Ambulation With a Transfemoral Bone-Anchored Powered Knee-Ankle Prosthesis: a Case Study

Recent advancements in powered prosthetic leg devices offer enhanced potential for mobility for individuals with lower limb amputations; however, challenges persist, particularly for those with transfemoral amputations and short residual limbs. This study investigates the combination of a bone-anchored prosthetic interface via osseointegration and a powered knee-ankle prosthesis, aiming to assess initial feasibility, functionality, and user experience. A 39-year-old female with a very short residual limb participated, using the Hybrid Knee and Polycentric Ankle powered leg connected to an osseointegrated implant. Training involved level-ground and incline walking, stair climbing, and sit-to-stand weight transfers. Results indicated successful ambulation across all activities, with the participant demonstrating ease in reciprocal stair climbing and improved ease of sit-to-stand movements compared to her prescribed, passive prosthesis. User feedback highlighted the benefits of level-walking knee swing assist and powered ankle plantarflexion, and stair ascent and sit-to-stand knee extension power, though cosmesis and weight remained areas of preference for her prescribed device. This case underscores the potential of combining osseointegration and powered prostheses to enhance functionality and mobility, paving the way for further research on this promising technology.