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Related Experiment Video

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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Total hip arthroplasty after lower extremity amputation.

Derek F Amanatullah, Robert T Trousdale, Rafael J Sierra

    Orthopedics
    |May 14, 2015
    PubMed
    Summary

    Total hip arthroplasty significantly improves hip function for lower extremity amputees, especially those with ipsilateral or below-knee amputations. This procedure offers substantial benefits for patients facing increased osteoarthritis risks post-amputation.

    Area of Science:

    • Orthopedic Surgery
    • Rehabilitative Medicine
    • Biomechanical Engineering

    Background:

    • Lower extremity amputation significantly increases the risk of hip osteoarthritis (OA) compared to the general population.
    • Amputees face higher physical demands, exacerbating joint stress and OA development.
    • Above-knee amputations carry a higher risk of ipsilateral hip OA than below-knee amputations.

    Purpose of the Study:

    • To evaluate the efficacy of total hip arthroplasty (THA) in lower extremity amputees.
    • To compare THA outcomes based on amputation level (ipsilateral vs. contralateral) and type (above-knee vs. below-knee).
    • To assess functional improvements and revision rates following THA in this patient cohort.

    Main Methods:

    • Retrospective review of 35 total hip arthroplasties performed after lower extremity amputation.

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  • Analysis of clinical follow-up data, including time from amputation to THA and Harris Hip Scores.
  • Comparison of outcomes based on amputation laterality and level.

    • Main Results:

    • THA led to statistically significant improvements in Harris Hip Scores for both contralateral (35.9 to 76.8) and ipsilateral (25.4 to 78.6) amputations.
    • Patients with ipsilateral or below-knee amputations progressed to THA more rapidly than those with contralateral or above-knee amputations.
    • Revision rates were 17.7% for contralateral and 11.1% for ipsilateral THA.

    Conclusions:

    • Total hip arthroplasty provides clinically significant functional improvements for lower extremity amputees.
    • Amputation level and laterality influence the timing of THA and potentially revision rates.
    • THA is a viable option for managing hip OA and improving quality of life in amputee patients.