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Changes in Tissue Composition and Load Response After Transtibial Amputation Indicate Biomechanical Adaptation.
J L Bramley1, P R Worsley2, D L Bader2
1School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Mailpoint M7, University Road, Southampton, SO17 1BJ, UK.
Annals of Biomedical Engineering
|September 28, 2021
Summary
Lower-limb amputation leads to increased intramuscular fat and stiffness in residual limb soft tissues. These changes impact prosthetic socket fit and increase tissue damage risk.
Area of Science:
- Biomedical Engineering
- Orthopedics
- Rehabilitation Medicine
Background:
- Residual limb soft tissues are vulnerable to damage despite potential for conditioning.
- Previous imaging studies did not differentiate superficial vs. intramuscular adipose distribution.
- Intramuscular fat levels correlate with reduced tolerance to mechanical loading, impacting prosthetic use.
Purpose of the Study:
- To compare soft tissue morphology and biomechanical response to mechanical loading in individuals with and without transtibial amputation.
- To investigate the relationship between intramuscular adipose distribution, tissue stiffness, and prosthetic socket variables.
Main Methods:
- Magnetic resonance imaging (MRI) was used to assess soft tissue morphology.
- Tissue structural stiffness measurements were combined with MRI data.
- Comparison between residual limbs, intact contralateral limbs, and control limbs.
Main Results:
- Residual limbs showed significantly higher intramuscular adipose infiltration compared to intact and control limbs.
- Intramuscular adipose content negatively correlated with daily prosthetic socket use.
- Residual limbs exhibited increased stiffness at the patellar tendon site.
Conclusions:
- Transtibial amputation results in muscle atrophy and adaptation, characterized by increased intramuscular fat and stiffness.
- These tissue alterations are critical for understanding prosthetic socket design and soft tissue damage risk in amputees.
