Article

The objective of this study was to examine the prevalence of low bone mineral density, based on World Health Organization diagnostic criteria, in patients with lower limb amputation. This is a cross-sectional study of 52 lower limb amputees in a national prosthetics center. All completed a questionnaire and had laboratory investigations and dual-energy x-ray absorptiometry assessment of lumbar spine and both hips. Study participants were 24 transtibial amputees (46.2%), 19 (36.5%) transfemoral amputees, 8 (15.4%) bilateral amputees, and 1 (1.9%) with a hip disarticulation. Six (11.5%) were unable to walk at all, 26 (50%) were only indoor walkers, and 20 (38.5%) were outdoor walkers. Thirty-three patients (68.8%) were vitamin D deficient, 25-hydroxyvitamin D level less than 50 nmol/L, and five (10.4%) had insufficiency, level between 50 and 72 nmol/L. Based on T-scores, 26 (50%) had osteopenia and 20 (38.5%) had osteoporosis at either lumbar spine or hip. Z-score <=?1 but >?2 occurred in 25 (48.1%), and Z-score <=?2 occurred in 10 (19.2%) at a minimum of one site. Negative correlation was found between duration of disability and bone mineral density (BMD) at the neck of femur (r = ?0.447, p = 0.002) and total proximal femur
(r = ?0.391, p = 0.009) on the amputated side. There was a significant difference between BMD of the sound and amputated sides at the neck of femur (t = 6.17, df = 43, p < 0.001) and total proximal femur (t = 7.79, df = 43, p < 0.001). BMD was not affected by amputation level or ambulatory status. Osteopenia and osteoporosis occur frequently in lower limb amputees. Hip BMD on the amputated side is correlated with duration since amputation. Bone health monitoring should form part of the long-term follow-up in this patient population

Langue : ANGLAIS