Prosthesis Rehabilitation in a Left Transfemoral Amputee with Rheumatoid Arthritis

Ishizaka M, Imai Y, Murata S, Okazaki T. Prosthesis Rehabilitation in a Left Transfemoral Amputee with Rheumatoid Arthritis. Jpn J Compr Rehabil Sci 2025; 16: 30-36.

This report describes the rehabilitation experience of a left-sided transfemoral amputee. The patient developed rheumatoid arthritis and multiple pyogenic arthritis immediately after left transfemoral amputation; additionally, he had multiple joint dysfunction and complications of immobilization, which altered his activities of daily living (ADL). He experienced difficulties in maintaining his economic status and living in his environment.

The patient was in his 50s, and at the beginning of the intervention, upper limb joint pain due to rheumatoid arthritis, muscle weakness of the limbs and trunk, reduced exercise tolerance caused by immobilization, and ADL disturbances, including one-leg standing, made prosthetic gait training impossible. Nevertheless, the patient was young, and his physical activity had been preserved until the left transfemoral amputation. Therefore, we speculated that he could achieve a prosthetic gait by improving the complications of immobilization under appropriate rheumatoid arthritis control. Rehabilitation training was conducted to improve ADL ability in stages taking rheumatoid arthritis into consideration, and social resources were utilized. Finally, he achieved prosthetic gait ability, which was necessary for survival in his living environment, and was discharged.

Even in cases where successful prosthetic ambulation is considered difficult during lower limb amputation, it is important not to exclude a patient from prosthesis fabrication by carefully predicting residual abilities that could be acquired afterward.