Article

Lower limb amputation sometimes predisposes to degenerative secondary
disorders. OBJECTIVES: To evaluate the distal femoral cartilage thicknesses of
patients with unilateral transtibial amputations using ultrasound and to
investigate the relationship between cartilage thickness and disease-related
parameters. STUDY DESIGN: Cross-sectional study. METHODS: Twenty-four unilateral
transtibial amputees (mean age: 46.4 +/- 8.5 years, range: 28-60 years) were
evaluated. Duration of prosthesis use (years) and daily walking time with
prosthesis (hours) were recorded. Functional status was assessed by gate velocity
(m/s), and 6-min walking distance (m) with prosthesis. Ultrasound was used to
measure distal femoral cartilage thicknesses bilaterally at medial/lateral
condyles and the intercondylar areas. The percentages of cartilage loss (of the
amputee-side in comparison with the nonamputee-side) were calculated. RESULTS:
Compared to the nonamputee-sides, distal femoral cartilage was significantly
thinner at lateral condyles and the intercondylar areas on the amputee-sides (p <
0.05). Significant positive correlations were detected between the percentage of
cartilage loss (at all three sites of measurement) and gate velocity, 6-min
walking distance, and daily walking time with prosthesis (all p < 0.05).
CONCLUSIONS: Future prospective controlled studies are warranted to determine the
principles of optimum prosthetic use regarding its possible effects on the
femoral cartilage of amputee patients. The correlations
between the cartilage loss in the amputee extremity with faster gait and longer
daily prosthetic use suggest that abnormal gait patterns might increase the
loading on the amputated extremity.

Langue : ANGLAIS