Functional Outcomes of Individuals Undergoing the Ewing Amputation

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Transtibial amputation (TTA) often follows failed limb salvage, impacting physical function.
• The Ewing amputation (EA) is a novel surgical technique for TTA.
• EA incorporates agonist-antagonist myoneural interfaces to potentially improve prosthetic integration.

Purpose of the Study:

• To evaluate the postoperative functional outcomes of the Ewing amputation (EA).
• To compare EA patient performance against their own preoperative status.
• To benchmark EA outcomes against transtibial amputees (TTAs) and able-bodied adults (ABAs).

Main Methods:

• An intervention cohort study was conducted at a tertiary/quaternary academic medical center.
• Twenty-two patients (aged 18-65) undergoing elective TTA due to failed limb salvage were included.
• Physical function tests and patient-reported outcome measures were assessed preoperatively and postoperatively (approx. 1-year follow-up).

Main Results:

• All 22 EA patients achieved prosthetic fitting.
• EA patients showed statistically significant improvements in most functional and patient-reported outcomes compared to their preoperative state (P<.01).
• EA patients demonstrated superior performance over TTAs and equivalent performance to ABAs on several key mobility tests (e.g., 10-meter walk, Timed Up and Go).

Conclusions:

• The Ewing amputation (EA) combined with rehabilitation enhances patient physical function.
• EA offers improved postoperative physical function compared to traditional TTAs.
• EA patients achieve functional levels comparable to able-bodied adults on specific measures.