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A New Implant for Transfemoral Amputation: Improved Gait and Comfort

Open Journal of Orthopedics 2021年第6期11卷 199-205页

作者： Mathieu Assal Halah Kutaish Richard Stern Alice Bonnefoy-Mazure Antoine Acker axel gamulin Stephane Stephane Gorki Carmona Alain Lacraz Foot & Ankle Surgery Center Centre Assal Hirslanden Clinique La Colline Geneva Switzerland Faculty of Medicine Geneva University Geneva Switzerland Willy Taillard Laboratory of Kinesiology Geneva University Hospitals and Geneva University Geneva Switzerland Division of Orthopaedic Surgery and Traumatology University Hospitals of Geneva Geneva Switzerland

Introduction: Transfemoral amputation results in a prosthesis which bears weight on the ischium. Gait disturbance, lack of an end-bearing stump and discomfort in the groin from the socket even while sitting, are important issues. Methods: This is a pilot report of an ongoing randomized blind clinical trial of a new intramedullary implant post transfemoral amputation. Here, we describe a single case illustrating the surgical technique and clinical outcome of a dysfunctional post-traumatic transfemoral amputation addressed with this implant. Clinical gait analysis, SF-12 and VAS were assessed pre- and post-intervention at 6 months of follow-up. Results: An improved stump control is accomplished by means of myoplasty and myodesis through an end-cap. Stride width improved from 0.21 m pre-op to 0.13 m post-op, and more symmetrical stride length (△0.21 m pre-op vs. △0.06 m post-op) was noted, indicating improved gait quality and stability. Gait velocity increased (0.51 ± 0.04 m/s pre-op vs. 0.64 ± 0.02 m/s post-op). Conclusion: This technique reveals improvements in gait parameters in a transfemoral amputee treated with a new procedure. Improved prosthesis control, sitting comfort, greater hip range of motion, better gait stability, and enhanced walking abilities were noted.

关键词： Above Knee Amputation Transfemoral Amputation Gritti-Stokes Weight-Bearing End-Cap

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