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Published on: January 24, 2018
Transtibial Amputation Outcomes Study (TAOS): Comparing Transtibial Amputation With and Without a Tibiofibular
Michael J Bosse1, Saam Morshed, Lisa Reider
1*Orthopaedic Trauma Service, Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC; †Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, University of San Francisco; ‡Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health; §Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma; ‖Department of Orthopaedic Surgery, Naval Medical Center San Diego; ¶Harborview Medical Center, University of Washington; **Department of Orthopaedic Surgery, Wake Forest Baptist Health; ††Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health; and ‡‡Orthopaedic Trauma Service, Tampa General Hospital, Florida Orthopaedic Institute.
Abstract:
The optimal technique for a transtibial amputation in a young, active, and healthy patient is controversial. Proponents of the Ertl procedure (in which the cut ends of the tibia and fibula are joined with a bone bridge synostosis) argue that the residual limb is more stable which confers better prosthetic fit and improved function especially among high-performing individuals. At the same time, the Ertl procedure is associated with longer operative and healing time and may be associated with a higher complication rate compared with the standard Burgess procedure. The TAOS is a prospective, multicenter randomized trial comparing 18-month outcomes after transtibial amputation using the Ertl versus Burgess approach among adults aged 18 to 60. The primary outcomes include surgical treatment for a complication and patient-reported function. Secondary outcomes include physical impairment, pain, and treatment cost.
