Ruud A Leijendekkers1, Gerben van Hinte1, Maria Wg Nijhuis-van der Sanden1,2, J Bart Staal2. 1. a Radboud University Medical Center , Department of Orthopedics, Physical Therapy , Nijmegen , The Netherlands. 2. b Radboud University Medical Center , Scientific Center for Quality of Care , Nijmegen , The Netherlands.
Abstract
BACKGROUND: In patients with a transfemoral amputation socket-related problems are associated with reduced prosthetic use, activity, and quality of life. Furthermore, gait asymmetries are present that may explain secondary complaints. Bone-anchored prostheses (BAPs) may help these patients. Two types of BAP are available, screw and press-fit implants. Rehabilitation following surgery for a press-fit BAP is poorly described. PURPOSE: To describe a rehabilitation program designed to minimize compensation strategies and increase activity using a case-report of an active, 70-year-old man with a traumatic transfemoral amputation who had used a socket prosthesis for 52 years and received a press-fit BAP [Endo-Exo Femoral Prosthesis - EEFP]. INTERVENTION: A 13-week physiotherapy program. OUTCOMES: Outcomes were assessed before surgery, at the end of rehabilitation, and six-month and one-year follow-ups. After rehabilitation gait had improved, the patient had more arm movement, more pelvic shift, less hip rotation during swing phase on the prosthetic side, and absence of vaulting on the sound side. Isometric hip abductor strength was 15% higher on the sound side and 16% higher on the prosthetic side, and walking distance increased from 200 m to 1500 m. At the six-month follow-up, the patient had lower back complications and reduced hip abductor strength and walking distance. At one-year follow-up, walking distance had recovered to 1000 m and gait pattern had improved again, with yielding and absence of terminal impact on the prosthetic side. CONCLUSION: The described rehabilitation program may be an effective method of improving gait in patients with an EEFP even after long-term socket usage.
BACKGROUND: In patients with a transfemoral amputation socket-related problems are associated with reduced prosthetic use, activity, and quality of life. Furthermore, gait asymmetries are present that may explain secondary complaints. Bone-anchored prostheses (BAPs) may help these patients. Two types of BAP are available, screw and press-fit implants. Rehabilitation following surgery for a press-fit BAP is poorly described. PURPOSE: To describe a rehabilitation program designed to minimize compensation strategies and increase activity using a case-report of an active, 70-year-old man with a traumatic transfemoral amputation who had used a socket prosthesis for 52 years and received a press-fit BAP [Endo-Exo Femoral Prosthesis - EEFP]. INTERVENTION: A 13-week physiotherapy program. OUTCOMES: Outcomes were assessed before surgery, at the end of rehabilitation, and six-month and one-year follow-ups. After rehabilitation gait had improved, the patient had more arm movement, more pelvic shift, less hip rotation during swing phase on the prosthetic side, and absence of vaulting on the sound side. Isometric hip abductor strength was 15% higher on the sound side and 16% higher on the prosthetic side, and walking distance increased from 200 m to 1500 m. At the six-month follow-up, the patient had lower back complications and reduced hip abductor strength and walking distance. At one-year follow-up, walking distance had recovered to 1000 m and gait pattern had improved again, with yielding and absence of terminal impact on the prosthetic side. CONCLUSION: The described rehabilitation program may be an effective method of improving gait in patients with an EEFP even after long-term socket usage.
Authors: Jamal Mohamed; David Reetz; Henk van de Meent; Hendrik Schreuder; Jan Paul Frölke; Ruud Leijendekkers Journal: Clin Orthop Relat Res Date: 2022-04-01 Impact factor: 4.755
Authors: Ruud A Leijendekkers; Gerben van Hinte; Amy D Sman; J Bart Staal; Maria W G Nijhuis-van der Sanden; Thomas J Hoogeboom Journal: PLoS One Date: 2017-06-22 Impact factor: 3.240
Authors: Ruud A Leijendekkers; Thomas J Hoogeboom; Gerben van Hinte; Lars Didden; Thomas Anijs; Maria W G Nijhuis-van der Sanden; Nico Verdonschot Journal: PLoS One Date: 2019-05-21 Impact factor: 3.240