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A Step in the Right Direction: Assessing Prosthetic Satisfaction and Mobility in Lower Limb Amputees with Osseointegration
Clara Choate
*2, Anna M. Vaeth
2, Albert Y. Truong
2, Jason S. Hoellwarth
1, Taylor J. Reif
1, S R. Rozbruch
1, David Otterburn
21Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY; 2Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, NY
Purpose: Periprosthetic pain and poor fit can impair quality of life in amputees with socket-based protheses. Osseointegration (OI) is a novel alternative to socket prostheses, using a titanium rod implanted into the residual limb. Nerve and soft tissue reconstruction can be done concurrently by a plastic surgeon to reduce pain and improve comfort. This study evaluated satisfaction and mobility limitations in lower-limb amputees with OI prostheses.
Methods: This was a cross-sectional survey including patients who received lower-limb OI implants at our institution. Collected demographics included age, amputation level, and body mass index (BMI). Participants completed a validated prosthesis experience survey 1 month to 6 years postoperatively. The Trinity Amputation and Prosthesis Experience Scales (TAPES) assessed satisfaction (1-10 scale) and limitations to activities (0=not limited, 1=limited a little, 2=limited a lot) with higher scores indicating greater limitations.
Results: A total of 27 patients (12 transtibial, 15 transfemoral) participated. The mean age was 50.9 and mean BMI was 28. The mean satisfaction with OI prostheses was 7.56 out of 10. The most limited activity was going to work (1.78) while the least limited was walking 100 meters (0.52). Walking half a mile and hobbies were between no limitation and little limitation (0.81 and 0.78, respectively). Mean total limitation score was 11.8 out of 20. Transtibial amputees had significantly lower limitation scores than transfemoral amputees (9.1 vs 13.8,
p=0.015). Satisfaction did not differ significantly between amputation level (7.67 vs. 7.47,
p=0.85).
Conclusion: Our findings showed high overall satisfaction ratings with OI prostheses and minimal limitations in key activities. Transtibial amputees experienced fewer mobility limitations, highlighting the ambulation benefits of OI prostheses for below-the-knee amputees. Future studies using the TAPES survey will allow us to compare prosthesis satisfaction between socket-based and OI-based prostheses for amputees.
