Clinical Evidence Regarding Outcome Measures in Traumatic Lower Limb Amputations Background



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Clinical Evidence Regarding Outcome Measures in Traumatic Lower Limb Amputations

Background

  • The height of the residual limb following amputation has a large impact on the amputee’s functional capacity and quality of life.

  • Physicians need accurate information as to the impact of the level of amputation on their patient’s lives.

  • It is understood that the more proximal the level of amputation the greater the physiological demand on the amputee.


Clinical Evidence
Quality of Life

  • Perceived quality of life in unilateral amputee patients progressively and significantly lowers as the level of amputation becomes more proximal from BKA to TKA to AKA.

  • Patients with bilateral amputation have a higher perceived quality of life than do unilateral TKA and AKA patients, but similar to unilateral BKA patients.


Mobility

  • TKA patients are able to walk further than AKA or bilateral amputees.

  • AKA and bilateral amputees show little to no difference in their mobility (assessed by ability to walk greater than 500ft.)


Employment

  • Approximately 70% of lower-limb amputees were able to return to employment post-amputation regardless of the residual limb height.

  • Lower proportions of active duty military were able to return to duty

    • 16% of BKA

    • 11% of AKA


Prosthesis Use

  • Patients with BKA wore their prosthesis significantly more than those with an AKA.

  • Patients with TKA wore their prosthesis less than BKA and AKA, but more than patients with bilateral amputations.

Pain Symptoms

  • Pain experienced with the residual limb was found to be similar in BKA and AKA.

  • Patients with TKA experience greater levels of perceived pain than do BKA or AKA patients.

  • Bilateral amputees suffer from the least amount of pain of all lower-limb amputees.



Penn-Barwell JG. Outcomes in lower limb amputation following trauma: a systematic review and meta-analysis. Injury. Dec 2011;42(12):1474-1479.



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