spelling doaj-art-38d64b185c38467f9f55b24282019cae2025-08-20T02:51:43ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032024-11-0121111210.1186/s12984-024-01509-4A one-year follow-up case series on gait analysis and patient-reported outcomes for persons with unilateral and bilateral transfemoral amputations undergoing direct skeletal fixationDiana Toderita0Tiereny McGuire1Alice M. Benton2Charles Handford3Arul Ramasamy4Paul Hindle5Anthony M. J. Bull6Louise McMenemy7Department of Bioengineering, Imperial College LondonDepartment of Bioengineering, Imperial College LondonDepartment of Bioengineering, Imperial College LondonDepartment of Bioengineering, Imperial College LondonDepartment of Bioengineering, Imperial College LondonSt. Paul’s HospitalDepartment of Bioengineering, Imperial College LondonDepartment of Bioengineering, Imperial College LondonAbstract 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.https://doi.org/10.1186/s12984-024-01509-4Osseointegrated prosthesesTransfemoral amputationGait analysisMusculoskeletal modelling
spellingShingle Diana Toderita
Tiereny McGuire
Alice M. Benton
Charles Handford
Arul Ramasamy
Paul Hindle
Anthony M. J. Bull
Louise McMenemy
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
Journal of NeuroEngineering and Rehabilitation
Osseointegrated prostheses
Transfemoral amputation
Gait analysis
Musculoskeletal modelling
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Osseointegrated prostheses
Transfemoral amputation
Gait analysis
Musculoskeletal modelling
url https://doi.org/10.1186/s12984-024-01509-4
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