Objective

Following a transfemoral (TF) amputation, the ability to walk with a prosthesis is the main objective of rehabilitation. The achieved speed of walking is considered a determining factor in the amputee’s perception of quality of life.

This experimental before-after study evaluates the walking abilities and improvement of important parameters such as gait, walking speed, pain and hours of prosthesis use in transfemoral amputees after placing a novel femoral implant that permits distal weight bearing of the residuum within a socket, adapted for distal load bearing.

Material and methods

Thirty TF amputees with an amputee history of more than 12 months received an all-inside femoral implant, comprised of a femoral stem and a polyethylene spacer that allows distal load of the residuum within an adapted socket. The post-intervention follow-up period was 14 months.

The applied rehabilitation schedule was our standard one, and no hardware changes were allowed during the follow-up period of 14 months, except for the adapted socket. Functionality was evaluated using the standard 2-minute walk test (2MWT) and the physiological cost index (PCI).

Results

To date 19 patients (8 trauma, 8 vascular and 3 tumour patients) have finished the follow-up period.

Prior to the implant placement the mean 2MWT covered distance was 103.16 m (SD = 33.03), and at 14 months was 124.95 m (SD = 39.22), ( P = 0.00); an increase of 21.1%.

The initial mean Visual Analogue Pain (VAS) score was 2.26 (SD = 2.76) and at 14 months 0.42 (SD = 0.77), ( P < 0.005), a reduction of 81.4%. The PCI reduction (D heart rate/walking speed) was not statistically significant ( P < 0.596). The observed increase of oxygen consumption in the vascular group (+ 20.15%) also indicates an additional beneficial general health improvement for this type of patients.

Discussion/Conclusion

The results of the present study show significant improvements in walking speed, pain reduction, hours of prosthesis use and general health status at 14 months after having received a femoral distal load implant in patients of different ethiology.