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LIMB-Q Analysis of Prosthetic Function and Satisfaction After Below-Knee Amputation
Leila I. Jones
*1, Rachel N. Rohrich
2, Finn Tobias
1, Ryan P. Lin
2, Sami Ferdousian
2, Hermon Tekalign
2, Richard C. Youn
2, Karen K. Evans
2, Christopher E. Attinger
2, Stephen Baker
21Georgetown University School of Medicine, Washington, ; 2Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, WA
Background: Optimal prosthetic function is key to restoring mobility and quality of life after below-knee amputation (BKA). Yet, many patients experience limited use or dissatisfaction with fit, comfort, or appearance. The LIMB-Q Prosthesis Modules, a validated patient-reported outcome (PRO) measure, assess prosthetic function and satisfaction. This study evaluates clinical factors associated with these outcomes in unilateral nontraumatic BKA patients.
Methods: A cross-sectional survey was conducted among patients with unilateral nontraumatic BKA presenting for routine follow-up at a high-volume limb center. Eligible patients had undergone BKA or lower extremity surgery ≥6 months earlier, had no open wounds, and were using a prosthesis. The LIMB-Q Prosthesis Module assessed two domains: Prosthesis: Function and Prosthesis: Satisfaction. Function items evaluate prosthesis use in physical activity and ambulation. Satisfaction items measure comfort, fit, and appearance. Higher scores reflect better outcomes. Univariate regression identified clinical factors associated with LIMB-Q scores.
Results: Thirteen patients were included. Most were male (76.9%) with a mean age of 65.6 ± 8.0 years and BMI of 33.5 ± 5.6 kg/m^2. Diabetes (92.3%), peripheral vascular disease (100%), neuropathy (76.9%), chronic kidney disease (61.5%), and end-stage renal disease (15.4%) were prevalent. Most were ambulatory: 46.2% walked independently, 46.2% used assistive devices. Higher BMI was significantly associated with worse prosthetic function (β = -2.5, p = 0.032). Neuropathy also showed a negative trend (β = -26.3, p = 0.075). No clinical factors significantly affected satisfaction.
Conclusion: In this pilot study, higher BMI and neuropathy were linked to worse prosthetic function, likely due to biomechanical and neuromuscular factors. Satisfaction was not influenced by comorbidities, suggesting other contributors like customization, rehab participation, and psychological adaptation.
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